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https://www.readbyqxmd.com/read/28743153/-how-much-alarm-can-the-human-being-tolerate
#1
Benedikt Lorenz, Jürgen Peters, Ulrich H Frey
Due to growing technisation of intensive care the number of devices with integrated alarm systems is steadily increasing. However, most of the sounding alarms are false alarms causing high levels of frustration, aggression and inappropriate behaviour amongst the medical personnel. All this jeopardises patient care. The high number of alarms also disturb the patients interrupting their sleep and provokes anxiety, and also increases the already high noise level in intensive care units and the operating theatre alike...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743147/-development-of-anaesthesia-related-mortality-and-impact-on-perioperative-outcome
#2
Peter Rosenberger, Berthold Drexler
Achievements in anaesthesiology form the basis for the tremendous development of surgical therapy. Reliable monitoring technology, which is scrutinized on a regular basis using checklists, is allowing anaesthesia at the borders of physiology. During the last decades, anaesthesia-related mortality has been decreasing considerably. Well-trained anaesthesiology staff, who considers patient- and procedure-specific risks in anaesthetic management, is of major importance. Furthermore, postoperative care in specialised units and intensive care wards is a key factor of improved patient outcome after surgery...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743102/incidence-of-delirium-after-cardiac-surgery-protocol-for-the-delirium-cs-canada-cross-sectional-cohort-study
#3
(no author information available yet)
BACKGROUND: Delirium is a recognized complication of cardiac surgery and is the focus of increasing attention owing to its negative effect on postoperative outcomes. However, little is known about the actual incidence of delirium following cardiac surgery, with published rates ranging widely, from 3%-78%. We describe the protocol for the DELIRIUM-CS Canada study, which will use validated and easily implementable bedside tools to determine the incidence of postoperative delirium in a contemporary cardiac surgery population...
July 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28742911/targeted-temperature-management-for-48-vs-24-hours-and-neurologic-outcome-after-out-of-hospital-cardiac-arrest-a-randomized-clinical-trial
#4
Hans Kirkegaard, Eldar Søreide, Inge de Haas, Ville Pettilä, Fabio Silvio Taccone, Urmet Arus, Christian Storm, Christian Hassager, Jørgen Feldbæk Nielsen, Christina Ankjær Sørensen, Susanne Ilkjær, Anni Nørgaard Jeppesen, Anders Morten Grejs, Christophe Henri Valdemar Duez, Jakob Hjort, Alf Inge Larsen, Valdo Toome, Marjaana Tiainen, Johanna Hästbacka, Timo Laitio, Markus B Skrifvars
Importance: International resuscitation guidelines recommend targeted temperature management (TTM) at 33°C to 36°C in unconscious patients with out-of-hospital cardiac arrest for at least 24 hours, but the optimal duration of TTM is uncertain. Objective: To determine whether TTM at 33°C for 48 hours results in better neurologic outcomes compared with currently recommended, standard, 24-hour TTM. Design, Setting, and Participants: This was an international, investigator-initiated, blinded-outcome-assessor, parallel, pragmatic, multicenter, randomized clinical superiority trial in 10 intensive care units (ICUs) at 10 university hospitals in 6 European countries...
July 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28742815/il33-mediated-ilc2-activation-and-neutrophil-il5-production-in-the-lung-response-after-severe-trauma-a-reverse-translation-study-from-a-human-cohort-to-a-mouse-trauma-model
#5
Jing Xu, Jesse Guardado, Rosemary Hoffman, Hui Xu, Rami Namas, Yoram Vodovotz, Li Xu, Mostafa Ramadan, Joshua Brown, Heth R Turnquist, Timothy R Billiar
BACKGROUND: The immunosuppression and immune dysregulation that follows severe injury includes type 2 immune responses manifested by elevations in interleukin (IL) 4, IL5, and IL13 early after injury. We hypothesized that IL33, an alarmin released early after tissue injury and a known regulator of type 2 immunity, contributes to the early type 2 immune responses after systemic injury. METHODS AND FINDINGS: Blunt trauma patients admitted to the trauma intensive care unit of a level I trauma center were enrolled in an observational study that included frequent blood sampling...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742783/end-expiratory-occlusion-test-predicts-fluid-responsiveness-in-patients-with-protective-ventilation-in-the-operating-room
#6
Matthieu Biais, Mathilde Larghi, Jeremy Henriot, Hugues de Courson, Musa Sesay, Karine Nouette-Gaulain
BACKGROUND: End-expiratory occlusion test (EEOT) has been proposed to predict fluid responsiveness in mechanically ventilated intensive care unit patients. The utility of this test during low-tidal-volume ventilation remains uncertain. This study aimed to determine whether hemodynamic variations induced by EEOT could predict the effect of volume expansion in patients with protective ventilation in the operating room. METHODS: Forty-one patients undergoing neurosurgery were included...
