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Nophanan Chaikittisilpa, Abhijit V Lele, Vivian H Lyons, Bala G Nair, Shu-Fang Newman, Patricia A Blissitt, Monica S Vavilala
BACKGROUND: Current guidelines recommend routine clamping of external ventricular drains (EVD) for intrahospital transport (IHT). The aim of this project was to describe intracranial hemodynamic complications associated with routine EVD clamping for IHT in neurocritically ill cerebrovascular patients. METHODS: We conducted a retrospective review of cerebrovascular adult patients with indwelling EVD admitted to the neurocritical care unit (NICU) during the months of September to December 2015 at a tertiary care center...
October 18, 2016: Neurocritical Care
(no author information available yet)
Equal Competency between emergency staff working in pre-hospital and intrahospital en vi -ron ments has been stressed by the National Board of Health and Welfare in Sweden, with appropriately trained ambulance nurses seen as key in providing a good standard of prehospital emergency care (PHEC).
October 1, 2000: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Ioannis Vogiatzis, Irena Dapcevic, Antonis Datsios, Kostas Koutsambasopoulos, Argirios Gontopoulos, Savas Grigoriadis
INTRODUCTION: The propeptide of brain natriuretic peptide (ProBNP) is used for the diagnosis of left ventricle dysfunction and heart failure. In patients with an Acute Coronary Syndrome (ACS) it can contribute to both short and long term prognosis of cardiovascular events that could be very important for management and therapy of these patients. AIM: The aim of this study was to evaluate the prognostic value of ProBNP for the clinical course after an acute coronary syndrome, compared with that of cardiac troponine T (cTnT) and the risk stratification of patients with acute coronary syndrome, both during hospitalization and six months later...
July 27, 2016: Medical Archives
M M Harish, S Janarthanan, Suhail Sarwar Siddiqui, Harish K Chaudhary, Natesh R Prabu, Jigeeshu V Divatia, Atul Prabhakar Kulkarni
BACKGROUND: The transport of critically ill patients for procedures or tests outside the Intensive Care Unit (ICU) is potentially hazardous; hence, the transport process must be organized and efficient. Plenty of data is available on pre- and inter-hospital transport of patients; the data on intrahospital transport of patients are limited. We audited the complications and benefits of intrahospital transport of critically ill patients in our tertiary care center over 6 months. MATERIALS AND METHODS: One hundred and twenty adult critically ill cancer patients transported from the ICU for either diagnostic or therapeutic procedure over 6 months were included...
August 2016: Indian Journal of Critical Care Medicine
Mathieu Martin, Fabrice Cook, David Lobo, Charlotte Vermersch, Arié Attias, Bouziane Ait-Mamar, Benoît Plaud, Roman Mounier, Gilles Dhonneur
BACKGROUND: Our aim was to assess the occurrence of secondary insults (SIs) or adverse events (AEs) during intrahospital transport (IHT) of severe traumatic brain injury (TBI) patients for head computed tomography (CT) scanning. METHODS: A prospective study based on severe TBI patients admitted from June 2011 through June 2013 in a level I trauma center. Patients received an IHT to perform a control CT scan in the first 3 days following trauma. The occurrence of SIs and AEs was assessed during the IHT for a control CT scan...
September 6, 2016: Neurocritical Care
Xavier Armoiry, Jean-François Obadia, Bernard Iung, Stephanie Polazzi, Antoine Duclos
OBJECTIVES: To describe the clinical outcomes of patients undergoing transcatheter aortic valve implantation (TAVI) and to determine the direct costs before and after TAVI. METHODS: A nationwide longitudinal study using data extracted from the French Hospital Information System. SELECTION CRITERIA: all patients who underwent TAVI between 1 January 2010 and 31 December 2010. Period of follow-up: 12 months preceding TAVI to 36 months after. End-points: mortality, morbidity and total costs of acute and rehabilitation care from the perspective of the hospital...
September 5, 2016: Interactive Cardiovascular and Thoracic Surgery
Li-Hsin Chang, Liang-Yu Lin, Ming-Tsun Tsai, Chorng-Kuang How, Jen-Huai Chiang, Vivian Chia-Rong Hsieh, Sung-Yuan Hu, Ming-Shun Hsieh
OBJECTIVE: Hyperglycaemic crisis was associated with significant intrahospital morbidity and mortality. However, the association between hyperglycaemic crisis and long-term cardiovascular outcomes remained unknown. This study aimed to investigate the association between hyperglycaemic crisis and subsequent long-term major adverse cardiovascular events (MACEs). PARTICIPANTS AND METHODS: This population-based cohort study was conducted using data from Taiwan's National Health Insurance Research Database for the period of 1996-2012...
