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https://www.readbyqxmd.com/read/28936968/-progress-of-pain-assessment-and-analgesia-strategy-for-mechanical-ventilation-patients
#1
Qingdong Li, Xianyao Wan
Standardized pain assessment is a precondition of appropriate analgesia for mechanical ventilation patients. However, routine pain assessment rates remain very low in intensive care unit (ICU). Behavioral pain scale (BPS) and critical-care pain observation tool (CPOT) can be used to assess pain in mechanical ventilation patients who are unable to report pain by themselves. No matter what strategy we taken, analgesia-first sedation should be used in priority. Meanwhile, patient-centered and goal-directed sedation strategy should be adopted based on the individual condition...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936597/terminal-weaning-or-immediate-extubation-for-withdrawing-mechanical-ventilation-in-critically-ill-patients-the-arreve-observational-study
#2
René Robert, Amélie Le Gouge, Nancy Kentish-Barnes, Alice Cottereau, Bruno Giraudeau, Mélanie Adda, Djillali Annane, Juliette Audibert, François Barbier, Patrick Bardou, Simon Bourcier, Jeremy Bourenne, Alexandre Boyer, François Brenas, Vincent Das, Arnaud Desachy, Jérôme Devaquet, Marc Feissel, Frédérique Ganster, Maïté Garrouste-Orgeas, Guillaume Grillet, Olivier Guisset, Rebecca Hamidfar-Roy, Anne-Claire Hyacinthe, Sebastien Jochmans, Mercé Jourdain, Alexandre Lautrette, Nicolas Lerolle, Olivier Lesieur, Fabien Lion, Philippe Mateu, Bruno Megarbane, Sybille Merceron, Emmanuelle Mercier, Jonathan Messika, Paul Morin-Longuet, Bénédicte Philippon-Jouve, Jean-Pierre Quenot, Anne Renault, Xavier Repesse, Jean-Philippe Rigaud, Ségolène Robin, Antoine Roquilly, Amélie Seguin, Didier Thevenin, Patrice Tirot, Isabelle Vinatier, Elie Azoulay, Jean Reignier
PURPOSE: The relative merits of immediate extubation versus terminal weaning for mechanical ventilation withdrawal are controversial, particularly regarding the experience of patients and relatives. METHODS: This prospective observational multicentre study (ARREVE) was done in 43 French ICUs to compare terminal weaning and immediate extubation, as chosen by the ICU team. Terminal weaning was a gradual decrease in the amount of ventilatory assistance and immediate extubation was extubation without any previous decrease in ventilatory assistance...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28913495/improvement-of-recovery-parameters-using-patient-controlled-epidural-analgesia-after-oncological-surgery-a-prospective-randomized-single-center-study
#3
Armeana Olimpia Zgâia, Cosmin Ioan Lisencu, Alexandru Rogobete, Cătălin Vlad, Patriciu Achimaş-Cadariu, Gabriel Lazăr, Maximilian Muntean, Florin Ignat, Vlad Ormindean, Alexandru Irimie
PURPOSE: The aim of this study was to compare patient-controlled epidural analgesia (PCEA) versus conventional opioid intravenous (IV) infusion after gastrointestinal cancer surgery regarding several post-surgery parameters of recovery. METHODS: One hundred and one patients were prospectively randomized to receive either thoracic/lumbar PCEA (PCEA group) or the standard analgesia technique used in our hospital, conventional IV infusion of morphine (IVMO group) after gastrointestinal cancer surgery...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28912876/effect-of-intercostal-nerve-block-combined-with-general-anesthesia-on-the-stress-response-in-patients-undergoing-minimally-invasive-mitral-valve-surgery
#4
Yanping Zhan, Guo Chen, Jian Huang, Benchao Hou, Weicheng Liu, Shibiao Chen
The aim of the present study was to investigate the effect of intercostal nerve block combined with general anesthesia on the stress response and postoperative recovery in patients undergoing minimally invasive mitral valve surgery (MIMVS). A total of 30 patients scheduled for MIMVS were randomly divided into two groups (n=15 each): Group A, which received intercostal nerve block combined with general anesthesia and group B, which received general anesthesia alone. Intercostal nerve block in group A was performed with 0...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28904523/music-listening-among-postoperative-patients-in-the-intensive-care-unit-a-randomized-controlled-trial-with-mixed-methods-analysis
#5
Nancy Ames, Rebecca Shuford, Li Yang, Brad Moriyama, Meredith Frey, Florencia Wilson, Thiruppavai Sundaramurthi, Danelle Gori, Andrew Mannes, Alexandra Ranucci, Deloris Koziol, Gwenyth R Wallen
BACKGROUND: Music listening may reduce the physiological, emotional, and mental effects of distress and anxiety. It is unclear whether music listening may reduce the amount of opioids used for pain management in critical care, postoperative patients or whether music may improve patient experience in the intensive care unit (ICU). METHODS: A total of 41 surgical patients were randomized to either music listening or controlled non-music listening groups on ICU admission...
