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critical care updates

Arnaud W Thille, Tommaso Mauri, Daniel Talmor
No abstract text is available yet for this article.
March 19, 2018: American Journal of Respiratory and Critical Care Medicine
Kimberly Joseph, Sameer Gupta, James Yon, Renee Partida, Lee Cartagena, John Kubasiak, Vanessa Buie, Jared Miller, Dorion Wiley, Kimberly Nagy, Frederic Starr, Andrew Dennis, Matthew Kaminsky, Faran Bokhari
BACKGROUND: Checklists have been advocated to improve quality outcomes/communication in the critical care setting, but results have been mixed. A new checklist process, "TRAUMA LIFE", was implemented in our Trauma Intensive Care Unit (TICU) to replace prior checklists. The purpose of this study was to evaluate the impact of the "TRAUMA LIFE" process implementation on quality metrics and on patient/family communication in the TICU. METHODS: "TRAUMA LIFE" was considered maturely implemented by 2016...
March 9, 2018: American Journal of Surgery
Karen C Uzark, John M Costello, Holly C DeSena, Ravi Thiagajaran, Melissa Smith-Parrish, Katja M Gist
OBJECTIVES: Pediatric cardiac intensive care continues to evolve, with rapid advances in knowledge and improvement in clinical outcomes. In the past, the Board of Directors of the Pediatric Cardiac Intensive Care Society created and subsequently updated a list of sentinel references focused on the care of critically ill children with congenital and acquired heart disease. The objective of this article is to provide clinicians with a compilation and brief summary of updated and useful references that have been published since 2012...
March 10, 2018: Pediatric Critical Care Medicine
Jeffrey J Pasternak, William L Lanier
We provide a synopsis of innovative research, recurring themes, and novel experimental findings pertinent to the care of neurosurgical patients and critically ill patients with neurological diseases. We cover the following broad topics: general neurosurgery, spine surgery, stroke, traumatic brain injury, monitoring, and anesthetic neurotoxicity.
April 2018: Journal of Neurosurgical Anesthesiology
Chong Sherry Cheever, Celestina Barbosa-Leiker
OBJECTIVE: The aims of this study were to determine the prevalence and describe the importance of alcohol screening for all patients with traumatic brain injury (TBI) and examine the relationship between gender, age, Abbreviated Injury Scale (AIS), emergent decompressive craniectomy, Glasgow Coma Scale (GCS) from the emergency department (ED), and the length of stay with alcohol screening. METHOD: This is a retrospective analysis of de-identified data from the 2012 TBI registry of a level 1 trauma center in the Pacific Northwest...
April 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Wojciech Francuzik, Sabine Dölle, Margitta Worm
Patients experiencing anaphylaxis who do not recover after treatment with intramuscular adrenaline are regarded as suffering from refractory anaphylaxis. The incidence of refractory anaphylaxis is estimated to range between 3-5% of anaphylaxis cases. The risk factors for refractory anaphylaxis are unknown. Areas covered: In the present analysis, we aimed to evaluate the management and risk factors of refractory anaphylaxis to highlight possible clinical implications for updating current management algorithms...
March 7, 2018: Expert Review of Clinical Immunology
Drayton A Hammond, Laura Baumgartner, Craig Cooper, Elisabeth Donahey, Serena A Harris, Jessica M Mercer, Mandy Morris, Mona K Patel, Angela M Plewa-Rusiecki, Alia A Poore, Ryan Szaniawski, Deanna Horner
PURPOSE: To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2017. The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 32 journals monthly for impactful articles and reviewed 115 during 2017. Two meta-analyses and eight original research trials were reviewed here from those included in the monthly CCPLU. Meta-analyses on early, goal-directed therapy for septic shock and statin therapy for acute respiratory distress syndrome were summarized...
February 26, 2018: Journal of Critical Care
Micaela Carwell
Therapeutic hypothermia, also referred to as targeted temperature management, has been a component of the postcardiac arrest treatment guidelines since 2010. Although almost a decade has passed since its inclusion in the postarrest guidelines, many unanswered questions remain regarding selection of the appropriate patient population, optimal target temperature, ideal window of time in which to initiate therapy after arrest, most efficient, safe, and accurate equipment choice for inducing and maintaining hypothermia, most effective duration of treatment, and rate of cooling or rewarming...