2016: BMJ Open
Gavin McCluskey, Carrie Wade, Jacqueline McKee, Peter McCarron, Ferghal McVerry, Mark O McCarron
BACKGROUND: Little is known of the impact of stroke laterality on the management process and outcome of patients with acute ischemic stroke (AIS). METHODS: Consecutive patients admitted to a general hospital over 1 year with supratentorial AIS were eligible for inclusion in the study. Baseline characteristics and risk factors, delays in hospital admission, imaging, intrahospital transfer to an acute stoke unit, stroke severity and classification, length of hospital admission, as well as 10-year mortality were measured and compared among right and left hemisphere AIS patients...
August 8, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
I I Berisavac, V V Padjen, M D Ercegovac, Lj G Beslać-Bumbaširević, P Dj Stanarčević, M S Stefanović-Budimkić, M M Radović, D R Jovanović
OBJECTIVES: Sepsis associated encephalopathy (SAE) represents a diffuse and/or multifactorial cerebral dysfunction during response to systemic infection. Study aim was to compare clinical and electroencephalogram (EEG) characteristics and intrahospital survival rate among SAE patients. PATIENTS AND METHODS: A prospective study, during 42 months' period, included 39 SAE patients assigned in two groups according the outcome (survival: 19, and death: 20 patients). All the patients' features were registered: demography, neurological status, infection type, seizure appearance, brain computerized tomography (CT), EEG, EEG reactivity, Glasgow Coma Score (GCS) and Acute Physiology and Chronic Health Evaluation II (APACHE II) Score...
September 2016: Clinical Neurology and Neurosurgery
Snezana Brkic, Rinaldo Pellicano, Vesna Turkulov, Marija Radovanovic, Ludovico Abenavoli
BACKGROUND: Clostridium difficile (C. difficile) diarrhea is a common, iatrogenic, nosocomial disease with a worldwide diffusion. Recent studies reported that the incidence of C. difficile infection (CDI) is rising, due to aging of the population and to greater prevalence of hypervirulent strains. We investigated whether the application of a prevention program lead to a decline in the incidence of intrahospital CDI. METHODS: The study was designed as observational, to compare the efficacy of Schülke preventive program with the standard protocols, in a period of 4 months...
June 2016: Minerva Medica
Neil B Davids
Over the past 14 years of conflict, the Department of Defense medical community has made significant strides in patient care. As the conflicts developed, many sources identified a critical gap in en route care, specifically the need for critical care trained personnel for point of injury and intrahospital transfers, as well as improved outcomes for patients who received care from critical care trained providers. As stopgap measures were implemented, the US Army instituted the Critical Care Flight Paramedic Program in order to meet this need of life saving critical care transport...
April 2016: U.S. Army Medical Department Journal
M A Kornienko, V N Kopyltsov, N V Shevlyagina, L V Didenko, L A Lyubasovskaya, T V Priputnevich, E N Ilina
The urgency of the staphylococcus research is due to its ability to cause severe infections: softtissue infections, endocarditis, sepsis, toxic shock syndrome, and food poisoning. Coagulase-positive Staphylococcus aureus is the main infection agent of intrahospital infections. This agent has many factors of pathogenicity, which are well known. Among the coagulase-negative staphylococcus (CNS) strains, S. haemolyticus and S. epidermidis are clinically important, because they cause infections in patients with weak immune system...
2016: Molekuliarnaia Genetika, Mikrobiologiia i Virusologiia
Alex Trofimov, George Kalentiev, Michail Yuriev, Vladislav Pavlov, Vera Grigoryeva
AIM: To assess the dynamic of intracranial pressure (ICP), cerebral perfusion pressure (CPP), and dynamic pressure reactivity index (PRx) during intrahospital transport. MATERIALS AND METHODS: There were 33 comatose patients with severe traumatic brain injury (TBI). The mean age was 36.3 ± 4.8 years (range 19-45 years), and there were 17 men and 16 women. The median Glasgow Coma Scale score at admission was 6.2 ± 0.7. Computed tomography (CT) included native CT, perfusion CT, and CT angiography...
