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https://www.readbyqxmd.com/read/28330688/management-of-spontaneous-pneumomediastinum-are-hospitalization-and-prophylactic-antibiotics-needed
#1
Masatomo Ebina, Akira Inoue, Akihiro Takaba, Koichi Ariyoshi
BACKGROUND: Spontaneous pneumomediastinum is defined as the presence of free air in the mediastinum without any apparent concomitant factors or disease. It is uncommon but usually benign and self-limiting. Generally, patients with spontaneous pneumomediastinum are admitted to hospital, and occasionally, prophylactic antibiotics are administered to prevent mediastinitis. The purpose of this study was to describe practices concerning the feasibility of outpatient treatment and follow-up of spontaneous pneumomediastinum and the necessity of prophylactic antibiotics...
March 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28323290/incidence-and-risk-factors-for-delirium-development-in-icu-patients-a-prospective-observational-study
#2
Marcela Kanova, Peter Sklienka, Roman Kula, Michal Burda, Jana Janoutova
BACKGROUND AND AIMS: Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. METHODS: A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period...
March 14, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28320561/the-effects-of-oral-rinse-with-0-2-and-2-chlorhexidine-on-oropharyngeal-colonization-and-ventilator-associated-pneumonia-in-adults-intensive-care-units
#3
Farid Zand, Leili Zahed, Parisa Mansouri, Freshte Dehghanrad, Maryam Bahrani, Mohammad Ghorbani
BACKGROUND: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Units (ICUs) which increases the length of ICU stay, duration of mechanical ventilation, and mortality. The present study used an oral care protocol and compared the effects of two different concentrations of chlorhexidine on reduction of oropharyngeal colonization and VAP. MATERIALS AND METHODS: This study was performed on 114 patients from trauma, surgery, neurosurgery, and general ICUs randomly allocated to two groups under oral care with 0...
March 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28316317/direct-two-minute-unassisted-breathing-evaluation-dtube-is-an-attractive-alternative-to-longer-spontaneous-breathing-trials-a-prospective-observational-study
#4
Matthew B Bloom, Jonathan Lu, Tri Tran, Marko Bukur, Rex Chung, Eric J Ley, Nicolas Melo, Ali Salim, Daniel R Margulies
We sought to identify a simple bedside method to predict successful extubation outcomes that might be used during rounds. We hypothesized that a direct 2-minute unassisted breathing evaluation (DTUBE) could replace a longer spontaneous breathing trial (SBT). Data were prospectively collected on all patients endotracheally intubated for >48 hours nearing extubation in a tertiary center's mixed trauma/surgical intensive care unit from August 2012 to August 2013. The SBT was performed for at least 30 minutes at 40 per cent FiO2, PEEP 5, and PS 8...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28316302/high-frequency-oscillatory-ventilation-hfov-as-primary-ventilator-strategy-in-the-management-of-severe-acute-respiratory-distress-syndrome-ards-with-pneumothorax-in-the-setting-of-trauma
#5
Kartik Prabhakaran, Daniel Hagler, Dominick Vitale, Alejandro Betancourt, Patrizio Petrone, Corrado P Marini
No abstract text is available yet for this article.
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28315043/the-intensive-care-medicine-clinical-research-agenda-in-paediatrics
#6
REVIEW
Mark J Peters, Andrew Argent, Marino Festa, Stéphane Leteurtre, Jefferson Piva, Ann Thompson, Douglas Willson, Pierre Tissières, Marisa Tucci, Jacques Lacroix
BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries...
