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https://www.readbyqxmd.com/read/29338144/mortality-and-long-term-quality-of-life-after-percutaneous-tracheotomy-in-intensive-care-unit-a-prospective-observational-study
#1
Maria Vargas, Yuda Sutherasan, Iole Brunetti, Camilla Micalizzi, Angelo Insorsi, Lorenzo Ball, Marta Folentino, Rosanna Sileo, Arduino DE Lucia, Manuela Cerana, Alessandro Accattatis, Domenico DE Lisi, Angelo Gratarola, Francesco Mora, Giorgio Peretti, Giuseppe Servillo, Paolo Pelosi
BACKGROUND: Quality of life and mortality after percutaneous dilatational tracheotomy (PDT) has been poorly investigated. The aims of this study were to evaluate the independent risk factors for Intensive Care Unit (ICU) mortality and investigate quality of life over the first year after PDT in critically ill patients. METHODS: This was a prospective, single-center, cohort study performed in a tertiary care University Hospital, enrolling consecutive ICU patients requiring elective PDT, collecting data during the tracheotomy procedure and the ICU stay...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29291585/quality-of-dying-and-death-in-the-icu-the-euroq2-project
#2
Rik T Gerritsen, Hanne Irene Jensen, Matty Koopmans, J Randall Curtis, Lois Downey, Jose G M Hofhuis, Ruth A Engelberg, Peter E Spronk, Jan G Zijlstra
PURPOSE: Knowledge of families' perspective of quality of intensive care unit (ICU) care is important, especially with regard to end-of-life (EOL) care. Adaptation of the US-developed "Quality of dying and death questionnaire" (QODD) to a European setting is lacking. The primary aim of this study is to examine the euroQODD's usability and its assessments of EOL care in a cohort of Danish and Dutch family members. METHODS: Family members of patients dying in an ICU after a stay of at least 48h were sent the euroQODD three weeks after the patient died...
December 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29280605/physical-restraints-in-intensive-care-experiences-of-patients-families-and-nurses
#3
Dawn Perez, Kath Peters, Lesley Wilkes, Gillian Murphy
Critically ill patients admitted to an intensive care unit (ICU) often require many invasive procedures and medical devices (Martin and Mathisen 2005). While these interventions are a necessity, they can potentially cause patients a great amount of pain and discomfort, often leading to restlessness and agitation (Langley et al. 2011).
May 2017: Australian Nursing & Midwifery Journal
https://www.readbyqxmd.com/read/29275138/does-a-history-of-psychoactive-substances-abuse-play-a-role-in-the-level-of-pain-of-the-patient-with-severe-trauma
#4
C López-López, A Arranz-Esteban, M V Martinez-Ureta, M C Sánchez-Rascón, C Morales-Sánchez, M Chico-Fernández
OBJECTIVE: To analyse the influence of psychotropic substance use on the level of pain in patients with severe trauma. DESIGN: Longitudinal analytical study. SCOPE: Intensive Care Unit (ICU) of Trauma and Emergencies. PATIENTS: severe trauma, non-communicative and mechanical ventilation >48hours. Two groups of patients were created: users and non-users of psychotropic substances according to medical records. INTERVENTIONS: Measurement of pain level at baseline and during mobilization, using the Pain Indicator Behaviour Scale...
December 20, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/29247307/attitudes-towards-end-of-life-issues-in-intensive-care-unit-among-italian-anesthesiologists-a-nation-wide-survey
#5
Andrea Cortegiani, Vincenzo Russotto, Santi Maurizio Raineri, Cesare Gregoretti, Antonino Giarratano, Sebastiano Mercadante
BACKGROUND: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). METHODS: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. RESULTS: Eight hundred and five persons responded to the full list of questions...
