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https://www.readbyqxmd.com/read/27706464/effect-of-postextubation-high-flow-nasal-cannula-vs-noninvasive-ventilation-on-reintubation-and-postextubation-respiratory-failure-in-high-risk-patients-a-randomized-clinical-trial
#1
RANDOMIZED CONTROLLED TRIAL
Gonzalo Hernández, Concepción Vaquero, Laura Colinas, Rafael Cuena, Paloma González, Alfonso Canabal, Susana Sanchez, Maria Luisa Rodriguez, Ana Villasclaras, Rafael Fernández
Importance: High-flow conditioned oxygen therapy delivered through nasal cannulae and noninvasive mechanical ventilation (NIV) may reduce the need for reintubation. Among the advantages of high-flow oxygen therapy are comfort, availability, lower costs, and additional physiopathological mechanisms. Objective: To test if high-flow conditioned oxygen therapy is noninferior to NIV for preventing postextubation respiratory failure and reintubation in patients at high risk of reintubation...
October 18, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27623758/ankle-brachial-index-for-the-diagnosis-of-lower-limb-peripheral-arterial-disease
#2
Fay Crawford, Karen Welch, Alina Andras, Francesca M Chappell
BACKGROUND: Peripheral arterial disease (PAD) of the lower limb is common, with prevalence of both symptomatic and asymptomatic disease estimated at 13% in the over 50 age group. Symptomatic PAD affects about 5% of individuals in Western populations between the ages of 55 and 74 years. The most common initial symptom of PAD is muscle pain on exercise that is relieved by rest and is attributed to reduced lower limb blood flow due to atherosclerotic disease (intermittent claudication). The ankle brachial index (ABI) is widely used by a variety of healthcare professionals, including specialist nurses, physicians, surgeons and podiatrists working in primary and secondary care settings, to assess signs and symptoms of PAD...
September 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27118355/non-invasive-ventilation-in-paediatric-critical-care
#3
Sarah L Morley
Non-invasive ventilation (NIV) is a well recognised and increasingly prevalent intervention in the paediatric critical care setting. In the acute setting NIV is used to provide respiratory support in a flexible manner that avoids a requirement for endotracheal intubation or tracheostomy, with the aim of avoiding the complications of invasive ventilation. This article will explore the physiological benefits, complications and epidemiology of the different modes of NIV including continuous positive airway pressure (CPAP), non-invasive positive pressure ventilation (NIPPV) and high-flow nasal cannula oxygen (HFNC)...
March 14, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/26975498/effect-of-postextubation-high-flow-nasal-cannula-vs-conventional-oxygen-therapy-on-reintubation-in-low-risk-patients-a-randomized-clinical-trial
#4
RANDOMIZED CONTROLLED TRIAL
Gonzalo Hernández, Concepción Vaquero, Paloma González, Carles Subira, Fernando Frutos-Vivar, Gemma Rialp, Cesar Laborda, Laura Colinas, Rafael Cuena, Rafael Fernández
IMPORTANCE: Studies of mechanically ventilated critically ill patients that combine populations that are at high and low risk for reintubation suggest that conditioned high-flow nasal cannula oxygen therapy after extubation improves oxygenation compared with conventional oxygen therapy. However, conclusive data about reintubation are lacking. OBJECTIVE: To determine whether high-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy for preventing reintubation in mechanically ventilated patients at low risk for reintubation...
April 5, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26590570/oral-alimentation-in-neonatal-and-adult-populations-requiring-high-flow-oxygen-via-nasal-cannula
#5
Steven B Leder, Jonathan M Siner, Matthew J Bizzarro, Brian M McGinley, Maureen A Lefton-Greif
Use of high-flow oxygen via nasal cannula (HFO2-NC) is increasingly common in intensive care unit (ICU) settings. Despite the critical interface between respiration and swallowing, and the high acuity of patients in ICUs, the impact of HFO2-NC on feeding and swallowing is unknown. The present prospective, single-center, cohort study investigated the impact of HFO2-NC use on oral alimentation in neonatal and adult ICU patients. Oral alimentation status was evaluated in 100 consecutive ICU inpatients (50 neonatal and 50 adult) requiring HFO2-NC...