March 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28290958/comparative-assessment-of-three-approaches-of-teaching-nonmedically-trained-persons-in-the-handling-of-supraglottic-airways-a-randomized-controlled-trial
#7
Mario Hensel, Willi Schmidbauer, Michael Benker, Paula Schmieder, Thoralf Kerner
BACKGROUND: The use of supraglottic airways has been recommended in combat trauma airway management. To ensure an adequate airway management on the battlefield, suitable training concepts are sought to efficiently teach as many soldiers as possible. Our aim was to compare three approaches of teaching laypersons in the handling of supraglottic airways in a mannequin model. METHODS: In this prospective randomized blinded study, 285 military service men without any medical background were divided into three groups and trained in the use of the Laryngeal Mask Airway Supreme (LMA) and the Laryngeal Tube Disposable (LT-D)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290954/improving-surgical-complications-and-patient-safety-at-the-nation-s-largest-military-hospital-an-analysis-of-national-surgical-quality-improvement-program-data
#8
Steve Maturo, Charlotte Hughes, George Kallingal, Stephen Silvey, A J Johnson, Douglas Soderdahl, Evan Renz, Joseph Brennan
INTRODUCTION: The U.S. Military Health System cares for over 9 million patients and encompasses 63 hospitals and 413 clinics worldwide. Military medicine balances the simultaneous tasks of caring for those patients wounded in military engagements, treating large numbers of families of service men and women, and training the next generation of health care providers and ancillary staff. Similar to civilian health care delivery in the United States, military medicine has also seen increased scrutiny in the areas of cost and quality...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288027/cumulative-probability-and-time-to-reintubation-in-u-s-icus
#9
Andrea N Miltiades, Hayley B Gershengorn, May Hua, Andrew A Kramer, Guohua Li, Hannah Wunsch
OBJECTIVE: Reintubation after liberation from mechanical ventilation is viewed as an adverse event in ICUs. We sought to describe the frequency of reintubations across U.S. ICUs and to propose a standard, appropriate time cutoff for reporting of reintubation events. DESIGN AND SETTING: We conducted a cohort study using data from the Project IMPACT database of 185 diverse ICUs in the United States. PATIENTS: We included patients who received mechanical ventilation and excluded patients who received a tracheostomy, had a do-not-resuscitate order placed, or died prior to first extubation...
March 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28286828/predictive-factors-of-poor-outcome-in-road-traffic-injures-a-retrospective-cohort-study
#10
Hamid Reza Hatamabadi, Majid Shojaee, Parvin Kashani, Mohammad Mehdi Forouzanfar, Dorrin Aghajani Nargesi, Mohammad Reza Amini Esfahani
INTRODUCTION: Road traffic injuries (RTI) are among the most important health problems worldwide as they cause more than 1.2 million deaths and 50 million injuries each year. Therefore, the present study aims to evaluate the outcome and aftermath of RTI in those who were injured and hospitalized due to a traffic accident. METHODS: In the present retrospective cohort study with a one-year follow-up, data were extracted from the profiles of the RTI hospitalized patients...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286808/effect-of-positive-end-expiratory-pressure-on-central-venous-pressure-in-patients-under-mechanical-ventilation
#11
Majid Shojaee, Anita Sabzghabaei, Hossein Alimohammadi, Hojjat Derakhshanfar, Afshin Amini, Bahareh Esmailzadeh
INTRODUCTION: Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. METHODS: In this quasi-experimental study, patients under mechanical ventilation were evaluated with the aim of assessing the effect of PEEP change on CVP. Non-trauma patients, over 18 years of age, who were under mechanical ventilation and had stable hemodynamics, with inserted CV line were entered...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28275495/resection-of-pulmonary-nodule-in-a-patient-with-subglottic-stenosis-under-modified-spontaneous-ventilation-anesthesia
#12
Jianfei Shen, Xuewei Chen, Lixia Liang, Kevin Phan, Jin-Shing Chen, Calvin S H Ng, Rene Horsleben Petersen, Diego González-Rivas, Jianxing He
Subglottic stenosis is an uncommon structural abnormality that can pose as a difficulty for patients undergoing surgery, and treatment is complex due to the special anatomical location. Pulmonary nodule resection in patients with subglottic stenosis is challenging and has not yet been reported. Here we present a case of pulmonary nodule resection in a patient with subglottic stenosis using uniportal thoracoscopy under spontaneous ventilation anesthesia (SVA). Compared with traditional double lumen endotracheal intubation, we believe this modified technique can significantly reduce airway trauma, and accelerate patient recovery...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28274684/high-frequency-ultrasound-sacral-images-in-the-critically-ill-tissue-characteristics-versus-visual-evaluation
#13
Mary Jo Grap, Christine M Schubert, Ruth S Burk, Valentina Lucas, Paul A Wetzel, Anathea Pepperl, Cindy L Munro
PURPOSE: High frequency ultrasound (HFUS) systems may identify tissue injury. We compared HFUS tissue characteristics (dermal thickness and dermal density) with visual image examination. METHODS: Longitudinal study in critically ill mechanically ventilated adults, from three ICUs (Surgical Trauma, Medical Respiratory, Neuroscience) enrolled within 24hours of airway intubation. Sacral HFUS images were obtained daily for up to seven days. Expert evaluation of the best image per day was completed and compared to HFUS generated tissue characteristics (dermal thickness and dermal density)...
