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prevention pressure injury

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https://www.readbyqxmd.com/read/28212050/volume-controlled-ventilation-does-not-prevent-injurious-inflation-during-spontaneous-effort
#1
Takeshi Yoshida, Susumu Nakahashi, Maria Aparecida Miyuki Nakamura, Yukiko Koyama, Rollin Roldan, Vinicius Torsani, Roberta R De Santis, Susimeire Gomes, Akinori Uchiyama, Marcelo B P Amato, Brian P Kavanagh, Yuji Fujino
RATIONALE: Spontaneous breathing during mechanical ventilation increases transpulmonary pressure and tidal volume, and worsens lung injury. Intuitively, controlling tidal volume and transpulmonary pressure might limit injury from added spontaneous effort. OBJECTIVES: To test the hypothesis that during spontaneous effort in injured lungs, tidal volume and transpulmonary pressure limitation by volume-controlled ventilation results in less injurious patterns of inflation...
February 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28209175/effectiveness-of-topical-silicone-gel-and-pressure-garment-therapy-for-burn-scar-prevention-and-management-in-children-study-protocol-for-a-randomised-controlled-trial
#2
Jodie Wiseman, Megan Simons, Roy Kimble, Robert Ware, Steven McPhail, Zephanie Tyack
BACKGROUND: Abnormal scar development following burn injury can cause substantial physical and psychological distress to children and their families. Common burn scar prevention and management techniques include silicone therapy, pressure garment therapy, or a combination of both. Currently, no definitive, high-quality evidence is available for the effectiveness of topical silicone gel or pressure garment therapy for the prevention and management of burn scars in the paediatric population...
February 16, 2017: Trials
https://www.readbyqxmd.com/read/28194393/resection-osteotomy-for-calcaneus-flattening-after-micro-surgical-flap-technical-note
#3
Mário Yoshihide Kuwae, Edegmar Nunes Costa, Ricardo Pereira da Silva, Alexandre Daher Albieri, Frederico Barra de Moraes
An open fracture of the calcaneus with loss of substance is a challenging injury and requires specialized care, involves high costs, and demands attention despite its lower incidence. The main complications are osteomyelitis, pressure ulcers, and fistulas, as well as pain conditions in the lateral, medial, and plantar regions. This is due to the wide loss of tissue and the change in anatomical conformation of the calcaneus in some cases. However, in cases of flattening of the calcaneus bone, these complications may be prevented or treated successfully...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28193605/potential-deaths-averted-and-serious-adverse-events-incurred-from-adoption-of-the-sprint-intensive-blood-pressure-regimen-in-the-u-s-projections-from-nhanes
#4
Adam P Bress, Holly Kramer, Rasha Khatib, Srinivasan Beddhu, Alfred K Cheung, Rachel Hess, Vinod K Bansal, Guichan Cao, Jerry Yee, Andrew E Moran, Ramon A Durazo-Arvizu, Paul Muntner, Richard S Cooper
Background -The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated a 27% reduction in all-cause mortality with a systolic blood-pressure (SBP) goal of <120 mmHg versus <140 mmHg among U.S. adults at high cardiovascular disease (CVD) risk but without diabetes, stroke, or heart failure. To quantify the potential benefits and risks of SPRINT intensive goal implementation, we estimated the deaths prevented and excess serious adverse events (SAEs) incurred if the SPRINT intensive SBP treatment goal was implemented in all eligible U...
