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https://www.readbyqxmd.com/read/27903206/long-term-outcomes-after-severe-drug-overdose
#1
Lee Y Wong, Rinaldo Bellomo, Ray Robbins, Johan Martensson, Richard Kanaan, Richard Newton, Chih-Chiang Hu, David M Taylor
OBJECTIVE: The long-term outcomes of patients with drug overdose admitted to the intensive care unit compared with those admitted to general wards have not been assessed. We aimed to compare the recurrence of overdose, mortality after hospital discharge, cause of death and quality-of-life scores (using the EQ-5D questionnaire) between the ICU patients and general ward patients. METHODS: We performed a retrospective cohort study of 102 ICU patients with drug overdose and 102 matched general ward patients with drug overdose in a university-affiliated teaching hospital between 2009 and 2013...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27902388/the-exploration-of-risk-factors-of-concurrent-bacteremia-among-critically-ill-patients-with-severe-dengue
#2
Chin-Ming Chen, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Hui-Chun Chao, Chiu-Yin Yeh, Wen-Liang Yu
We investigated the clinical features of intensive care unit (ICU) patients with a concomitant severe dengue infection and bacteremia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during a July 31-November 31, 2015 were reviewed. Patients with "concurrent bacteremia" (positive bacterial blood culture within 72 hours of ICU admission) were identified. ICU admission was required for 142 patients; 22 (15.5%) had concurrent bacteremia. Streptococcus spp. was the most common pathogen, then Escherichia coli, and then Staphylococcus spp...
November 7, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27867308/effect-of-n-methyl-d-aspartate-receptor-antagonist-dextromethorphan-on-opioid-analgesia-in-pediatric-intensive-care-unit
#3
Mohammed Naeem, Hala Al Alem, Ali Al Shehri, Majed Al-Jeraisy
Objective. Pain control is an essential goal in the management of critical children. Narcotics are the mainstay for pain control. Patients frequently need escalating doses of narcotics. In such cases an adjunctive therapy may be beneficial. Dextromethorphan (DM) is NMDA receptor antagonist and may prevent tolerance to narcotics; however, its definitive role is still unclear. We sought whether dextromethorphan addition could decrease the requirements of fentanyl to control pain in critical children. Design. Double-blind, randomized control trial (RCT)...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27867133/fiberoptic-bronchoscopy-and-remifentanil-target-controlled-infusion-in-critically-ill-patients-with-acute-hypoxaemic-respiratory-failure-a-descriptive-study
#4
Saïda Rezaiguia-Delclaux, Florent Laverdure, Talna Kortchinsky, Léa Lemasle, Audrey Imbert, François Stéphan
INTRODUCTION: Sedation optimizes patient comfort and ease of execution during fiberoptic bronchoscopy (FOB). Our objective was to describe the safety and efficacy of remifentanil-TCI during FOB in non-intubated, hypoxaemic, thoracic-surgery ICU patients. METHODS: Consecutive spontaneously breathing adults requiring FOB after thoracic surgery were included if they had hypoxaemia (PaO2/FiO2 < 300mmHg or need for non-invasive ventilation [NIV]) and prior FOB failure under topical anaesthesia...
November 17, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27861180/improving-hospital-survival-and-reducing-brain-dysfunction-at-seven-california-community-hospitals-implementing-pad-guidelines-via-the-abcdef-bundle-in-6-064-patients
#5
Mary Ann Barnes-Daly, Gary Phillips, E Wesley Ely
OBJECTIVES: To track compliance by an interprofessional team with the Awakening and Breathing Coordination, Choice of drugs, Delirium monitoring and management, Early mobility, and Family engagement (ABCDEF) bundle in implementing the Pain, Agitation, and Delirium guidelines. The aim was to study the association between ABCDEF bundle compliance and outcomes including hospital survival and delirium-free and coma-free days in community hospitals. DESIGN: A prospective cohort quality improvement initiative involving ICU patients...