July 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742779/a-novel-method-of-evaluating-key-factors-for-success-in-a-multifaceted-critical-care-fellowship-using-data-envelopment-analysis
#7
Vikram Tiwari, Avinash B Kumar
BACKGROUND: The current system of summative multi-rater evaluations and standardized tests to determine readiness to graduate from critical care fellowships has limitations. We sought to pilot the use of data envelopment analysis (DEA) to assess what aspects of the fellowship program contribute the most to an individual fellow's success. DEA is a nonparametric, operations research technique that uses linear programming to determine the technical efficiency of an entity based on its relative usage of resources in producing the outcome...
July 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742757/concurrent-validity-and-responsiveness-of-promis-health-domains-among-patients-presenting-for-anterior-cervical-spine-surgery
#8
Taylor E Purvis, Elena Andreou, Brian J Neuman, Lee H Riley, Richard L Skolasky
STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine validity and responsiveness of Patient-Reported Outcomes Measurement Information System (PROMIS) health domains. SUMMARY OF BACKGROUND DATA: PROMIS health domains (anxiety, depression, fatigue, pain, physical function, satisfaction with participation in social roles, sleep disturbance) may measure quality of care and determine minimal important differences (MIDs) after spine surgery...
July 24, 2017: Spine
https://www.readbyqxmd.com/read/28742736/comparative-analysis-of-perioperative-outcomes-using-nationally-derived-hospital-discharge-data-relative-to-a-prospective-multicenter-surgical-database-of-adult-spinal-deformity-surgery
#9
Gregory W Poorman, Peter G Passias, Aaron J Buckland, Cyrus M Jalai, Michael Kelly, Daniel M Sciubba, Brian J Neuman, D Kojo Hamilton, Amit Jain, Bassel Diebo, Virginie Lafage, Shay Bess, Eric O Klineberg
STUDY DESIGN: Retrospective analysis of three prospectively collected databases. OBJECTIVE: To compare perioperative outcomes in Adult Spinal Deformity (ASD) surgeries in a surgeon-run (SR-ASD) and two national databases: the Nationwide Inpatient Sample (NIS) and the National Surgical Quality Improvement Program (NSQIP). SUMMARY OF BACKGROUND DATA: Much has been learned on the treatment of ASD in the last decade with prospective multicenter collaborative research focusing on this specific condition...
August 1, 2017: Spine
https://www.readbyqxmd.com/read/28742515/do-exercises-improve-back-pain-in-pregnancy
#10
Muhammad Azrai Abu, Nur Azurah Abdul Ghani, Lim Pei Shan, Aqmar Suraya Sulaiman, Mohd Hashim Omar, Mohd Hisam Muhamad Ariffin, Azmi Baharuddin, Shuhaila Shohaimi, Zuraidah Che Man
Objective To assess the efficacy of an exercise program towards reducing back pain in pregnant women. Methods In this prospective control study, 145 low risk pregnant women who scored more than 20 for functional limitation assessment were recruited. The severity of back pain was assessed using the visual analoque scale (VAS) and the functional limitation was assessed using the Oswestry disability questionnaire (ODQ). All participants were informed of back care measures and provided with Paracetamol as an adjunct analgesia...
