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Patient Temperature Management

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https://www.readbyqxmd.com/read/29026630/sinister-seafood-bacteraemia-secondary-to-non-o1-o139-vibrio-cholerae-infection
#1
Maxime J Billick, Philip W Lam, Isaac I Bogoch
Introduction.Vibrio species are curved, motile Gram-negative bacilli found in estuarine and marine environments, and are known to cause to gastroenteritis, skin and soft tissue infections, and septicaemia. While not responsible for cholera epidemics, non-O1/O139 Vibrio cholerae (NOVC) is increasingly reported as a cause of gastroenteritis. Case presentation. A 66-year-old man presented to an emergency department with a 1 week history of epigastric pain, emesis and fever. Blood cultures drawn on admission initially demonstrated Gram-negative bacilli, and ultimately grew NOVC, which was later confirmed by matrix-assisted laser desorption ionization-time of flight MS...
July 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29021143/cold-agglutinins-in-a-patient-undergoing-normothermic-cardiac-operation-with-warm-cardioplegia
#2
Tatsuhiko Ogawa
Cold agglutinins are autoantibodies that agglutinate red blood cells at low temperatures, leading to haemagglutination and haemolysis. They are generally of no clinical significance. However, when people with cold agglutinins undergo cardiac operation with hypothermia and cold cardioplegia, they can experience complications. Thus, different perioperative management is required for such patients. We describe a 74-year-old man with cold agglutinins incidentally detected on the preoperative screening test. He had never experienced any complications or developed a haematological disease...
October 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29019336/chemotherapy-induced-febrile-neutropenia-in-solid-tumours
#3
Ayman Rasmy, Mohammed Al Mashiakhi, Amal Ameen
Febrile neutropaenia (FN) is defined as an oral temperature of >38.3°C or two consecutive readings of >38.0°C for 2 hours and an absolute neutrophil count (ANC) of <0.5 × 109/l, or expected to fall below 0.5 × 109/l. Fever is one of the characteristic symptoms of FN and is usually associated with the presence of an infection caused by various microorganisms. The incidence and epidemiology of FN are variable based on different factors: (type of cancer, the age/sex of the patient, chemotherapy type /number of cycles)...
September 2017: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/29017648/-neurological-prognostic-value-of-gray-white-matter-ratio-in-patients-after-respiratory-and-cardiac-arrest
#4
Hengjun Liu, Peng Xu, Fei He, Yao Liu, Jun Wang
OBJECTIVE: To evaluate the role of gray-white-matter ratio (GWR) on neurological outcome in patients with coma after cardiopulmonary resuscitation (CPR) post-respiratory and cardiac arrest (CA). METHODS: Respiratory and CA patients with restoration of spontaneous circulation (ROSC) and coma after CPR admitted to Nanjing Drum Tower Hospital Clinical Medical College of Nanjing Medical University from February 2013 to June 2016 were enrolled. All patients were subjected to target temperature management (TTM) after CPR, and received cranial CT within 5 days after ROSC...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28989276/stability-of-medicines-after-repackaging-into-multicompartment-compliance-aids-eight-criteria-for-detection-of-visual-alteration
#5
Valerie Albert, Michael Lanz, Georgios Imanidis, Kurt E Hersberger, Isabelle Arnet
INTRODUCTION: Multicompartment compliance aids (MCA) are widely used by patients. They support the management of medication and reduce unintentional nonadherence. MCA are filled with medicines unpacked from their original packaging. Swiss pharmacists currently provide MCA for 1-2 weeks, although little and controversial information exists on the stability of repackaged medicines. OBJECTIVE: We aimed to validate the usefulness of a simple screening method capable of detecting visual stability problems with repackaged medicines...
