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https://www.readbyqxmd.com/read/28736006/advantages-of-epidural-analgesia-on-pulmonary-functions-in-liver-transplant-donors
#1
H K Atalan, B Gucyetmez, R Donmez, A Kargi, K Y Polat
OBJECTIVE: Epidural analgesia (EA) has positive effects on anesthetic requirement, blood loss, postoperative analgesia, and pulmonary function tests (PFTs). The purpose of the present study was to investigate the effect of EA on postoperative PFTs in liver transplant donors (LTDs). METHODS: In the present study, 66 LTDs were classified as total intravenous anesthesia (TIVA) and TIVA+EA groups. Patient's age, sex, body mass index, induction and maintenance dose of propofol (IDP and MDP), operation duration, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, visual analog scale (VAS), atelectasis scores, and lengths of intensive care unit (ICU) and hospital stays were recorded...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#2
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28727703/intrathecal-morphine-improves-hemodynamic-parameters-and-analgesia-in-patients-undergoing-aortic-valve-replacement-surgery-a-prospective-double-blind-randomized-trial
#3
Hamed Elgendy, Hatem A R Helmy
BACKGROUND: Intrathecal morphine (ITM) has been used in hopes of providing good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. OBJECTIVES: To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. STUDY DESIGN: A randomized, double-blind trial...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28708954/pneumococcal-and-influenza-vaccination-status-of-hospitalized-adults-with-community-acquired-pneumonia-and-the-effects-of-vaccination-on-clinical-presentation
#4
Ezgi Demirdogen Cetinoglu, Esra Uzaslan, Abdullah Sayıner, Aykut Cilli, Oguz Kılınc, Aysın Sakar Coskun, Armağan Hazar, Nurdan Kokturk, Ayten Filiz, Mehmet Polatli
BACKGROUND: Previous reports have shown that vaccination rates of adult at-risk populations are low in Turkey. There are differing reports with regards to the effectiveness of the influenza and the pneumococcal polysaccharide vaccine (PPSV23) on the clinical outcomes of community acquired pneumonia (CAP). The purpose of this study was to analyze the influenza (FV) and pneumococcal vaccination (PV) status, the factors that influence the receipt of influenza/pneumococcal vaccine and the effects of prior vaccination on the clinical outcomes in adults hospitalized with CAP...
July 14, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28707741/randomized-clinical-trial-of-psychological-support-and-sleep-adjuvant-measures-for-postoperative-sleep-disturbance-in-patients-undergoing-oesophagectomy
#5
M Scarpa, E Pinto, E Saraceni, F Cavallin, M Parotto, R Alfieri, M T Nardi, M R Marchi, M Cagol, C Castoro
BACKGROUND: Major surgery such as oesophagectomy requires a postoperative stay in intensive care. Painful stimuli lead to sleep disturbance and impairment in quality of life. The aim of this study was to evaluate the effect of psychological counselling and sleep adjuvant measures on postoperative quality of sleep and quality of life. METHODS: This RCT was performed between January 2013 and October 2015. Patients undergoing oesophagectomy for cancer were randomized into one of four groups receiving: psychological counselling plus sleep adjuvant measures during the ICU stay; psychological counselling alone; sleep adjuvant measures alone during the ICU stay; or standard care...
July 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28689992/characteristics-of-palliative-care-consultation-at-an-academic-level-one-trauma-center
#6
Emily B Rivet, Paula Ferrada, Tara Albrecht, J Brian Cassel, Beth Broering, Danielle Noreika, Egidio Del Fabbro
BACKGROUND: The current status of palliative care consultation for trauma patients has not been well characterized. We hypothesized that palliative care consultation currently is requested for patients too late to have any clinical significance. METHODS: A retrospective chart review was performed for traumatically injured patients' ≥18 years of age who received palliative care consultation at an academic medical center during a one-year period. RESULTS: The palliative care team evaluated 82 patients with a median age of 60 years...
June 28, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28685304/perioperative-and-icu-healthcare-analytics-within-a-veterans-integrated-system-network-a-qualitative-gap-analysis
#7
Seshadri Mudumbai, Ferenc Ayer, Jerry Stefanko
Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28644698/sleep-disturbance-after-hospitalization-and-critical-illness-a-systematic-review
#8
Marcus T Altman, Melissa P Knauert, Margaret A Pisani
BACKGROUND: Sleep disturbance during intensive care unit (ICU) admission is common and severe. Sleep disturbance has been observed in survivors of critical illness even after transfer out of the ICU. Not only is sleep important to overall health and well-being, but patients after critical illness are also in a physiologically vulnerable state. Understanding how sleep disturbance impacts recovery from critical illness after hospital discharge is therefore clinically meaningful. OBJECTIVE: This systematic review aimed to summarize studies that identify the prevalence of and risk factors for sleep disturbance after hospital discharge for critical illness survivors...