December 15, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29243344/intensive-care-survivor-reported-symptoms-a-longitudinal-study-of-survivors-symptoms
#6
Anne Kathrine Langerud, Tone Rustøen, Milaancarova Småstuen, Ulf Kongsgaard, Audun Stubhaug
BACKGROUND: There is growing interest in potential long-term outcomes following intensive care, but few researchers have studied the prevalence of multiple symptoms or the association between pain and other symptoms. AIMS: To investigate the prevalence of anxiety, depression, fatigue, sleep disturbance and post-traumatic stress symptoms (PTSS) among intensive care survivors 3 months and 1 year after being discharged from an intensive care unit (ICU) and to determine whether pain is associated with higher prevalence of these symptoms 3 months and 1 year after ICU stay...
December 15, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29234960/a-new-postoperative-pain-management-intravenous-acetaminophen-acelio%C3%A2-leads-to-enhanced-recovery-after-esophagectomy-a-propensity-score-matched-analysis
#7
Yu Ohkura, Junichi Shindoh, Masaki Ueno, Toshiro Iizuka, Shusuke Haruta, Harushi Udagawa
PURPOSES: To investigate the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhance the recovery after esophagectomy. METHODS: A propensity score-matched population was created using the 93 and 69 consecutive patients who underwent esophagectomy for esophageal cancer before and after the introduction of postoperative scheduled intravenous acetaminophen, and the short-term clinical outcomes were compared. RESULTS: Significant defervescence was demonstrated in the Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (p < 0...
December 12, 2017: Surgery Today
https://www.readbyqxmd.com/read/29225976/intensive-care-in-a-patient-with-toxic-epidermal-necrolysis
#8
J Wallenborn, M Fischer
Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29223743/early-vs-late-tracheostomy-in-intensive-care-settings-impact-on-icu-and-hospital-costs
#9
Brent Herritt, Dipayan Chaudhuri, Kednapa Thavorn, Dalibor Kubelik, Kwadwo Kyeremanteng
INTRODUCTION: Up to 12% of the 800,000 patients who undergo mechanical ventilation in the United States every year require tracheostomies. A recent systematic review showed that early tracheostomy was associated with better outcomes: more ventilator-free days, shorter ICU stays, less sedation and reduced long-term mortality. However, the financial impact of early tracheostomies remain unknown. OBJECTIVES: To conduct a cost-analysis on the timing of tracheostomy in mechanically ventilated patients...
December 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29216952/-sepsis-induced-cardiomyopathy-complicated-with-cardiogenic-shock-patients-supported-with-extracorporeal-membrane-oxygenation
#10
Changzhi Liu, Ruiqiu Zhu, Zhujiang Zhou, Haifeng Liu, Jingcheng Lin, Shuchao Wen, Liuer Zuo
Sepsis-induced cardiomyopathy is a reversible myocardial dysfunction due to sepsis, which may be severe enough to complicate cardiogenic shock, and without effective drug and with high mortality during the acute phase. A case of sepsis-induced cardiomyopathy complicated with cardiogenic shock was treated in the intensive care unit (ICU) of Shunde Hospital Southern Medical University. A 37 years old female patient was admitted because she had suffered repeated fever for 5 days, chest tightness and abdominal pain for 3 days...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29212080/clinical-evaluation-of-continuous-renal-replacement-therapy-in-combination-with-ultrasound-guided-percutaneous-transhepatic-gallbladder-drainage-for-acute-severe-biliary-pancreatitis-a-retrospective-study
#11
Qingyun Zhu, Xinting Pan, Yongxian Cao, Hongqiao Wang, Ning Yu, Fuguo Liu, Shigang Yang, Yunlong Wang, Yunbo Sun, Zhengbin Wang
BACKGROUND/AIMS: This study aimed to report the clinical efficacy of continuous renal replacement therapy (CRRT) in combination with ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) (CRRT+PTGD) in the treatment of acute severe biliary pancreatitis (ASBP). METHODS: Between January 2010 and January 2016, 40 cases of patients with ASBP who received routine CRRT (CRRT group) and 40 of those who received CRRT+PTGD (CRRT+PTGD group) at the Affiliated Hospital of Qingdao University (Qingdao, China) were retrospectively reviewed...