April 2018: Critical Care Nursing Quarterly
James J McCarthy, Brendan Carr, Comilla Sasson, Bentley J Bobrow, Clifton W Callaway, Robert W Neumar, Jose Maria E Ferrer, J Lee Garvey, Joseph P Ornato, Louis Gonzales, Christopher B Granger, Monica E Kleinman, Chris Bjerke, Graham Nichol
The American Heart Association previously recommended implementation of cardiac resuscitation systems of care that consist of interconnected community, emergency medical services, and hospital efforts to measure and improve the process of care and outcome for patients with cardiac arrest. In addition, the American Heart Association proposed a national process to develop and implement evidence-based guidelines for cardiac resuscitation systems of care. Significant experience has been gained with implementing these systems, and new evidence has accumulated...
February 26, 2018: Circulation
Mario Ganau, Andrea Lavinio, Lara Prisco
Traumatic brain injury (TBI) is a global public health epidemic. It represents the principal cause of death and disability in individuals under 35 in the United States. In the subacute phase, severe TBI patients who recover consciousness go through a state of agitation and delirium. However, there is only limited research exploring the characteristics of post-traumatic delirium (PTD) although it is likely to be more frequent than in general Intensive Care Unit (ICU) patients. Evidence suggest the incidence of delirium in non-TBI ICU patients is up to 86%...
February 22, 2018: Minerva Anestesiologica
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia Rodgers, James A Russell, Greet Van den Berghe
To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients.
February 23, 2018: Intensive Care Medicine
Sakyajit Bhattacharya, Vijay Huddar, Vaibhav Rajan, Chandan K Reddy
An Acute Hypotensive Episode (AHE) is the sudden onset of a sustained period of low blood pressure and is one among the most critical conditions in Intensive Care Units (ICU). Without timely medical care, it can lead to an irreversible organ damage and death. By identifying patients at risk for AHE early, adequate medical intervention can save lives and improve patient outcomes. In this paper, we design a novel dual-boundary classification based approach for identifying patients at risk for AHE. Our algorithm uses only simple summary statistics of past Blood Pressure measurements and can be used in an online environment facilitating real-time updates and prediction...
2018: PloS One
Lena M Napolitano, Venkatakrishna Rajajee, Kyle J Gunnerson, Michael D Maile, Michael Quasney, Robert C Hyzy
Critical care fellowship training in the United States differs based on specific specialty, and includes medicine, surgery, anesthesiology, pediatrics, emergency medicine and neurocritical care training pathways. We provide an update regarding the number and growth of U.S. critical care fellowship training programs, on-duty residents and certified diplomates, and review the different critical care physician training pathways available to residents interested in pursuing a fellowship in critical care. Data were obtained from the Accreditation Council for Graduate Medical Education (ACGME) and specialty boards [American Board of Internal Medicine (ABIM), American Board of Surgery (ABS), American Board of Anesthesiology (ABA), American Board of Pediatrics (ABP), American Board of Emergency Medicine (ABEM)] and the United Council for Neurologic Subspecialties (UCNS) for the last 16 years (2001-2017)...
February 17, 2018: Journal of Trauma and Acute Care Surgery
Audrey Rankin, Cathal A Cadogan, Cristín Ryan, Barbara Clyne, Susan M Smith, Carmel M Hughes
OBJECTIVES: To develop a core outcome set (COS) for use in effectiveness trials of interventions aiming to improve the appropriateness of polypharmacy in older people in primary care. DESIGN: Standard COS development methodology was followed, comprising identification of outcomes of studies from an update of a Cochrane systematic review and previously collected qualitative data and an online Delphi consensus exercise involving three rounds. PARTICIPANTS: An international panel of 160 stakeholders comprising 120 healthcare experts and a public participant panel of 40 older people...