February 13, 2017: Circulation
https://www.readbyqxmd.com/read/28187816/multimodal-neurologic-monitoring
#5
G Korbakis, P M Vespa
Neurocritical care has two main objectives. Initially, the emphasis is on treatment of patients with acute damage to the central nervous system whether through infection, trauma, or hemorrhagic or ischemic stroke. Thereafter, attention shifts to the identification of secondary processes that may lead to further brain injury, including fever, seizures, and ischemia, among others. Multimodal monitoring is the concept of using various tools and data integration to understand brain physiology and guide therapeutic interventions to prevent secondary brain injury...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187804/decompressive-craniectomy-in-acute-brain-injury
#6
D A Brown, E F M Wijdicks
Decompressive surgery to reduce pressure under the skull varies from a burrhole, bone flap to removal of a large skull segment. Decompressive craniectomy is the removal of a large enough segment of skull to reduce refractory intracranial pressure and to maintain cerebral compliance for the purpose of preventing neurologic deterioration. Decompressive hemicraniectomy and bifrontal craniectomy are the most commonly performed procedures. Bifrontal craniectomy is most often utilized with generalized cerebral edema in the absence of a focal mass lesion and when there are bilateral frontal contusions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186167/in-vivo-pharmacological-evaluations-of-pilocarpine-loaded-antioxidant-functionalized-biodegradable-thermogels-in-glaucomatous-rabbits
#7
Shih-Feng Chou, Li-Jyuan Luo, Jui-Yang Lai
To alleviate oxidative stress-induced ocular hypertension, grafting of antioxidant molecules to drug carriers enables a dual-function mechanism to effectively treat glaucomatous intraocular pressure (IOP) dysregulation. Providing potential application for intracameral administration of antiglaucoma medications, this study, for the first time, aims to examine in vivo pharmacological efficacy of pilocarpine-loaded antioxidant-functionalized biodegradable thermogels in glaucomatous rabbits. A series of gallic acid (GA)-grafted gelatin-g-poly(N-isopropylacrylamide) (GN) polymers were synthesized via redox reactions at 20-50 °C...
February 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28182968/measuring-postural-control-during-mini-squat-posture-in-men-with-early-knee-osteoarthritis
#8
M Petrella, K Gramani-Say, P R M S Serrão, G C Lessi, J A Barela, R P Carvalho, S M Mattiello
Studies have suggested a compromised postural control in individuals with knee osteoarthritis (OA) evidenced by larger and faster displacement of center of pressure (COP). However, quantification of postural control in the mini-squat posture performed by patients with early knee OA and its relation to muscle strength and self-reported symptoms have not been investigated. The main aim of this cross-sectional, observational, controlled study was to determine whether postural control in the mini-squat posture differs between individuals with early knee OA and a control group (CG) and verify the relation among knee extensor torque (KET) and self-reported physical function, stiffness and pain...
February 6, 2017: Human Movement Science
https://www.readbyqxmd.com/read/28177542/reduced-prevalence-and-severity-of-wounds-following-implementation-of-the-champions-for-skin-integrity-model-to-facilitate-uptake-of-evidence-based-practice-in-aged-care
#9
Helen E Edwards, Anne M Chang, Michelle Gibb, Kathleen J Finlayson, Christina Parker, Maria O'Reilly, Jan McDowell, Patricia Shuter
AIMS: To evaluate the implementation of the Champions for Skin Integrity Model on facilitating uptake of evidence-based wound management and improving skin integrity in residents of aged care facilities BACKGROUND: The incidence of skin tears, pressure injuries and leg ulcers increases with age and such wounds can be a serious issue in aged care facilities. Older adults are not only at higher risk for wounds related to chronic disease, but also injuries related to falls and manual handling requirements...
February 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28169293/a-latent-structural-equation-model-of-risk-behaviors-and-pressure-ulcer-outcomes-among-people-with-spinal-cord-injury
#10
C Li, N D DiPiro, J Krause
STUDY DESIGN: Cross-sectional. OBJECTIVE: Our purpose was to develop a latent structural model to demonstrate the relationship between factor structures of risk health behaviors and pressure ulcer (PrU) outcomes among participants with spinal cord injury (SCI). SETTING: Data were collected at a large specialty hospital and analyzed at a medical university in the Southeastern USA. METHODS: In total, 1871 participants with traumatic SCI of at least 1-year duration were recruited...