2016: Acta Neurochirurgica. Supplement
J Kleffmann, R Pahl, W Deinsberger, A Ferbert, C Roth
BACKGROUND: Intrahospital transport is associated with a high rate of complications. Investigations of this problem using neuromonitoring remain scarce. METHODS: This is a monocentric, prospective observational study. Patients with severe brain diseases and intracranial pressure (ICP) monitoring were included. Continuous monitoring of ICP, cerebral perfusion pressure (CPP), oxygen saturation (SpO2), heart rate, and mean arterial pressure was measured during seven different periods of intrahospital transport (baseline for 30 min, I = preparation, II = transport I, III = CT scan, IV = transport II, V = postprocessing, and follow-up for another 30 min)...
May 3, 2016: Neurocritical Care
A Koscielny, M Kühnel, F Verrel, J C Kalff
Introduction: Although the perioperative management has been optimised over the past few decades, there has not been a remarkable improvement in the mortality rates of patients with a ruptured abdominal aortic aneurysm (rAAA). The aim of this retrospective trial was to define pre-, intra- and postoperative parameters which influence the perioperative and long-term outcome of patients and which can be modified by the operating team. Methods: A retrospective database analysis was performed in 49 patients who had undergone an operation of rAAA in our certified centre of vascular surgery between the beginning of 2006 and the end of 2012...
May 2, 2016: Zentralblatt Für Chirurgie
Zied Hajjej, Hedi Gharsallah, Ines Boussaidi, Mayssa Daiki, Iheb Labbene, Mustapha Ferjani
BACKGROUND: Mishaps are common during transport and may have major impacts on patients. AIMS: The main objectives of our study are: first to determine the incidence of complications during intra hospital transports (IHT) of critically ill patients, and second, to determine their risk factors. METHODS: All intra hospital transports for diagnostic and therapeutic purposes of patients consecutively admitted in an 18-bed medical surgical intensive care unit in an university hospital, have been studied prospectively during a period of six months (September 1st 2012 to February 28th 2013)...
November 2015: La Tunisie Médicale
Thomas J Sandora, Monica Fung, Patrice Melvin, Dionne A Graham, Shawn J Rangel
IMPORTANCE: Appropriate use of surgical antibiotic prophylaxis (AP) reduces surgical site infection rates, but prior data suggest variability in use patterns. OBJECTIVE: To assess national variability and appropriateness of AP in pediatric surgical patients. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 31 freestanding children's hospitals in the United States using administrative data from 2010-2013. The study included 603 734 children younger than 18 years who underwent one of the 45 most commonly performed operations...
June 1, 2016: JAMA Pediatrics
Honey M Jones, Michael E Zychowicz, Mary Champagne, Deirdre K Thornlow
BACKGROUND: Intrahospital transport of the critically ill adult carries inherent risks that can be manifested as unexpected events. OBJECTIVE: The aim of this study is to evaluate the implementation of a standardized evaluation plan for intrahospital transports to/from adult intensive care units. METHODS: Nurses at a level I trauma/academic center captured clinical data throughout transport. Outcome measures included compliance with the organization's transport policy and unexpected events...
May 2016: Dimensions of Critical Care Nursing: DCCN
Christiane Cuny, Lothar H Wieler, Wolfgang Witte
During the past 25 years an increase in the prevalence of methicillin-resistant Staphylococcus aureus (HA-MRSA) was recorded worldwide. Additionally, MRSA infections may occur outside and independent of hospitals, caused by community associated MRSA (CA-MRSA). In Germany, we found that at least 10% of these sporadic infections are due to livestock-associated MRSA (LA-MRSA), which is initially associated with livestock. The majority of these MRSA cases are attributed to clonal complex CC398. LA-MRSA CC398 colonizes the animals asymptomatically in about half of conventional pig farms...
2015: Antibiotics
S O Korohl, I I Zherdev, A M Domanskiy
Experience of medical sorting of 434 injured persons with a gun-shot woundings of extremities in 2014-2015 yrs is adduced. The principles of organization and treatment for medical sorting of wounded persons were elaborated. Prognostic intrahospital, diagnostic and evacuation--transport sorting was introduced in wounded persons in the IV level hospital, concerning severity of traumatic shock and prognosis of their survival.
December 2015: Klinichna Khirurhiia
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