February 20, 2018: Journal of the American Geriatrics Society
Chris Williams, Andrew Parry
Assisting with tracheal intubation is an aspect of clinical practice that requires knowledge and skill if the procedure is to be carried out in a timely and safe manner. Maintaining this knowledge and skill requires good quality education and regular opportunities to practise. These two factors appear to be inconsistent in critical care units. This article details an audit performed on a large tertiary referral centre critical care unit. It was undertaken in two phases: the first was a self-assessment of knowledge and the second was a practical assessment of the audit subjects in a simulated setting...
February 22, 2018: British Journal of Nursing: BJN
Jillian T Henderson, Elizabeth M Webber, George F Sawaya
Importance: Ovarian cancer is relatively rare but the fifth-leading cause of cancer mortality among United States women. Objective: To systematically review evidence on benefits and harms of ovarian cancer screening among average-risk women to inform the United States Preventive Services Task Force. Data Sources: MEDLINE, PubMed, Cochrane Collaboration Registry of Controlled Trials; studies published in English from January 1, 2003, through January 31, 2017; ongoing surveillance in targeted publications through November 22, 2017...
February 13, 2018: JAMA: the Journal of the American Medical Association
Chiara De Waure, Leuconoe Grazia Sisti, Andrea Poscia, Walter Ricciardi
Italy is witnessing relevant challenges in the field of prevention and control of vaccine-preventable diseases. The worrying and growing phenomenon of "vaccine-hesitancy" has contributed to the reduction of vaccination coverage, undermining goals reached thanks to vaccines introduction. The new Italian National Immunization Plan (NIP) 2017-2019 and the update of the list of Essential Care Levels (LEA), approved in the current year, extend the vaccination offer based on the latest scientific evidence with the introduction of new vaccines and the enlargement of target population...
September 2017: Igiene e Sanità Pubblica
Kevin G Blyth, Daniel J Murphy
Malignant Pleural Mesothelioma (MPM) is currently an incurable cancer with a typical survival of 1 year from the time of diagnosis. The recent genomic and transcriptomic characterization of MPM presents new opportunities and challenges for MPM researchers. Recent advances in clinical and laboratory diagnostics, and proposals for an updated, data-driven, staging system, also present new challenges for clinicians and hospital services involved in MPM care. The aim of this review is first to introduce the reader to the topic of MPM, a disease that is causally linked to prior, typically occupational, exposure to asbestos fibres...
January 2018: Respiratory Medicine
Maimuna Mendy, Rita T Lawlor, Anne Linda van Kappel, Peter H J Riegman, Fay Betsou, Oliver D Cohen, Marianne K Henderson
Biobanks provide a critical infrastructure to support research in human health. Biospecimens and their accompanying data are increasingly needed to support biomedical research and clinical care. The original text was initially published in the Handbook for Cancer Research in Africa. The value of this publication is great as it underlines the importance of biobanks in Africa as a key resource to increase quality scientific research and participate in global health research. Therefore, a revision to extend these principles to other low resource contexts, to include updated material and references and add the topic of biobank sustainability were relevant...
March 2018: Clinics in Laboratory Medicine
Can Ince, E Christiaan Boerma, Maurizio Cecconi, Daniel De Backer, Nathan I Shapiro, Jacques Duranteau, Michael R Pinsky, Antonio Artigas, Jean-Louis Teboul, Irwin K M Reiss, Cesar Aldecoa, Sam D Hutchings, Abele Donati, Marco Maggiorini, Fabio S Taccone, Glenn Hernandez, Didier Payen, Dick Tibboel, Daniel S Martin, Alexander Zarbock, Xavier Monnet, Arnaldo Dubin, Jan Bakker, Jean-Louis Vincent, Thomas W L Scheeren
PURPOSE: Hand-held vital microscopes (HVMs) were introduced to observe sublingual microcirculatory alterations at the bedside in different shock states in critically ill patients. This consensus aims to provide clinicians with guidelines for practical use and interpretation of the sublingual microcirculation. Furthermore, it aims to promote the integration of routine application of HVM microcirculatory monitoring in conventional hemodynamic monitoring of systemic hemodynamic variables...
February 6, 2018: Intensive Care Medicine
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