November 17, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851493/1858-intravenous-ketamine-for-refractory-sickle-cell-pain-crisis-management-in-the-medical-icu
#6
Aesha Jobanputra, Deepali Dixit, Sabiha Hussain
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850836/1200-outcomes-associated-with-implementation-of-a-pain-agitation-and-delirium-guideline-in-the-icu
#7
Christine Swartzman, Pamela Andrews, Richard Feibelman, Daleen Penoyer, Mary Sole
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850648/1010-outcomes-of-an-icu-pain-agitation-sedation-protocol-in-oncology-mechanically-ventilated-patients
#8
Trisha Patel, Dana Bullick, Sharon Barniak, Sarah Fulcher, Meredith Grigsby, Dean Howarth, Joanne McGovern, Jeffrey Hoag
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850410/772-validation-of-a-revised-pain-assessment-tool-for-brain-injured-icu-patients
#9
Celine Gelinas, Madalina Boitor, Darina M Tsoller, Manon Choinière, David Streiner, Kathleen Puntillo
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#10
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27847697/comparison-of-the-effect-of-open-and-closed-endotracheal-suctioning-methods-on-pain-and-agitation-in-medical-icu-patients-a-clinical-trial
#11
Raziyeh Dastdadeh, Abbas Ebadi, Amir Vahedian-Azimi
BACKGROUND: Endotracheal suctioning is a necessary procedure practiced by nurses in intensive care units to remove lung secretions. This procedure leads to higher oxygenation levels and reduced breathing difficulties. It also prevents atelectasis, pulmonary infections, and the accumulation of secretions. OBJECTIVES: The present study aims to compare the effectiveness of open and closed endotracheal suction tube systems on pain and agitation in patients under mechanical ventilation...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843781/comparison-of-bispectral-index-monitoring-with-the-critical-care-pain-observation-tool-in-the-pain-assessment-of-intubated-adult-patients-after-cardiac-surgery
#12
Zahra Faritous, Arvin Barzanji, Rasoul Azarfarin, Behshid Ghadrdoost, Mohsen Ziyaeifard, Nahid Aghdaei, Mostafa Alavi
BACKGROUND: Detecting pain is crucial in sedated and mechanically ventilated patients, as they are unable to communicate verbally. OBJECTIVES: This study aimed to compare Bispectral index (BIS) monitoring with the Critical-care pain observation tool (CPOT) and vital signs for pain assessment during painful procedures in intubated adult patients after cardiac surgery. MATERIALS AND METHODS: Seventy consecutive patients who underwent cardiac surgery (coronary artery bypass graft or valvular surgery) were enrolled in the study...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27833752/accuracy-of-critical-care-pain-observation-tool-and-behavioral-pain-scale-to-assess-pain-in-critically-ill-conscious-and-unconscious-patients-prospective-observational-study
#13
Paolo Severgnini, Paolo Pelosi, Elena Contino, Elisa Serafinelli, Raffaele Novario, Maurizio Chiaranda
BACKGROUND: Critically ill patients admitted to intensive care unit (ICU) may suffer from different painful stimuli, but the assessment of pain is difficult because most of them are almost sedated and unable to self-report. Thus, it is important to optimize evaluation of pain in these patients. The main aim of this study was to compare two commonly used scales for pain evaluation: Critical Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS), in both conscious and unconscious patients...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27826778/comparison-of-single-and-multi-incision-minimally-invasive-esophagectomy-mie-for-treating-esophageal-cancer-a-propensity-matched-study
#14
Jang-Ming Lee, Shang-Chi Chen, Shun-Mao Yang, Ying-Fan Tseng, Pei-Wen Yang, Pei-Ming Huang
OBJECTIVE: To compare the perioperative outcome of minimally invasive (MIE) esophagectomy performed with a single- or a multi-incision in treating esophageal cancer. METHOD: Patients with esophageal cancer who underwent MIE from 2006 to 2016 were evaluated. A 3-4-cm incision was created in both the thoracoscopic and the laparoscopic phases during the single-incision MIE procedures. A propensity-matched comparison was made between the two groups of patients. RESULTS: We analyzed a total of 48 pairs of patients with propensity-matched from the cohort of 360 patients undergoing MIE during 2006-2015...