February 7, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28164044/accidental-bolt-gun-injury-to-femur-a-case-report
#11
Ravi Prasad Kattimani, Sanath Shetty, Humayun Mirza
INTRODUCTION: Bolt gun or slaughterer's guns are used in meat industry for "humane killing" of animals. Injuries caused by bolt gun are rare, reported exclusively from central European countries. We report a case of 28 year old male, who accidentally shot himself with a bolt gun to his right thigh. CASE REPORT: A 28 years old male presented to our Accident and Emergency department after accidental injury to his right thigh with bolt gun. He had an entry wound measuring 2 cm in length and 1 cm in breadth over anterior aspect of lower one third of thigh at lower and sustained Grade II compound fracture of right femur shaft at distal one third...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28161027/update-on-traumatic-acute-spinal-cord-injury-part-2
#12
M Mourelo Fariña, S Salvador de la Barrera, A Montoto Marqués, M E Ferreiro Velasco, R Galeiras Vázquez
The aim of treatment in acute traumatic spinal cord injury is to preserve residual neurologic function, avoid secondary injury, and restore spinal alignment and stability. In this second part of the review, we describe the management of spinal cord injury focusing on issues related to short-term respiratory management, where the preservation of diaphragmatic function is a priority, with prediction of the duration of mechanical ventilation and the need for tracheostomy. Surgical assessment of spinal injuries based on updated criteria is discussed, taking into account that although the type of intervention depends on the surgical team, nowadays treatment should afford early spinal decompression and stabilization...
February 1, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28153465/-prevention-and-treatment-of-skin-lesions-associated-with-non-invasive-mechanical-ventilation-recommendations-of-experts
#13
M Raurell-Torredà, A Romero-Collado, M Rodríguez-Palma, M Farrés-Tarafa, J D Martí, B Hurtado-Pardos, L Peñarrubia-San Florencio, P Saez-Paredes, A M Esquinas
INTRODUCTION: In the last two decades, non-invasive mechanical ventilation (NIV) has been consolidated as an initial strategy for the management of respiratory failure in critical adult and paediatric patients. OBJECTIVES: To identify risk factors and preventive strategies to reduce the incidence of skin lesions associated with clinical devices (LESADIC) related to NIV, as well as the most effective treatment for injuries that cannot be avoided. METHODOLOGY: Review in the MEDLINE, CINAHL and Cochrane databases of studies published in the last 10years to reach consensus through an expert panel...
January 30, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28151965/prevention-of-contrast-induced-acute-kidney-injury-in-patients-undergoing-cardiovascular-procedures-a-systematic-review-and-network-meta-analysis
#14
Eliano P Navarese, Paul A Gurbel, Felicita Andreotti, Michalina Marta Kołodziejczak, Suetonia C Palmer, Sofia Dias, Antonino Buffon, Jacek Kubica, Mariusz Kowalewski, Tomasz Jadczyk, Michał Laskiewicz, Marek Jędrzejek, Maximillian Brockmeyer, Flavio Airoldi, Marinella Ruospo, Stefano De Servi, Wojciech Wojakowski, Christopher O' Connor, Giovanni F M Strippoli
BACKGROUND: Interventional diagnostic and therapeutic procedures requiring intravascular iodinated contrast steadily increase patient exposure to the risks of contrast-induced acute kidney injury (CIAKI), which is associated with death, nonfatal cardiovascular events, and prolonged hospitalization. The aim of this study was to investigate the efficacy of pharmacological and non-pharmacological treatments for CIAKI prevention in patients undergoing cardiovascular invasive procedures with iodinated contrast...
2017: PloS One
https://www.readbyqxmd.com/read/28151837/pressure-mapping-in-elderly-care-a-tool-to-increase-pressure-injury-knowledge-and-awareness-among-staff
#15
Lisa Hultin, Estrid Olsson, Cheryl Carli, Lena Gunningberg
PURPOSE: The purpose of this study was to evaluate the use of a pressure mapping system with real-time feedback of pressure points in elderly care, with specific focus on pressure injury (PI) knowledge/attitudes (staff), interface pressure, and PI prevention activities (residents). DESIGN: Descriptive, 1-group pretest/posttest study. SUBJECTS AND SETTING: A convenience sample of 40 assistant nurses and aides participated in the study; staff members were recruited at daytime, and 1 nighttime meeting was held at the facility...
