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https://www.readbyqxmd.com/read/28107491/association-of-in-hospital-mortality-and-dysglycemia-in-septic-patients
#1
Hsiao-Yun Chao, Peng-Hui Liu, Shen-Che Lin, Chun-Kuei Chen, Jih-Chang Chen, Yi-Lin Chan, Chin-Chieh Wu, Gerald N Blaney, Zhen-Ying Liu, Cho-Ju Wu, Kuan-Fu Chen
BACKGROUND: The associations between dysglycemia and mortality in septic patients with and without diabetes are yet to be confirmed. Our aim was to analyze the association of diabetes and sepsis mortality, and to examine how dysglycemia (hyperglycemia, hypoglycemia and glucose variability) affects in-hospital mortality of patients with suspected sepsis in emergency department (ED) and intensive care units. METHODS: Clinically suspected septic patients admitted to ED were included, and stratified into subgroups according to in-hospital mortality and the presence of diabetes...
2017: PloS One
https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#2
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107311/performance-of-international-classification-of-diseases-based-injury-severity-measures-used-to-predict-in-hospital-mortality-and-intensive-care-admission-among-traumatic-brain-injured-patients
#3
Mathieu Gagné, Lynne Moore, Marie-Josée Sirois, Marc Simard, Claudia Beaudoin, Brice Lionel Batomen Kuimi
BACKGROUND: The International Classification of Diseases (ICD) is the main classification system used for population-based traumatic brain injury (TBI) surveillance activities but does not contain direct information on injury severity. International Classification of Diseases-based injury severity measures can be empirically derived or mapped to the Abbreviated Injury Scale, but no single approach has been formally recommended for TBI. OBJECTIVE: The aim of this study was to compare the accuracy of different ICD-based injury severity measures for predicting in-hospital mortality and intensive care unit (ICU) admission in TBI patients...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#4
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28107026/impact-of-mobile-intensive-care-unit-use-on-total-ischemic-time-and-clinical-outcomes-in-st-elevation-myocardial-infarction-patients-real-world-data-from-the-acute-coronary-syndrome-israeli-survey
#5
Edward Koifman, Roy Beigel, Zaza Iakobishvili, Nir Shlomo, Yitschak Biton, Avi Sabbag, Elad Asher, Shaul Atar, Shmuel Gottlieb, Ronny Alcalai, Doron Zahger, Amit Segev, Ilan Goldenberg, Rafael Strugo, Shlomi Matetzky
BACKGROUND: Ischemic time has prognostic importance in ST-elevation myocardial infarction patients. Mobile intensive care unit use can reduce components of total ischemic time by appropriate triage of ST-elevation myocardial infarction patients. METHODS: Data from the Acute Coronary Survey in Israel registry 2000-2010 were analyzed to evaluate factors associated with mobile intensive care unit use and its impact on total ischemic time and patient outcomes. RESULTS: The study comprised 5474 ST-elevation myocardial infarction patients enrolled in the Acute Coronary Survey in Israel registry, of whom 46% ( n=2538) arrived via mobile intensive care units...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28107024/the-host-response-in-sepsis-patients-developing-intensive-care-unit-acquired-secondary-infections
#6
Lonneke A van Vught, Maryse A Wiewel, Arie J Hoogendijk, Jos F Frencken, Brendon P Scicluna, Peter M C Klein Klouwenberg, Aeilko H Zwinderman, Rene Lutter, Janneke Horn, Marcus J Schultz, Marc M J Bonten, Olaf L Cremer, Tom van der Poll
RATIONALE: Sepsis can be complicated by secondary infections. We explored the possibility that sepsis patients developing a secondary infection while in the Intensive Care Unit (ICU) display sustained inflammatory, vascular and procoagulant responses. OBJECTIVE: To compare systemic proinflammatory host responses in patients with sepsis who acquire a new infection with those who do not. METHODS: Consecutive sepsis patients with a length of ICU stay >48 hours were prospectively analyzed for the development of ICU-acquired infections...