April 2016: Dysphagia
https://www.readbyqxmd.com/read/26426458/randomized-trial-of-apneic-oxygenation-during-endotracheal-intubation-of-the-critically-ill
#6
RANDOMIZED CONTROLLED TRIAL
Matthew W Semler, David R Janz, Robert J Lentz, Daniel T Matthews, Brett C Norman, Tufik R Assad, Raj D Keriwala, Benjamin A Ferrell, Michael J Noto, Andrew C McKown, Emily G Kocurek, Melissa A Warren, Luis E Huerta, Todd W Rice
RATIONALE: Hypoxemia is common during endotracheal intubation of critically ill patients and may predispose to cardiac arrest and death. Administration of supplemental oxygen during laryngoscopy (apneic oxygenation) may prevent hypoxemia. OBJECTIVES: To determine if apneic oxygenation increases the lowest arterial oxygen saturation experienced by patients undergoing endotracheal intubation in the intensive care unit. METHODS: This was a randomized, open-label, pragmatic trial in which 150 adults undergoing endotracheal intubation in a medical intensive care unit were randomized to receive 15 L/min of 100% oxygen via high-flow nasal cannula during laryngoscopy (apneic oxygenation) or no supplemental oxygen during laryngoscopy (usual care)...
February 1, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/26370853/high-flow-nasal-cannula-therapy-for-acute-hypoxemic-respiratory-failure-in-adults-a-retrospective-analysis
#7
Woo Hyun Cho, Hye Ju Yeo, Seong Hoon Yoon, SeungEun Lee, Doo SooJeon, Yun Seong Kim, Ki Uk Kim, Kwangha Lee, Hye Kyung Park, Min Ki Lee
OBJECTIVE: High-flow nasal cannula (HFNC) therapy is an oxygen delivery system. However, evidence regarding the clinical applications of HFNC is still emerging. We herein evaluated the clinical predictors of HFNC therapy success for adult patients with acute hypoxemic respiratory failure. METHODS: We retrospectively reviewed the medical records of the subjects with acute hypoxemic respiratory failure supported by HFNC therapy in the medical intensive care unit between July 2011 and March 2013...
2015: Internal Medicine
https://www.readbyqxmd.com/read/26060320/high-flow-nasal-cannula-in-a-mixed-adult-icu
#8
Kristina A Gaunt, Sarah K Spilman, Meghan E Halub, Julie A Jackson, Keith D Lamb, Sheryl M Sahr
BACKGROUND: Humidified, high-flow nasal cannula (HFNC) enables mucociliary clearance, accurate oxygen measurement, precise control of flow, and low-level positive airway pressure. There is sparse information concerning the timing of HFNC on patient outcomes such as incidence of adverse events during hospitalization, ICU stay, and post-ICU stay. METHODS: This is a retrospective analysis of a heterogeneous population of medical and trauma ICU patients who received HFNC therapy in a critical care setting...
October 2015: Respiratory Care
https://www.readbyqxmd.com/read/26051847/what-is-the-role-of-the-physiotherapist-in-paediatric-intensive-care-units-a-systematic-review-of-the-evidence-for-respiratory-and-rehabilitation-interventions-for-mechanically-ventilated-patients
#9
REVIEW
Ellie Hawkins, Anne Jones
BACKGROUND: Physiotherapy in intensive care units (ICU) has traditionally focussed on the respiratory management of mechanically ventilated patients. Gradually, focus has shifted to include rehabilitation in adult ICUs, though evidence of a similar shift in the paediatric ICU (PICU) is limited. OBJECTIVES: Review the evidence to determine the role of physiotherapists in the management of mechanically ventilated patients in PICU. DATA SOURCES: A search was conducted of: PEDro, CINAHL, Medline, PubMed and the Cochrane Library...
December 2015: Physiotherapy
https://www.readbyqxmd.com/read/25984667/an-elevated-percentage-of-reticulated-platelet-is-associated-with-increased-mortality-in-septic-shock-patients
#10
Qin Wu, Jianan Ren, Dong Hu, Pengjun Jiang, Guanwei Li, Nadeem Anjum, Gefei Wang, Guosheng Gu, Jun Chen, Xiuwen Wu, Song Liu, Yuan Li, Yunzhao Zhao, Jieshou Li
Microcirculatory changes and coagulation disturbances are thought to play a key role in sepsis. Some evidence suggests that the percentage of reticulated platelets (RP%) may be a valuable and cost-effective sepsis screening parameter. This was a prospective study in surgical patients to investigate the potential value of RP% as a predictor of mortality in septic shock patients.This was a prospective study conducted in a surgical critical care center of a Chinese tertiary care hospital. Consecutive septic shock patients were enrolled at admission...