July 25, 2017: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/28742105/long-term-risk-of-dementia-after-acute-respiratory-failure-requiring-intensive-care-unit-admission
#11
Chih-Cheng Lai, Chung-Han Ho, Chin-Ming Chen, Shyh-Ren Chiang, Chien-Ming Chao, Wei-Lun Liu, Yu-Chieh Lin, Jhi-Joung Wang, Kuo-Chen Cheng
This retrospective, population-based cohort study aims to investigate the long-term risk of newly diagnosed dementia in patients discharged for acute respiratory failure that required mechanical ventilation (MV) and intensive care unit (ICU) admission. From the Taiwan National Health Insurance Research Database, first-time ICU patients using MV between June 1, 1998, and December 31, 2012, were enrolled, and they were followed-up until the earliest onset of one of our two endpoints: a new diagnosis of dementia (primary endpoint), or the end of the study...
2017: PloS One
https://www.readbyqxmd.com/read/28741665/remote-ischemic-preconditioning-and-clinical-outcomes-in-on-pump-coronary-artery-bypass-grafting-a-meta-analysis-of-14-randomized-controlled-trials
#12
Bin Yi, Jianhui Wang, Dingwu Yi, Yanling Zhu, Yumei Jiang, Yi Li, Shaoyan Mo, Yi Liu, Jian Rong
The purpose of this article is to perform the first pooled analysis on remote ischemic preconditioning (RIPC) used for the improvement of clinical outcomes of patients only undergoing on-pump coronary artery bypass grafting (CABG) in randomized controlled trials (RCTs). A systematic search was performed using PubMed, the Cochrane Library, and the Web of Science to identify studies that described the effect of RIPC on postoperative mortality in patients only undergoing on-pump CABG. The outcomes included postoperative mortality, postoperative morbidity (including incidence of myocardial infarction, atrial fibrillation, stroke, acute kidney injury, and renal replacement therapy), mechanical ventilation (MV), intensive care unit length of stay (ICU LOS), and hospital length of stay (HLOS)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28741102/the-range-of-neurological-complications-in-chikungunya-fever
#13
T Cerny, M Schwarz, U Schwarz, J Lemant, P Gérardin, E Keller
BACKGROUND: Chikungunya fever is a globally spreading mosquito-borne disease that shows an unexpected neurovirulence. Even though the neurological complications have been a major cause of intensive care unit admission and death, to date, there is no systematic analysis of their spectrum available. OBJECTIVE: To review evidence of neurological manifestations in Chikungunya fever and map their epidemiology, clinical spectrum, pathomechanisms, diagnostics, therapies and outcomes...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28740960/prognostic-factors-in-patients-with-acute-mesenteric-ischemia
#14
Doğan Yıldırım, Adnan Hut, Cihad Tatar, Turgut Dönmez, Muzaffer Akıncı, Mehmet Toptaş
OBJECTIVE: Acute mesenteric ischemia, one of the causes of acute abdominal pain due to occlusion of the superior mesenteric artery, has a fatal course as a result of intestinal necrosis. There is no specific laboratory test to diagnose acute mesenteric ischemia. The basis of treatment in cases of acute mesenteric ischemia is composed of early diagnosis, resection of intestinal sections with infarction, regulation of intestinal blood flow, second look laparotomy when required, and intensive care support...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28740958/the-outcomes-of-intestinal-resection-during-debulking-surgery-for-ovarian-cancer
#15
Serdar Gökay Terzioğlu, Murat Özgür Kılıç, Nilüfer Çetinkaya, Eralp Baser, Tayfun Güngör, Cevdet Adıgüzel
OBJECTIVE: To evaluate the clinical and surgical outcomes of intestinal resection during primary debulking surgery for ovarian cancer. MATERIAL AND METHODS: This retrospective study was conducted at Zekai Tahir Burak Women's Health Training and Research Hospital between 2009 and 2013. The patients who underwent intestinal resection during debulking surgery for stage 3 ovarian cancer were included in the analysis. Data regarding patient age, body mass index, tumor histology, disease stage, the site of intestinal resection, all postoperative complications, duration of intensive care unit admission and hospital stay were collected and analyzed...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28740850/the-role-of-dog-population-management-in-rabies-elimination-a-review-of-current-approaches-and-future-opportunities