January 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28106501/treatment-of-chronic-subdural-hematomas-with-subdural-evacuating-port-system-placement-in-the-intensive-care-unit-evolution-of-practice-and-comparison-with-bur-hole-evacuation-in-the-operating-room
#7
Alexander C Flint, Sheila L Chan, Vivek A Rao, Allen D Efron, Maziyar A Kalani, William F Sheridan
OBJECTIVE The aims of this study were to evaluate a multiyear experience with subdural evacuating port system (SEPS) placement for chronic subdural hematoma (cSDH) in the intensive care unit at a tertiary neurosurgical center and to compare SEPS placement with bur hole evacuation in the operating room. METHODS All cases of cSDH evacuation were captured over a 7-year period at a tertiary neurosurgical center within an integrated health care delivery system. The authors compared the performance characteristics of SEPS and bur hole placement with respect to recurrence rates, change in recurrence rates over time, complications, length of stay, discharge disposition, and mortality rates...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28105858/hplc-ms-ms-method-for-dexmedetomidine-quantification-with-design-of-experiments-approach-application-to-pediatric-pharmacokinetic-study
#8
Oliwia Szerkus, Wiktoria Struck-Lewicka, Marta Kordalewska, Ewa Bartosińska, Renata Bujak, Agnieszka Borsuk, Agnieszk Bienert, Alicja Bartkowska-Śniatkowska, Justyna Warzybok, Paweł Wiczling, Antoni Nasal, Roman Kaliszan, Mchał Jan Markuszewski, Danuta Siluk
AIM: The purpose of this work was to develop and validate a rapid and robust LC-MS/MS method for the determination of dexmedetomidine (DEX) in plasma, suitable for analysis of a large number of samples. METHOD: Systematic approach, Design of Experiments, was applied to optimize ESI source parameters and to evaluate method robustness, therefore, a rapid, stable and cost-effective assay was developed. The method was validated according to US FDA guidelines. LLOQ was determined at 5 pg/ml...
January 20, 2017: Bioanalysis
https://www.readbyqxmd.com/read/28105598/clinical-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine
#9
REVIEW
Maud A S Weerink, Michel M R F Struys, Laura N Hannivoort, Clemens R M Barends, Anthony R Absalom, Pieter Colin
Dexmedetomidine is an α2-adrenoceptor agonist with sedative, anxiolytic, sympatholytic, and analgesic-sparing effects, and minimal depression of respiratory function. It is potent and highly selective for α2-receptors with an α2:α1 ratio of 1620:1. Hemodynamic effects, which include transient hypertension, bradycardia, and hypotension, result from the drug's peripheral vasoconstrictive and sympatholytic properties. Dexmedetomidine exerts its hypnotic action through activation of central pre- and postsynaptic α2-receptors in the locus coeruleus, thereby inducting a state of unconsciousness similar to natural sleep, with the unique aspect that patients remain easily rousable and cooperative...
January 19, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28105408/predictors-of-prolonged-mechanical-ventilation-in-pediatric-patients-after-cardiac-surgery-for-congenital-heart-disease
#10
Avisa Tabib, Seyed Ehsan Abrishami, Mohammad Mahdavi, Hojjat Mortezaeian, Ziae Totonchi
BACKGROUND: The duration of mechanical ventilation (MV) is one of the most important clinical factors which predict outcomes in pediatric cardiac surgery. The prolonged mechanical ventilation (PMV) following cardiac surgery is a multifactorial phenomenon and there are conflicts regarding its predictors in pediatric population between different centers. OBJECTIVES: The current study aimed to describe PMV predictors in patients undergoing cardiac surgery for congenital heart disease in a tertiary center for pediatric cardiovascular diseases in Iran...
August 2016: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28105373/vascular-changes-on-fluorescein-angiography-of-premature-infants-with-low-risk-of-retinopathy-of-prematurity-after-high-oxygen-exposure
#11
Maria Ana Martinez-Castellanos, Raul Velez-Montoya, Kenneth Price, Andree Henaine-Berra, Gerardo García-Aguirre, Virgilio Morales-Canton, Linda Alejandra Cernichiaro-Espinosa
PURPOSE: To describe a wide array of peripheral vascular changes using fluorescein angiography in preterm neonates, without high risk characteristics for developing retinopathy of prematurity, that were exposed to high oxygen concentration. METHODS: Retrospective, two center, case series. Newborns at two different hospitals with ≥1500 g or gestational age of ≥32 weeks, fluorescein angiography performed, and with high oxygen exposure without adequate control were included...