2017: Integrative Medicine Insights
https://www.readbyqxmd.com/read/28899285/predicting-rehabilitation-length-of-stay-in-canada-it-s-not-just-about-impairment
#6
B Catharine Craven, Dilnur Kurban, Farnoosh Farahani, Carly S Rivers, Chester Ho, A Gary Linassi, Dany H Gagnon, Colleen O'Connell, Karen Ethans, Laurent J Bouyer, Vanessa K Noonan
INTRODUCTION: Current tertiary Spinal Cord Injury (SCI) rehabilitation funding and rehabilitation length of stay (R-LOS) in most North American jurisdictions are linked to an individual's impairment. Our objectives were to: 1) describe the impact of relevant demographic, impairment and medical complexity variables at rehabilitation admission on R-LOS among adult Canadians with traumatic SCI; and 2) identify factors which extend R-LOS. METHODS: Data from 1,376 adults with traumatic SCI were obtained via chart abstraction and administrative data linkage from 15 Rick Hansen SCI Registry sites (2004-2014)...
September 12, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28886613/-acute-monkshood-intoxication-requiring-acute-resuscitation-in-suicidal-intent
#7
Michael Stetzenbach, Boris Schnorbus, Ingo Sagoschen, Werner Bleser, Dominik Legner, Andreas Stürer
We report about an acute monkshood intoxication requiring acute resuscitation in suicidal intent in a 56-year-old patient. The Blue Monkshood (Aconitum napellus) is considered to be the most toxic plant in Europe. All plant parts contain the highly toxic alkonoid aconitin. The lethal dose in adults is 2 - 6 mg. Intoxications are often fatal. Asymptomatic patients with suspected monkshood intoxication should also be monitored on an ICU. First signs of intoxication are paraesthesia in the mouth and throat area, abdominal cramps, nausea, vomiting and severe pain in skeletal muscle...
September 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28882377/lasting-impression-of-violence-retained-bullets-and-depressive-symptoms
#8
Randi N Smith, Mark J Seamon, Vinayak Kumar, Andrew Robinson, Justine Shults, Patrick M Reilly, Therese S Richmond
BACKGROUND: Over 70,000 nonfatal firearm injuries occur in the US annually, frequently leaving victims injured with retained bullets. The long-term psychological risks associated with retained bullets remains unstudied. By serving as a constant reminder of injury, we hypothesized that the presence of retained bullets after firearm injury is associated with increased PTSD and depression symptom severity. METHODS: We conducted a prospective cohort study (2013-2015) of Black male survivors of firearm injury at an urban Level I trauma center...
September 4, 2017: Injury
https://www.readbyqxmd.com/read/28877145/european-society-of-anaesthesiology-and-european-board-of-anaesthesiology-guidelines-for-procedural-sedation-and-analgesia-in-adults
#9
Jochen Hinkelbein, Massimo Lamperti, Jonas Akeson, Joao Santos, Joao Costa, Edoardo De Robertis, Dan Longrois, Vesna Novak-Jankovic, Flavia Petrini, Michel M R F Struys, Francis Veyckemans, Thomas Fuchs-Buder, Robert Fitzgerald
: Procedural sedation and analgesia (PSA) has become a widespread practice given the increasing demand to relieve anxiety, discomfort and pain during invasive diagnostic and therapeutic procedures. The role of, and credentialing required by, anaesthesiologists and practitioners performing PSA has been debated for years in different guidelines. For this reason, the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology have created a taskforce of experts that has been assigned to create an evidence-based guideline and, whenever the evidence was weak, a consensus amongst experts on: the evaluation of adult patients undergoing PSA, the role and competences required for the clinicians to safely perform PSA, the commonly used drugs for PSA, the adverse events that PSA can lead to, the minimum monitoring requirements and post-procedure discharge criteria...
September 5, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28876686/management-of-failed-mitral-valve-replacement-the-durban-experience
#10
D Kistan, M Booysen, G Alexander, T E Madiba
BACKGROUND: Mitral valve replacement is the procedure of choice in patients with severe mitral valve disease. However, these patients are surviving longer and are thus at an increased risk of prosthesis failure or valve-related complications. METHOD: Study setting: Inkosi Albert Luthuli Central Hospital, a tertiary referral Hospital in Durban. Study population: All patients undergoing redo mechanical mitral valve replacement surgery between January 2005 and December 2014...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28870847/bundle-of-care-for-blunt-chest-trauma-patients-improves-analgesia-but-increases-rates-of-intensive-care-unit-admission-a-retrospective-case-control-study
#11
Cédric Carrie, Laurent Stecken, Elsa Cayrol, Vincent Cottenceau, Laurent Petit, Philippe Revel, Matthieu Biais, François Sztark
INTRODUCTION: This single-centre retrospective case-control study aimed to assess the effectiveness of a multidisciplinary clinical pathway for blunt chest trauma patients admitted in emergency department (ED). PATIENTS AND METHODS: All consecutive blunt chest trauma patients with more than 3 rib fractures and no indication of mechanical ventilation were compared to a retrospective cohort over two 24-month periods, before and after the introduction of the bundle of care...