June 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28639958/pediatric-jellyfish-envenomation-in-the-mediterranean-sea
#9
Miguel Glatstein, Dikla Adir, Bella Galil, Dennis Scolnik, Ayelet Rimon, Dikla Pivko-Levy, Christopher Hoyte
BACKGROUND: Several species of jellyfish native to the western Indian Ocean have entered the Mediterranean Sea through the Suez Canal. Since the late 1980s, each summer Rhopilema nomadica forms swarms as long as 100 km in the southeastern Levant and since the millennium aggregations of additional nonnative jellyfish have been sighted. The aim of this study was to evaluate children seen in the emergency department after jellyfish envenomations and to establish patterns of toxicity associated with this organism...
June 20, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28638303/the-use-of-gabapentin-for-pain-and-agitation-in-neonates-and-infants-in-a-neonatal-icu
#10
Gretchen L Sacha, Maria G Foreman, Kay Kyllonen, Ricardo J Rodriguez
OBJECTIVES: Limited data support how to safely and effectively treat refractory pain and agitation in neonates and infants. Gabapentin has been used in this patient population and has shown promising results, yet there is still a paucity of data about its clinical efficacy. There is a need for a larger evaluation to determine its effectiveness. This study describes one institution's experience with gabapentin for the treatment of refractory pain and agitation in the neonatal intensive care unit (NICU)...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28619390/the-effect-of-massage-on-acute-postoperative-pain-in-critically-and-acutely-ill-adults-post-thoracic-surgery-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
REVIEW
Madalina Boitor, Céline Gélinas, Melissa Richard-Lalonde, Brett D Thombs
Critical care practice guidelines identify a lack of clear evidence on the effectiveness of massage for pain control. To assess the effect of massage on acute pain in critically and acutely ill adults post-thoracic surgery. Medline, Embase, CINAHL, PsychInfo, Web of Science, Scopus and Cochrane Library databases were searched. Eligible studies were randomized controlled trials (RCTs) evaluating the effect of massage compared to attention control/sham massage or standard care alone on acute pain intensity post-thoracic surgery...
June 12, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28618123/-pain-relieved-but-still-struggling-critically-ill-patients-experiences-of-pain-and-other-discomforts-during-analgosedation
#12
Helene Berntzen, Ida Torunn Bjørk, Hilde Wøien
AIM & OBJECTIVE: To explore how critically ill patients treated according to a strategy of analgosedation experience and handle pain, other discomforts, and wakefulness. BACKGROUND: Patients experience both pain and discomfort while in the intensive care unit (ICU). International guidelines recommend focused pain treatment and light sedation. An analgosedation protocol favoring pain management, light sedation and early mobilization was implemented in our university hospital medical and surgical ICU in Norway in 2014...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28604379/physiotherapy-immediately-after-thymectomy-in-patients-with-myasthenia-gravis-two-cases-and-review-of-the-literature
#13
Massimiliano Polastri, Franco Stella, Massimo Lambertini, Walter Trani, Annalisa Ghetti, Andrea Dell'Amore
AIM: Myasthenia gravis (MG) is a rare autoimmune disease characterized by activation of autoantibodies against acetylcholine receptors: patients with MG typically experience muscle weakness and fatigue. The aims of the present study were 1) to describe immediate postoperative physiotherapeutic interventions in two MG patients who underwent thymectomy, and 2) to discuss postoperative rehabilitative issues in MG patients. MATERIALS AND METHODS: This was a non-experimental study analyzing two subjects with MG who underwent thymectomy...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28598043/clinical-profile-of-hypertensive-emergencies-in-an-intensive-care-unit
#14
Shubhangi V Dhadke, Vithal N Dhadke, Dhruv S Batra
AIMS AND OBJECTIVE: To study the prevalence of hypertensive emergencies in an ICU set up and to study the clinical presentation of hypertensive emergencies related to cardiovascular, neurological and renovascular system. METHODS: Type of Study: Cross-sectional, descriptive study. DURATION OF STUDY: Two years from 1st December 2011 till 30th November 2013. SAMPLE SIZE: 50 patients of hypertensive emergencies admitted to the intensive care unit of Dr...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28595447/therapeutic-suggestions-with-critically-ill-in-palliative-care
#15
Adrienn K Szilágyi, Zoltán Kekecs, Katalin Varga
Suggestions can be used without formal hypnosis, especially with critically ill patients, due to their spontaneous trance state. In this paper we outline data on the effectiveness of therapeutic suggestions. We interpret the possible mechanism of therapeutic suggestions in the context of stress cognition. Basic principles of formulating suggestions are discussed and some recommended versions of non-pharmacological pain control are provided. Case vignettes are given of how suggestions are used with critically ill ICU patients...