#16
REVIEW
Louise H Taylor, Ryan M Wallace, Deepashree Balaram, Joann M Lindenmayer, Douglas C Eckery, Beryl Mutonono-Watkiss, Ellie Parravani, Louis H Nel
Free-roaming dogs and rabies transmission are integrally linked across many low-income countries, and large unmanaged dog populations can be daunting to rabies control program planners. Dog population management (DPM) is a multifaceted concept that aims to improve the health and well-being of free-roaming dogs, reduce problems they may cause, and may also aim to reduce dog population size. In theory, DPM can facilitate more effective rabies control. Community engagement focused on promoting responsible dog ownership and better veterinary care could improve the health of individual animals and dog vaccination coverage, thus reducing rabies transmission...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28740714/aortic-valve-replacement-in-patients-with-a-left-ventricular-ejection-fraction-%C3%A2-35-performed-via-a-minimally-invasive-right-thoracotomy
#17
Orlando Santana, Steve Xydas, Roy F Williams, Angelo La Pietra, Maurice Mawad, Vicente Behrens, Esteban Escolar, Christos G Mihos
BACKGROUND: We evaluated the outcomes of patients with aortic valve pathology in the setting of a left ventricular ejection fraction ≤35% who underwent minimally invasive aortic valve replacement (AVR), with or without concomitant mitral valve (MV) surgery. METHODS: All minimally invasive AVR in patients with a left ventricular ejection fraction ≤35%, performed via a right thoracotomy for aortic stenosis or regurgitation between January 2009 and March 2013, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740712/hybrid-approach-of-percutaneous-coronary-intervention-followed-by-minimally-invasive-mitral-valve-surgery-a-5-year-single-center-experience
#18
Orlando Santana, Steve Xydas, Roy F Williams, Maurice Mawad, Todd B Heimowitz, Andrés M Pineda, Howard S Goldman, Christos G Mihos
BACKGROUND: The current study evaluated the safety and feasibility of staged ("hybrid") percutaneous coronary intervention (PCI) followed by isolated minimally invasive mitral valve (MV) surgery [PCI + minimally invasive mitral valve surgery (MIMVS)], for patients with concomitant coronary artery and MV disease. METHODS: A total of 93 patients who underwent PCI + MIMVS for coronary artery and MV disease between February 2009 and April 2014 were retrospectively analyzed...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740710/percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-compared-with-median-sternotomy-coronary-artery-bypass-graft-and-valve-surgery-in-patients-with-prior-cardiac-surgery
#19
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Jason C Wigley, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients with prior cardiac surgery requiring re-operative coronary and valve surgery, a hybrid approach of percutaneous coronary intervention followed by minimally invasive valve surgery (PCI + MIVS) may be an alternative to the standard median sternotomy coronary artery bypass and valve surgery (CABG + valve). METHODS: The outcomes of patients with prior cardiac surgery, presenting with coronary artery and valvular disease, who underwent PCI + MIVS (N=39) were retrospectively compared with those who underwent CABG + valve (N=28) via a repeat median sternotomy, between February 2009 and April 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740685/minimally-invasive-aortic-valve-replacement-in-high-risk-patient-groups
#20
REVIEW
Daniel Fudulu, Harriet Lewis, Umberto Benedetto, Massimo Caputo, Gianni Angelini, Hunaid A Vohra
Minimally invasive aortic valve replacement (AVR) aims to preserve the sternal integrity and improve postoperative outcomes. In low risk patients, this technique can be achieved with comparable mortality to the conventional approach and there is evidence of possible reduction in intensive care and hospital length of stay, transfusion requirement, renal dysfunction, improved respiratory function and increased patient satisfaction. In this review, we aim to asses if these benefits can be transferred to the high risk patient groups...
June 2017: Journal of Thoracic Disease
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