September 1, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28865447/multicenter-assessment-of-sedation-and-delirium-practices-in-the-intensive-care-units-in-poland-is-this-common-practice-in-eastern-europe
#12
Katarzyna Kotfis, Małgorzata Zegan-Barańska, Maciej Żukowski, Krzysztof Kusza, Mariusz Kaczmarczyk, E Wesley Ely
BACKGROUND: The majority of critically ill patients experience distress during their stay in the Intensive Care Unit (ICU), resulting from systemic illness, multiple interventions and environmental factors. Providing humane care should address concomitant treatment of pain, agitation and delirium. The use of sedation and approaches to ICU delirium should be monitored according to structured guidelines. However, it is unknown to what extent these concepts are followed in Eastern European countries like Poland...
September 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28843455/end-of-life-experience-of-older-adults-dying-of-end-stage-renal-disease-a-comparison-with-cancer
#13
Melissa W Wachterman, Stuart R Lipsitz, Karl A Lorenz, Edward R Marcantonio, Zhonghe Li, Nancy L Keating
CONTEXT: Older adults with end-stage renal disease (ESRD) are a rapidly growing group of seriously-ill patients. Yet, despite a mortality rate almost twice that of cancer, less is known about ESRD's impact on patients' end-of-life experience. OBJECTIVE: To compare the end-of-life experience of older adults who died of ESRD versus cancer. METHODS: We used data from the Health and Retirement Study (HRS), a nationally-representative survey of older adults...
August 23, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28832908/pain-assessment-in-intensive-care-paint-an-observational-study-of-physician-documented-pain-assessment-in-45-intensive-care-units-in-the-united-kingdom
#14
H I Kemp, C Bantel, F Gordon, S J Brett, H C Laycock
Pain is a common and distressing symptom experienced by intensive care patients. Assessing pain in this environment is challenging, and published guidelines have been inconsistently implemented. The Pain Assessment in INTensive care (PAINT) study aimed to evaluate the frequency and type of physician pain assessments with respect to published guidelines. This observational service evaluation considered all pain and analgesia-related entries in patients' records over a 24-h period, in 45 adult intensive care units (ICUs) in London and the South-East of England...
June 2017: Anaesthesia
https://www.readbyqxmd.com/read/28830362/impact-of-intrathecal-morphine-analgesia-on-the-incidence-of-pulmonary-complications-after-cardiac-surgery-a-single-center-propensity-matched-cohort-study
#15
Christoph Ellenberger, Tornike Sologashvili, Krishnan Bhaskaran, Marc Licker
BACKGROUND: Acute pain and systemic opioids may both negatively impact respiratory function after cardiac surgery. This study analyzes the local practice of using intrathecal morphine analgesia (ITMA) with minimal parenteral opioid administration in cardiac surgery, specifically the impact on postoperative pulmonary complications (PPCs). METHODS: Data from adult patients who underwent elective cardiac surgery between January 2002, and December 2013 in a single center were analyzed...
August 22, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28826983/impact-of-a-stay-in-the-intensive-care-unit-on-the-preparation-of-advance-directives-descriptive-exploratory-qualitative-study
#16
Pascal Andreu, Auguste Dargent, Audrey Large, Nicolas Meunier-Beillard, Sandrine Vinault, Uriel Leiva Rojas, Fiona Ecarnot, Sébastien Prin, Pierre-Emmanuel Charles, Isabelle Fournel, Jean-Philippe Rigaud, Jean-Pierre Quenot
BACKGROUND: Our objective was to assess, through a qualitative, exploratory study, the thought processes of patients regarding the formulation of Advance Directives (AD) after a stay in the ICU. METHODS: Study performed from May to July 2016 using telephone interviews performed by four senior ICU physicians. Inclusion criteria were: patients discharged from ICU to home >3 months previously. Semi-directive interviews with patients focused on 5 main points surrounding AD...
August 4, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#17
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28800980/pain-in-the-icu-can-we-adequately-treat-what-we-can-t-hear
#18
EDITORIAL
Yury Khelemsky, Adam S Evans
No abstract text is available yet for this article.
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#19
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large, detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to 160 US adult ICUs from 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV-based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28774327/could-remifentanil-reduce-duration-of-mechanical-ventilation-in-comparison-with-other-opioids-for-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#20
Yibing Zhu, Yinhua Wang, Bin Du, Xiuming Xi
BACKGROUND: Sedation and analgesia are commonly required to relieve anxiety and pain in mechanically ventilated patients. Fentanyl and morphine are the most frequently used opioids. Remifentanil is a selective μ-opioid receptor that is metabolized by unspecific esterases and eliminated independently of liver or renal function. Remifentanil has a rapid onset and offset and a short context-sensitive half-life regardless of the duration of infusion, which may lead to reductions in weaning and extubation...
August 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
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