May 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/25921729/role-of-cd64-expression-on-neutrophils-in-the-diagnosis-of-sepsis-and-the-prediction-of-mortality-in-adult-critically-ill-patients
#11
Matthaios Papadimitriou-Olivgeris, Kalliopi Lekka, Konstantinos Zisimopoulos, Iris Spiliopoulou, Dionysios Logothetis, Georgios Theodorou, Evangelos D Anastassiou, Fotini Fligou, Marina Karakantza, Markos Marangos
Intensive care unit patients who developed systemic inflammatory response syndrome (SIRS) with proven microbial etiology were assigned to the infectious causes (n = 29), while patients with negative cultures and more probable other etiology were assigned to the noninfectious causes (n = 37). Flow cytometry was used to detect the presence of CD64 on neutrophils. The multivariate analysis revealed that KPC-producing Klebsiella pneumoniae rectal colonization and >1.39 mean fluorescence intensity (MFI) of CD64 expression on neutrophils upon day 1 of SIRS were significantly associated with an infectious SIRS...
July 2015: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/25909418/ventilator-gas-delivery-wave-form-substantially-impacts-plateau-pressure-and-peak-to-plateau-pressure-gradient-determination
#12
Adrian Anthony Maung, Dirk C Johnson, Gina M Luckianow, Lewis J Kaplan
BACKGROUND: To determine whether plateau pressure (Pplat) measurement is lowered and peak airway pressure (Pawpeak)-to-Plat gradient is increased by measurement on a decelerating compared with square gas delivery wave form. METHODS: Prospective before and after study of mechanically ventilated injured and critically ill patients in an adult surgical intensive care unit. Pplat, Pawpeak, and Pawpeak-to-Pplat gradient were measured on decelerating and square gas delivery wave forms...
May 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/25885130/flow-cytometric-analysis-of-mixed-phenotype-acute-leukemia-experience-from-a-tertiary-oncology-center
#13
Renu Sukumaran, Rekha A Nair, Priya Mary Jacob, Kunjulekshmi Amma Raveendran Nair Anila, Shruthy Prem, Rajeswary Binitha, Parukuttyamma Kusumakumary
INTRODUCTION: Mixed phenotype acute leukemia (MPAL) is a rare subset of acute leukemia where the blasts exhibit lineage specific antigens of more than one lineage. Flow cytometric immunophenotyping is essential for the diagnosis of MPAL and the accurate diagnosis highly depends on the panel of markers used. The precise incidence of MPAL is uncertain as various institutions use different combinations of antibodies to assign the blasts to a particular lineage. AIM: The aim was to study the immunoprofile of acute leukemia including aberrant antigen expressions and to study the incidence, clinical features, laboratory findings, and immunophenotype of MPAL in our institution...
April 2015: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/25881181/a-qualitative-evaluation-of-the-crucial-attributes-of-contextual-information-necessary-in-ehr-design-to-support-patient-centered-medical-home-care
#14
Charlene R Weir, Nancy Staggers, Bryan Gibson, Kristina Doing-Harris, Robyn Barrus, Robert Dunlea
BACKGROUND: Effective implementation of a Primary Care Medical Home model of care (PCMH) requires integration of patients' contextual information (physical, mental, social and financial status) into an easily retrievable information source for the healthcare team and clinical decision-making. This project explored clinicians' perceptions about important attributes of contextual information for clinical decision-making, how contextual information is expressed in CPRS clinical documentation as well as how clinicians in a highly computerized environment manage information flow related to these areas...