March 5, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28272189/cannabis-use-has-negligible-effects-following-severe-traumatic-injury
#14
Kareem R AbdelFattah, Courtney R Edwards, Michael W Cripps, Christian T Minshall, Herb A Phelan, Joseph P Minei, Alexander L Eastman
Nearly half of all states have legalized medical marijuana or recreational-use marijuana. As more states move toward legalization, the effects on injured patients must be evaluated. This study sought to determine effects of cannabis positivity at the time of severe injury on hospital outcomes compared with individuals negative for illicit substances and those who were users of other illicit substances. A Level I trauma center performed a retrospective chart review covering subjects over a 2-year period with toxicology performed and an Injury Severity Score (ISS) of more than 16...
March 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#15
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
March 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28261294/influence-of-intraoperative-positive-end-expiratory-pressure-level-on-pulmonary-complications-in-emergency-major-trauma-surgery
#16
Thomas Stueber, Jan Karsten, Nikolas Voigt, Michaela Wilhelmi
INTRODUCTION: Pulmonary complications have a major impact on the morbidity and mortality of critically ill patients with multiple trauma. Intraoperative protective ventilation with low tidal volume may prevent lung injury and infection, whereas the role of positive end-expiratory pressure (PEEP) levels is unclear. The aim of this study was to evaluate the influence of different intraoperative PEEP levels on incidence of pulmonary complications after emergency trauma surgery. MATERIAL AND METHODS: We retrospectively analysed data of multiple trauma patients who underwent emergency surgery within 24 h after injury in our level I trauma centre (n = 86)...
March 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28257336/preadmission-oral-corticosteroids-are-associated-with-reduced-risk-of-acute-respiratory-distress-syndrome-in-critically-ill-adults-with-sepsis
#17
Andrew C McKown, Erin M McGuinn, Lorraine B Ware, Li Wang, David R Janz, Todd W Rice, Matthew W Semler
OBJECTIVES: To determine the association between preadmission oral corticosteroid receipt and the development of acute respiratory distress syndrome in critically ill patients with sepsis. DESIGN: Retrospective observational study. SETTING: Medical, surgical, trauma, and cardiovascular ICUs of an academic medical center. PATIENTS: A total of 1,080 critically ill patients with sepsis. INTERVENTIONS: None...
March 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28254541/an-experience-with-traumatic-brain-injury-is-early-tracheostomy-associated-with-better-prognosis
#18
Hosseinali Khalili, Shahram Paydar, Rasool Safari, Peyman Arasteh, Amin Niakan, Amin Abolhasani Foroughi
OBJECTIVE: In this study we compared the effects of early tracheostomy (ET) versus late tracheostomy (LT) on traumatic brain injury (TBI) related outcomes and prognosis. PATIENTS AND METHODS: Data on 152 TBI patients with a Glasgow coma scale (GCS) of ≤8, admitted to Rajaee hospital, between March 1, 2014 and August 23, 2015, were collected. Rajaee hospital is the main referral trauma center in southern Iran and is affiliated to Shiraz University of Medical Sciences...
February 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28254102/auricular-acupuncture-analgesia-in-thoracic-trauma-a-case-report
#19
Georgios S Papadopoulos, Petros Tzimas, Antonia Liarmakopoulou, Anastasios M Petrou
We report a case of thoracic trauma (rib fractures with pneumothorax and pulmonary contusions) with severe chest pain leading to ineffective ventilation and oxygenation. The patient presented to our emergency department. The patient had chronic obstructive pulmonary disease and was completely unable to take deep breaths and clear secretions from his bronchial tree. After obtaining informed consent, we applied auricular acupuncture to ameliorate pain and hopefully improve his functional ability to cough and breathe deeply...
January 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28252524/development-and-prospective-validation-of-tools-to-accurately-identify-neurosurgical-and-critical-care-events-in-children-with-traumatic-brain-injury
#20
Tellen D Bennett, Peter E DeWitt, Rebecca R Dixon, Cory Kartchner, Yamila Sierra, Diane Ladell, Rajendu Srivastava, Jay Riva-Cambrin, Allison Kempe, Desmond K Runyan, Heather T Keenan, J Michael Dean
OBJECTIVE: To develop and validate case definitions (computable phenotypes) to accurately identify neurosurgical and critical care events in children with traumatic brain injury. DESIGN: Prospective observational cohort study, May 2013 to September 2015. SETTING: Two large U.S. children's hospitals with level 1 Pediatric Trauma Centers. PATIENTS: One hundred seventy-four children less than 18 years old admitted to an ICU after traumatic brain injury...
March 1, 2017: Pediatric Critical Care Medicine
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