2017: Drugs & Therapy Perspectives: for Rational Drug Selection and Use
https://www.readbyqxmd.com/read/28988962/prehospital-cooling-to-improve-successful-targeted-temperature-management-after-cardiac-arrest-a-randomized-controlled-trial
#6
D C Scales, S Cheskes, P R Verbeek, R Pinto, D Austin, S C Brooks, K N Dainty, K Goncharenko, M Mamdani, K E Thorpe, L J Morrison
RATIONALE: Targeted temperature management (TTM) improves survival with good neurological outcome after out-of-hospital cardiac arrest (OHCA), but is delivered inconsistently and often with delay. OBJECTIVE: To determine if prehospital cooling by paramedics leads to higher rates of 'successful TTM', defined as achieving a target temperature of 32-34°C within 6h of hospital arrival. METHODS: Pragmatic RCT comparing prehospital cooling (surface ice packs, cold saline infusion, wristband reminders) initiated 5min after return of spontaneous circulation (ROSC) versus usual resuscitation and transport...
October 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28981963/serum-tau-and-neurological-outcome-in-cardiac-arrest
#7
Niklas Mattsson, Henrik Zetterberg, Niklas Nielsen, Kaj Blennow, Josef Dankiewicz, Hans Friberg, Gisela Lilja, Philip S Insel, Christian Rylander, Pascal Stammet, Anders Aneman, Christian Hassager, Jesper Kjaergaard, Michael Kuiper, Tommaso Pellis, Jørn Wetterslev, Matthew Wise, Tobias Cronberg
OBJECTIVE: To test serum tau as a predictor of neurological outcome after cardiac arrest. METHODS: We measured the neuronal protein tau in serum at 24, 48, and 72 h after cardiac arrest in 689 patients in the prospective international Target Temperature Management trial. The main outcome was poor neurological outcome, defined as Cerebral Performance Category 3-5 at 6 months. RESULTS: Increased tau was associated with poor outcome at 6 months after cardiac arrest (median 38...
October 5, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28977264/recent-advances-in-bedside-microcirculation-assessment-in-critically-ill-patients
#8
Philipe Franco do Amaral Tafner, Felipe Ko Chen, Roberto Rabello, Thiago Domingos Corrêa, Renato Carneiro de Freitas Chaves, Ary Serpa
Parameters related to macrocirculation, such as the mean arterial pressure, central venous pressure, cardiac output, mixed venous saturation and central oxygen saturation, are commonly used in the hemodynamic assessment of critically ill patients. However, several studies have shown that there is a dissociation between these parameters and the state of microcirculation in this group of patients. Techniques that allow direct viewing of the microcirculation are not completely disseminated, nor are they incorporated into the clinical management of patients in shock...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28969380/chronic-non-freezing-cold-injury-results-in-neuropathic-pain-due-to-a-sensory-neuropathy
#9
Tom A Vale, Mkael Symmonds, Michael Polydefkis, Kelly Byrnes, Andrew S C Rice, Andreas C Themistocleous, David L H Bennett
Non-freezing cold injury develops after sustained exposure to cold temperatures, resulting in tissue cooling but not freezing. This can result in persistent sensory disturbance of the hands and feet including numbness, paraesthesia and chronic pain. Both vascular and neurological aetiologies of this pain have been suggested but remain unproven. We prospectively approached patients referred for clinical assessment of chronic pain following non-freezing cold injury between 12 February 2014 and 30 November 2016...
October 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28968238/sex-differences-in-the-psychophysical-response-to-contact-heat-in-moderate-cognitive-impairment-alzheimer-s-disease-a-cross-sectional-brief-report
#10
Ronald L Cowan, Paul A Beach, Sebastian W Atalla, Mary S Dietrich, Stephen P Bruehl, Jie Deng, Jinjiao Wang, Paul A Newhouse, John C Gore, Todd B Monroe
BACKGROUND: People with Alzheimer's disease (AD) report pain less frequently and receive less pain medication than people without AD. Recent studies have begun to elucidate how pain may be altered in those with AD. However, potential sex differences in pain responsiveness have never been explored in these patients. It is unclear whether sex differences found in prior studies of healthy young and older individuals extend to people with AD. OBJECTIVE: The purpose of this study was to examine sex differences in the psychophysical response to experimental thermal pain in people with AD...