May 28, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28590164/care-of-the-critically-ill-burn-patient-an-overview-from-the-perspective-of-optimizing-palliative-care
#16
Daniel E Ray, Mohana B Karlekar, Donnelle L Crouse, Margaret Campbell, J Randall Curtis, Jeffrey Edwards, Dana R Lustbader, Anne C Mosenthal, Colleen Mulkerin, Kathleen A Puntillo, David E Weissman, Renee D Boss, Karen J Brasel, Judith E Nelson
Burn specialists have long recognized the need for and have role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many U.S. hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context...
July 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28579349/electromagnetic-guided-placement-of-nasoduodenal-feeding-tubes-versus-endoscopic-placement-a-randomized-multicenter-trial
#17
Wouter F W Kappelle, Daisy Walter, Paul Stadhouders, Hendrik J A Jebbink, Frank P Vleggaar, Peter van der Schaar, Jan Willem Kappelle, Ingeborg van der Tweel, Medard F M Van den Broek, Frank J Wessels, Peter D Siersema, Jan F Monkelbaan
BACKGROUND AND AIMS: Electromagnetic-guided placement (EMP) of a nasoduodenal feeding tube by trained nurses is an attractive alternative to esophagogastroduodenoscopy guided placement (EGDP). We aimed to compare EMP and EGDP in outpatients, ward patients, and critically ill patients with normal upper GI anatomy. METHODS: In 3 centers with no prior experience in EMP, patients were randomized to placement of a single lumen nasoduodenal feeding tube either with EGDP or EMP...
June 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28570317/safety-of-nebulized-epinephrine-in-smoke-inhalation-injury
#18
Guillermo Foncerrada, Francisco Lima, Robert P Clayton, Ronald P Mlcak, Perenlei Enkhbaatar, David N Herndon, Oscar E Suman
This pilot study was conducted to profile safety of nebulized racemic epinephrine when used as a therapy for smoke inhalation injury in severely burned children. We enrolled 16 patients who were 7 to 19 years of age ([mean ± SD], 12 ± 4 years) with burns covering more than 30% of the TBSA (55 ± 17%) and smoke inhalation injury, as diagnosed by bronchoscopy at burn center admission. Patients were randomized to receive either standard of care (n = 8), which consisted of nebulized acetylcysteine, nebulized heparin, and nebulized albuterol, or to receive standard of care plus nebulized epinephrine (n = 8)...
May 16, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28569130/meta-analysis-of-electroacupuncture-in-cardiac-anesthesia-and-intensive-care
#19
Sven Asmussen, Rene Przkora, Dirk M Maybauer, John F Fraser, Filippo Sanfilippo, Kristofer Jennings, Michael Adamzik, Marc O Maybauer
BACKGROUND: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. METHODS: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28567237/level-of-headaches-after-surgical-aneurysm-clipping-decreases-significantly-faster-compared-to-endovascular-coiled-patients
#20
Athanasios K Petridis, Jan F Cornelius, Marcel A Kamp, Sina Falahati, Igor Fischer, Hans Jakob Steiger
In incidental aneurysms, endovascular treatment can lead to post-procedural headaches. We studied the difference of surgical clipping vs. endovascular coiling in concern to post-procedural headaches in patients with ruptured aneurysms. Sixty-seven patients with aneurysmal subarachnoidal haemorrhage were treated in our department from September 1(st) 2015 - September 1(st) 2016. 43 Patients were included in the study and the rest was excluded because of late recovery or high-grade subarachnoid bleedings. Twenty-two were surgical treated and twenty-one were interventionally treated...
April 6, 2017: Clinics and Practice
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