November 30, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29205142/necrotizing-fasciitis-associated-with-primary-cutaneous-b-cell-lymphoma-a-case-report
#12
K G Spiridakis, D S Intzepogazoglou, M E Flamourakis, E E Sfakianakis, A V Daskalaki, E K Vakonaki, E Rahmanis, G E Kostakis, M S Christodoulakis
Necrotizing fasciitis is a rapidly progressive and life-threatening infection of the deeper skin layers and subcutaneous tissues that moves along the facial planes. OBJECTIVES: We present the rare case of a patient with necrotizing fasciitis associated with high malignancy b-cell lymphoma. Our purpose is to investigate the probable connection between the two pathologies and evaluate the importance of early surgical intervention. CASE REPORT: 51-year old Caucasian woman presented at the E...
May 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29194144/thoracic-epidural-analgesia-and-mortality-in-acute-pancreatitis-a-multicenter-propensity-analysis
#13
Matthieu Jabaudon, Nouria Belhadj-Tahar, Thomas Rimmelé, Olivier Joannes-Boyau, Stéphanie Bulyez, Jean-Yves Lefrant, Yannick Malledant, Marc Leone, Paer-Selim Abback, Fabienne Tamion, Hervé Dupont, Brice Lortat-Jacob, Philippe Guerci, Thomas Kerforne, Raphael Cinotti, Laurent Jacob, Philippe Verdier, Thierry Dugernier, Bruno Pereira, Jean-Michel Constantin
OBJECTIVE: Recent preclinical and clinical data suggest that thoracic epidural analgesia, a technique primarily aimed at decreasing pain, might exert anti-inflammatory effects, enhance splanchnic and pancreatic blood flow during acute pancreatitis; however, the influence of epidural analgesia on mortality remains under investigated in this setting. This study was therefore designed to assess the impact of epidural analgesia on mortality in ICU patients with acute pancreatitis. DESIGN: Multicenter retrospective, observational, cohort study...
November 30, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29189705/validation-of-the-italian-version-of-the-critical-pain-observation-tool-in-brain-injured-critically-ill-adults
#14
Francesco Sulla, Nilson De Souza Ramos, Noemi Terzi, Tania Trenta, Mariella Uneddu, Melanny Alessandra Zaldivar Cruces, Leopoldo Sarli
BACKGROUND AND AIM: Pain in intensive care units (ICUs) is a frequent and often undermanaged problem. Brain-injured patients are often unable to reliably self-report their pain, calling forth the need to use behavioural scales such as the Critical-Care Pain Observation Tool (CPOT). This study aimed to test the reliability and validity of the Italian CPOT use with brain-injured ICU adults. METHOD: A sample of 50 adults critical care patients was included. Each patient was assessed by two independent observers at three predefined times - at rest; during mobilization for hygiene; 20 minutes later - using the CPOT, PAINAD, and NRS...
November 30, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29183752/a-1-year-comparison-of-a-community-based-exercise-program-versus-a-day-hospital-based-exercise-program-on-quality-of-life-and-mental-health-in-severely-burned-children
#15
Raquel Peña, Oscar E Suman, Marta Rosenberg, Clark R Andersen, David N Herndon, Walter J Meyer
OBJECTIVE: To compare the effects of long term psychosocial functioning and mental health of a "Day-Hospital" Based Exercise Program (DAYEX) versus a Community Based Exercise Program (COMBEX). DESIGN: This was a prospective design that consisted of two groups (DAYEX and COMBEX). SETTING: A children's hospital specialized in burn care (Shriner's Hospitals for Children, Inc., Galveston, Texas) PARTICIPANTS: A total of 18 patients, (n=9 DAYEX and n=9 COMBEX) were assessed at Intensive Care Unit (ICU) discharge and up to 1 year post burn...