September 29, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28968162/severe-hypothermia-management-in-mountain-rescue-a-survey-study
#11
Paweł Podsiadło, Tomasz Darocha, Sylweriusz Kosiński, Kinga Sałapa, Mirosław Ziętkiewicz, Tomasz Sanak, Rachel Turner, Hermann Brugger
Podsiadło, Paweł, Tomasz Darocha, Sylweriusz Kosiński, Kinga Sałapa, Mirosław Ziętkiewicz, Tomasz Sanak, Rachel Turner, and Hermann Brugger. Severe hypothermia management in mountain rescue: a survey study. High Alt Med Biol 00:000-000, 2017. INTRODUCTION: Severe hypothermia is a rare but demanding medical emergency. Although mortality is high, if well managed, the neurological outcome of survivors can be excellent. The aim of the study was to assess whether mountain rescue teams (MRTs) are able to meet the guidelines in the management of severe hypothermia, regarding their equipment and procedures...
October 2, 2017: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/28962807/targeted-temperature-management-in-brain-injured-patients
#12
REVIEW
Fred Rincon
Evidence from animal models indicates that lowering temperature by a few degrees can produce substantial neuroprotection. In humans, hypothermia has been found to be neuroprotective with a significant impact on mortality and long-term functional outcome only in cardiac arrest and neonatal hypoxic-ischemic encephalopathy. Clinical trials have explored the potential role of maintaining normothermia and treating fever in critically ill brain injured patients. This review concentrates on basic concepts to understand the physiologic interactions of thermoregulation, effects of thermal modulation in critically ill patients, proposed mechanisms of action of temperature modulation, and practical aspects of targeted temperature management...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28962805/management-of-traumatic-brain-injury-an-update
#13
REVIEW
Mohamed H Abou El Fadl, Kristine H O'Phelan
The care of patients with traumatic brain injury can be one of the most challenging and rewarding aspects of clinical neurocritical care. This article reviews the approach to unique aspects specific to the care of this patient population. These aspects include appropriate use of sedation and analgesia, and the principles and the clinical use of intracranial monitors. Common clinical challenges encountered in these patients are also discussed, including the treatment of intracranial hypertension, temperature management, and control of sympathetic hyperactivity...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28953559/novel-concepts-for-damage-control-resuscitation-in-trauma
#14
Philbert Y Van, John B Holcomb, Martin A Schreiber
PURPOSE OF REVIEW: Traumatic injuries are a major cause of mortality worldwide. Damage control resuscitation or balanced transfusion of plasma, platelets, and red blood cells for the management of exsanguinating hemorrhage after trauma has become the standard of care. We review the literature regarding the use of alternatives to achieve the desired 1 : 1:1 ratio as availability of plasma and platelets can be problematic in some environments. RECENT FINDINGS: Liquid and freeze dried plasma (FDP) are logistically easier to use and may be superior to fresh frozen plasma...
September 26, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28951293/targeted-temperature-management-using-the-esophageal-cooling-device-after-cardiac-arrest-the-cool-study-a-feasibility-and-safety-study
#15
Antoine Goury, Florent Poirson, Ulriikka Chaput, Sebastian Voicu, Pierre Garçon, Thomas Beeken, Isabelle Malissin, Lamia Kerdjana, Jonathan Chelly, Dominique Vodovar, Oueslati Haikel, Jean Michel Ekherian, Philippe Marteau, Eric Vicaut, Bruno Megarbane, Nicolas Deye
BACKGROUND: Targeted temperature management (TTM) between 32-36°C is recommended after out-of-hospital cardiac arrest (OHCA). We aimed to assess the feasibility and safety of the "Esophageal Cooling Device" (ECD) in performing TTM. PATIENTS AND METHODS: This single-centre, prospective, interventional study included 17 comatose OHCA patients. Main exclusion criteria were: delay between OHCA and return of spontaneous circulation (ROSC)>60min, delay between sustained ROSC and inclusion >360min, known oesophageal disease...