2015: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/25857484/psychometric-analysis-of-behavioral-pain-scale-brazilian-version-in-sedated-and-mechanically-ventilated-adult-patients-a-preliminary-study
#15
Isabela F Azevedo-Santos, Iura G N Alves, Daniel Badauê-Passos, Valter J Santana-Filho, Josimari M DeSantana
BACKGROUND AND PURPOSE: Pain assessment in Intensive Care Units (ICU) can be performed based on validated instruments as the Behavioral Pain Scale (BPS). Despite the existence of this clinical score, there is no Brazilian version of it to assess critically ill patients. This study aimed to translate the BPS into Brazilian Portuguese, verify its psychometric properties (reliability, validity, and responsiveness) and the correlation between pain measured and heart rate (HR), blood pressure (BP), Ramsay, and RASS scores...
April 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/25822477/a-conceptual-framework-for-improving-critical-care-patient-flow-and-bed-use
#16
Kusum S Mathews, Elisa F Long
RATIONALE: High demand for intensive care unit (ICU) services and limited bed availability have prompted hospitals to address capacity planning challenges. Simulation modeling can examine ICU bed assignment policies, accounting for patient acuity, to reduce ICU admission delays. OBJECTIVES: To provide a framework for data-driven modeling of ICU patient flow, identify key measurable outcomes, and present illustrative analysis demonstrating the impact of various bed allocation scenarios on outcomes...
June 2015: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/25809544/development-and-implementation-of-intranasal-naloxone-opioid-overdose-response-protocol-at-a-homeless-health-clinic
#17
Chin Hwa Y Dahlem, Molly J Horstman, Brent C Williams
PURPOSE: To describe the development, implementation, and preliminary evaluation of Opioid Overdose Response Protocol using intranasal (IN) naloxone in a homeless shelter. DATA SOURCES: Opioid Overdose Response Protocol and training curriculum were developed using the Massachusetts Department of Public Health Opioid Overdose Education and Naloxone Distribution (OEND) flow chart, the American Heart Association (AHA) simplified adult basic life support algorithm, and resources through Harms Reduction Coalition...
January 2016: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/25686465/thromboelastography-teg-and-rotational-thromboelastometry-rotem-for-trauma-induced-coagulopathy-in-adult-trauma-patients-with-bleeding
#18
REVIEW
Harriet Hunt, Simon Stanworth, Nicola Curry, Tom Woolley, Chris Cooper, Obioha Ukoumunne, Zhivko Zhelev, Chris Hyde
BACKGROUND: Trauma-induced coagulopathy (TIC) is a disorder of the blood clotting process that occurs soon after trauma injury. A diagnosis of TIC on admission is associated with increased mortality rates, increased burdens of transfusion, greater risks of complications and longer stays in critical care. Current diagnostic testing follows local hospital processes and normally involves conventional coagulation tests including prothrombin time ratio/international normalized ratio (PTr/INR), activated partial prothrombin time and full blood count...
February 16, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/25558703/comparison-of-the-effectiveness-of-high-flow-nasal-oxygen-cannula-vs-standard-non-rebreather-oxygen-face-mask-in-post-extubation-intensive-care-unit-patients
#19
COMPARATIVE STUDY
Evgeni Brotfain, Alexander Zlotnik, Andrei Schwartz, Amit Frenkel, Leonid Koyfman, Shaun E Gruenbaum, Moti Klein
BACKGROUND: Optimal oxygen supply is the cornerstone of the management of critically ill patients after extubation, especially in patients at high risk for extubation failure. In recent years, high flow oxygen system devices have offered an appropriate alternative to standard oxygen therapy devices such as conventional face masks and nasal prongs. OBJECTIVES: To assess the clinical effects of high flow nasal cannula (HFNC) compared with standard oxygen face masks in Intensive Care Unit (ICU) patients after extubation...
November 2014: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/25494358/the-impact-of-the-organization-of-high-dependency-care-on-acute-hospital-mortality-and-patient-flow-for-critically-ill-patients
#20
Hannah Wunsch, David A Harrison, Andrew Jones, Kathryn Rowan
RATIONALE: Little is known about the utility of provision of high-dependency care (HDC) that is in a geographically separate location from a primary intensive care unit (ICU). OBJECTIVES: To determine whether the availability of HDC in a geographically separate unit affects patient flow or mortality for critically ill patients. METHODS: Admissions to ICUs in the United Kingdom, from 2009 to 2011, who received Level 3 intensive care in the first 24 hours after admission and subsequently Level 2 HDC...
January 15, 2015: American Journal of Respiratory and Critical Care Medicine
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