November 25, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29181204/a-case-of-invasive-pneumococcal-infection-with-septic-shock-and-rare-complications
#16
John R Woytanowski, Nausheen Hakim, Caytlin Deering, Sara Schultz
Invasive pneumococcus is a serious illness with potentially devastating outcomes. A 64-year-old female with a medical history of psoriatic arthritis and diabetes was transferred from an outside hospital for ventilator dependent respiratory failure and altered mental status. She initially presented with worsening back pain and was found to have leukocytosis with bandemia and acute renal failure but she was in septic shock upon arrival to our tertiary care center. Her blood cultures grew Streptococcus pneumoniae and MRI of the brain revealed pus within the posterior lateral ventricles and multiple infarcts...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29166887/self-confidence-and-knowledge-of-german-icu-physicians-in-palliative-care-a-multicentre-prospective-study
#17
Veronika Krautheim, Andrea Schmitz, Gesine Benze, Thomas Standl, Christine Schiessl, Wolfgang Waldeyer, Alexander Hapfelmeier, Eberhard F Kochs, Gerhard Schneider, Klaus J Wagner, Christian M Schulz
BACKGROUND: Little is known about ICU physicians' self-confidence and knowledge related to palliative care. Our objective was to investigate self-confidence and knowledge of German ICU physicians related to palliative care, and to assess the impact of work experience, gender, specialty and additional certifications in pain or palliative medicine. METHODS: In a multicentre prospective observational study ICU physicians of ten hospitals were asked to rate their self-confidence and to complete a multiple choice questionnaire for the assessment of knowledge...
November 22, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29146105/content-validation-of-behaviours-and-autonomic-responses-for-the-assessment-of-pain-in-critically-ill-adults-with-a-brain-injury
#18
Céline Gélinas, Kathleen A Puntillo, Madalina Boitor, Mélanie Bérubé, Jane Topolovec-Vranic, Anne-Sylvie Ramelet, Aaron M Joffe, Melissa Richard-Lalonde, Francis Bernard, David L Streiner
BACKGROUND: The evidence shows that brain-injured patients express behaviours that are related to their level of consciousness (LOC), and different from other patients in the intensive care unit (ICU). Therefore, existing behavioural scales should be revised to enhance their content and validity for use in these patients. OBJECTIVES: The aim was to evaluate the content relevance of behaviours and autonomic responses for pain assessment of brain-injured ICU patients from the perspective of critical care clinicians...
November 13, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29136716/-the-impact-of-goal-directed-analgesia-on-mechanical-ventilated-patients-s-outcomes-in-intensive-care-unit-a-clinical-observational-study
#19
Q D Li, X Y Wan, Y L Zhang, S W Li, L L Han, W W Li, H Y Shi
To investigate the impact of goal directed analgesia on the outcome of patients with mechanical ventilation in intensive care unit.A total of 126 patients who needed mechanical ventilation were recruited.With a method of before and after paired comparison, they were divided into two group: (1) analgesia with empirical administration or control group; (2) goal directed analgesia based on critical-care pain observation tool (CPOT). Compared with the control group, after goal directed analgesia was applied, the consumption of midazolam significantly dropped from (368...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29121287/analgesia-nociception-index-for-the-assessment-of-pain-in-critically-ill-patients-a-diagnostic-accuracy-study
#20
G Chanques, T Tarri, A Ride, A Prades, A De Jong, J Carr, N Molinari, S Jaber
Background: Behavioural pain tools are used in Intensive Care Unit (ICU) patients unable to self-report their pain-intensity but need sustained efforts to educate and train the ICU team because of the subjective nature of these clinical tools. This study measured the validity and performance of an electrophysiological monitoring tool based on the spectral analysis of heart rate variability, the Analgesia Nociception Index (ANI) which varies from 0 (minimal parasympathetic tone, maximal stress-response and pain) to 100 (maximal parasympathetic tone, minimal stress-response and pain)...
October 1, 2017: British Journal of Anaesthesia
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