November 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27824799/the-glasgow-coma-scale-gcs-deciphering-the-motor-component-of-the-gcs
#15
Megan Maserati, Anita Fetzick, Ava Puccio
The Glasgow Coma Scale (GCS) was developed to standardize the assessment of neurologically compromised patients, to assist in triaging severity of injury, and to direct management decisions for an individualized plan of care. This examination allows for frequent assessments to ascertain worsening of neurological symptoms that would warrant additional radiological scans or interventions. The GCS score is composed of three components: eye, verbal, and motor, with motor being the most difficult to assess. A need for clarification of the motor component of the GCS was identified in a neurotrauma intensive care unit (ICU) at a level 1 hospital in the United States...
December 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/27821124/severe-leptospirosis-and-pancreatitis-a-case-series-from-a-leptospirosis-outbreak-in-anuradhapura-district-sri-lanka
#16
N J Herath, C J Kamburapola, S B Agampodi
BACKGROUND: Acute pancreatitis is identified as an atypical and rare presentation of leptospirosis. In this report, we discuss a case series of severe leptospirosis with pancreatitis as a main complication during an unusual outbreak of leptospirosis in Anuradhapura district, Sri Lanka. CASE PRESENTATION: We retrospectively reviewed clinical presentation, investigations, treatment and outcome of six confirmed cases of severe leptospirosis admitted to intensive care unit (ICU) of Teaching Hospital, Anuradhapura, within a three months period from November 2014 to January 2015...
November 7, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27811559/rib-fractures-in-trauma-patients-does-operative-fixation-improve-outcome
#17
Peter Majak, Pål A Næss
PURPOSE OF REVIEW: Renewed interest in surgical fixation of rib fractures has emerged. However, conservative treatment is still preferred at most surgical departments. We wanted to evaluate whether operative treatment of rib fractures may benefit severely injured patients. RECENT FINDINGS: Several studies report a reduction in mechanical ventilation time, ICU length of stay (LOS), hospital LOS, pneumonia, need for tracheostomy, pain and costs in operatively treated patients with multiple rib fractures compared with patients treated nonoperatively...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27793165/surviving-critical-illness-what-is-next-an-expert-consensus-statement-on-physical-rehabilitation-after-hospital-discharge
#18
M E Major, R Kwakman, M E Kho, B Connolly, D McWilliams, L Denehy, S Hanekom, S Patman, R Gosselink, C Jones, F Nollet, D M Needham, R H H Engelbert, M van der Schaaf
BACKGROUND: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness? METHODS: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record...
October 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27777355/analgesia-in-the-surgical-intensive-care-unit
#19
REVIEW
Eric Ehieli, Suraj Yalamuri, Charles S Brudney, Srinivas Pyati
Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critically ill patients in the ICU presents numerous challenges to intensivists. Inconsistencies in pain assessment, analgesic prescription and variation in monitoring sedation and analgesia result in suboptimal pain management. Inadequate pain control can have deleterious effects on several organ systems in critically ill patients...
October 24, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27773516/development-of-a-nomogram-for-predicting-the-probability-of-postoperative-delirium-in-patients-undergoing-free-flap-reconstruction-for-head-and-neck-cancer
#20
N Y Choi, E H Kim, C H Baek, I Sohn, S Yeon, M K Chung
PURPOSE: To develop nomogram for prediction of postoperative delirium (POD) in patients undergoing ablative and reconstruction surgery for head and neck cancer. METHODS: Total 341 patients were retrospectively analyzed, and clinical variables in preoperative, intraoperative and postoperative periods were compared between delirium group (n = 89) and non-delirium group (n = 252). Multivariate logistic regression, receiver operating characteristics curve, and area under the curve (AUC) were used to generate and test a nomogram, which performance was evaluated by 10-fold cross validation (CV) procedure...
October 14, 2016: European Journal of Surgical Oncology
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