February 1, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28149410/the-importance-of-postural-control-in-relation-to-technical-abilities-in-small-sided-soccer-games
#16
Çağlar Edis, Faik Vural, Hikmet Vurgun
Making assessments regarding postural control and balance is very important for injury prevention in soccer. However, there has been no study that has associated postural control variables with branch-specific technical properties in a game. The aim of the present study was to determine the relationships between variables designating postural control levels and technical performance variables in different (1:1, 2:2 and 3:3) small-sided games (SSGs). Sixteen trained male amateur soccer players volunteered to take part in the study (age 17...
December 1, 2016: Journal of Human Kinetics
https://www.readbyqxmd.com/read/28146639/fifty-years-of-research-in-ards-setting-positive-end-expiratory-pressure-in-the-acute-respiratory-distress-syndrome
#17
Sarina K Sahetya, Ewan C Goligher, Roy G Brower
Positive end-expiratory pressure (PEEP) has been utilized during mechanical ventilation since the first description of the acute respiratory distress syndrome (ARDS). In the subsequent decades, many different strategies for optimally titrating PEEP have been proposed. Higher PEEP can improve arterial oxygenation, reduce tidal lung stress and strain, and promote more homogenous ventilation by preventing alveolar collapse at end expiration. However, PEEP may also cause circulatory depression and contribute to ventilator-induced lung injury through alveolar overdistention...
February 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28141600/preventing-pressure-injuries-in-neonates-undergoing-therapeutic-hypothermia-for-hypoxic-ischemic-encephalopathy-an-interprofessional-quality-improvement-project
#18
Alexandra Luton, Jae Hernandez, Clive Robert Patterson, Jill Nielsen-Farrell, Anita Thompson, Jeffrey R Kaiser
BACKGROUND: Hospital-acquired pressure injuries (HAPIs) can be caused by multiple factors including pressure, shear, friction, moisture/incontinence, device-related pressure, immobility, inactivity, and nutritional deficits. Along with immobility, medical device-related (MDR) HAPIs are a primary cause of pressure injury in neonates, as the clinical practice setting has become increasingly technologically advanced. It is estimated that up to 50% of HAPIs are MDR in pediatric patients. Neonates are at particular risk for HAPI because of their specific anatomical, physiological, and developmental vulnerabilities...
January 30, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28132546/needle-free-devices-keeping-the-system-closed
#19
Linda J Kelly, Tracey Jones, Stephanie Kirkham
Health professionals are under increasing pressure to reduce costs while ensuring patient safety. As the number of vascular access devices (VADs) used in health care continues to increase, there is a need to reduce the complications of infection and occlusion associated with them. Needle-free devices (NFDs), also known as needleless connectors, have been available since the early 1990s and the type and variety of these devices has continued to develop. As well as the original aim of NFDs to maintain a closed system and to reduce the risk of needlestick injuries and blood spillage, NFDs are now designed with the aim of improving clinical outcomes by reducing the common complications of infection and catheter occlusion...
January 26, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28125935/atraumatic-spine-distraction-induces-metabolic-distress-in-spinal-motor-neurons
#20
Jennifer Elizabeth Bell, Jennifer L Seifert, Eileen Nicole Shimizu, Daniel J Sucato, Mario Romero-Ortega
Correction forces during spine deformity surgery including distraction, impart significant stresses to the spinal cord, which may result in permanent injury. Intraoperative neuromonitoring (IONM) is commonly used by surgeons to recognize possible damage to the spinal cord in cases of evident traumatic or vascular damage to the spinal cord. However, mild insult to the spinal cord, which does not result in obvious trauma or electrophysiological changes, present a major clinical challenge as the mechanisms of this type of spinal cord injury (SCI) remain largely unknown, and thus preventive strategies are lacking...
January 26, 2017: Journal of Neurotrauma
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