September 23, 2017: Resuscitation
https://www.readbyqxmd.com/read/28947390/level-of-systemic-inflammation-and-endothelial-injury-is-associated-with-cardiovascular-dysfunction-and-vasopressor-support-in-post-cardiac-arrest-patients
#16
John Bro-Jeppesen, Pär I Johansson, Jesper Kjaergaard, Michael Wanscher, Sisse R Ostrowski, Mette Bjerre, Christian Hassager
AIM: Post-cardiac arrest syndrome (PCAS) is characterized by a sepsis-like inflammatory response and hemodynamic instability. We investigated the associations between systemic inflammation, endothelial damage and hemodynamic parameters including vasopressor support in patients with out-of-hospital cardiac arrest (OHCA). METHODS: In this post-hoc study, we analysed data from 163 comatose patients included at a single center in the Target Temperature Management (TTM) trial, randomly assigned to TTM at 33°C or 36°C for 24h...
September 23, 2017: Resuscitation
https://www.readbyqxmd.com/read/28946920/role-of-bispectral-index-monitoring-and-burst-suppression-in-prognostication-following-out-of-hospital-cardiac-arrest-a-systematic-review-protocol
#17
Leanne Eveson, Marcela Vizcaychipi, Shashank Patil
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is associated with significant mortality or may have a poor neurological outcome. Various community-training programmes have improved practices like bystander cardiopulmonary resuscitation (CPR) and early defibrillation using automated external defibrillator (AED). Post-resuscitation care has also changed significantly in the millennium. Interventions like targeted temperature management (TTM), avoidance of hyperoxia and emergency cardiac catheterisation have given patients a chance of a better neurological outcome...
September 25, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28942010/the-potential-role-of-auditory-evoked-potentials-to-assess-prognosis-in-comatose-survivors-from-cardiac-arrest
#18
Paolo De Santis, Irene Lamanna, Nicolas Mavroudakis, Benjamin Legros, Jean-Louis Vincent, Jacques Creteur, Fabio Silvio Taccone
AIM: Few data are available on the use of brainstem auditory evoked potentials (BAEPs) in combination with other electrophysiological tools to assess prognosis of comatose survivors from cardiac arrest (CA). METHODS: Retrospective analysis of data from all adult patients (>18years of age) admitted to our Dept of Intensive Care after CA over a 6-year period who were comatose (Glasgow Coma Scale <9) on admission, had been treated with targeted temperature management and had BAEP testing...
September 21, 2017: Resuscitation
https://www.readbyqxmd.com/read/28935129/environmental-design-for-end-of-life-care-an-integrative-review-on-improving-quality-of-life-and-managing-symptoms-for-patients-in-institutional-settings
#19
REVIEW
Rana Sagha Zadeh, Paul Eshelman, Judith Setla, Laura Kennedy, Emily Hon, Aleksa Basara
CONTEXT: The environment in which end-of-life care is delivered can support or detract from the physical, psychological, social, and spiritual needs of patients, their families, and their caretakers. OBJECTIVES: This review aims to organize and analyze the existing evidence related to environmental design factors that improve the quality of life and total well-being of people involved in end-of-life care and to clarify directions for future research. METHOD: This integrated literature review synthesized and summarized research evidence from the fields of medicine, environmental psychology, nursing, palliative care, architecture, interior design, and evidence-based design...
September 18, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28931363/a-guideline-based-policy-to-decrease-intensive-care-unit-admission-rates-for-accidental-hypothermia
#20
Herman R Sequeira, Hesham E Mohamed, Neal Hakimi, Dorothy B Wakefield, Jonathan Fine
RATIONALE: Despite guidelines advising passive rewarming for mild accidental hypothermia (AH), patients are frequently admitted to intensive care unit (ICU) for active rewarming using a forced-air warming device. We implemented a new policy at our institution aimed at safely reducing ICU admissions for AH. We analyzed our practice pre- and post-policy intervention and compared our experiences with acute care hospitals in Connecticut. METHODS: A retrospective chart review was performed on 203 participants with AH identified by primary and secondary discharge codes...
January 1, 2017: Journal of Intensive Care Medicine
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