2017: International Journal of Retina and Vitreous
https://www.readbyqxmd.com/read/28104641/measured-head-ct-cta-skin-dose-and-intensive-care-unit-patient-cumulative-exposure
#12
R D Nawfel, G S Young
BACKGROUND AND PURPOSE: Estimates of cumulative CT/CTA radiation dose based on volumetric CT dose index have raised concern that neurological intensive care unit patient exposures may reach thresholds for deterministic skin injury. Because the accuracy of volumetric CT dose index for this purpose in unknown, we set out to directly measure head CT and CTA peak skin dose, assess the relationship of volumetric CT dose index to measured peak skin dose, and determine whether multiple CT/CTA exposures in typical patients in the neurological intensive care unit produce cumulative doses approaching or exceeding single-dose deterministic thresholds for skin injury...
January 19, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28104546/dying-in-intensive-care-units-of-india-commentaries-on-policies-and-position-papers-on-palliative-and-end-of-life-care
#13
REVIEW
Jaydeep Sengupta, Suhita Chopra Chatterjee
PURPOSE: This study critically examines the available policy guidelines on integration of palliative and end-of-life care in Indian intensive care units to appraise their congruence with Indian reality. MATERIALS AND METHODS: Six position statements and guidelines issued by the Indian Society for Critical Care Medicine and the Indian Association of Palliative Care from 2005 till 2015 were examined. The present study reflects upon the recommendations suggested by these texts...
December 24, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28104401/leading-causes-of-preterm-delivery-as-risk-factors-for-intraventricular-hemorrhage-in-very-preterm-infants-results-of-the-epipage-2-cohort-study
#14
Marie Chevallier, Thierry Debillon, Veronique Pierrat, Pierre Delorme, Gilles Kayem, Mélanie Durox, François Goffinet, Stephane Marret, Pierre Yves Ancel
BACKGROUND: Intraventricular hemorrhage is a major risk factor for neurodevelopmental disabilities in preterm infants. However, few studies have investigated how pregnancy complications responsible for preterm delivery are related to intraventricular hemorrhage. OBJECTIVE: To investigate the association between the main causes of preterm delivery and intraventricular hemorrhage in very preterm infants born in France during 2011 between 22 and 31 weeks of gestation...
January 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28103769/evaluation-of-neuroleptic-utilization-in-the-intensive-care-unit-during-transitions-of-care
#15
Brian Gilbert, James R Morales, Randi J Searcy, Donald W Johnson, Jason A Ferreira
PURPOSE: The purpose of this study was to identify risk factors associated with inappropriate continuation of neuroleptics postdischarge from the intensive care unit (ICU) and hospital. MATERIALS AND METHODS: A retrospective chart review was performed including all patients greater than 18 years of age who received neuroleptic medications in an ICU. RESULTS: One hundred sixty-one patients were included during the 12- month study period. There were 85 (53%) patients discharged from the ICU with inappropriate continuation of a neuroleptic medication...
February 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28103590/risk-factors-for-intrapartum-fever-in-term-gestations-and-associated-maternal-and-neonatal-sequelae
#16
Angela P H Burgess, Justin E Katz, Michael Moretti, Nisha Lakhi
AIM: To determine factors associated with intrapartum fever and to examine associated maternal and neonatal outcomes. METHODS: Retrospective study of patients between 360/7 and 420/7 gestational weeks who entered spontaneous or induced active labor and developed temperature ≥38°C; a similar group that did not develop fever were controls. Univariate and multivariate analyses were performed with p < 0.05 as significant. RESULTS: Fifty-four febrile patients and 306 nonfebrile controls met inclusion criteria...
January 20, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28102857/vocal-fold-paralysis-in-preterm-infants-prevalence-and-analysis-of-risk-factors
#17
J Jabbour, M Uhing, T Robey
OBJECTIVE: To calculate the prevalence of vocal fold paralysis (VFP) in preterm (<37 weeks of gestation) infants at a single neonatal intensive care unit (NICU) and identify risk factors for the development of VFP. STUDY DESIGN: This is a case control study of all surviving preterm infants admitted to the NICU at Children's Hospital of Wisconsin from 2006 to 2012, comparing those with and without VFP. Multivariate analysis was performed to identify significant risk factors for VFP...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28102855/the-prevalence-of-feeding-problems-in-children-formerly-treated-in-a-neonatal-intensive-care-unit
#18
M Hoogewerf, H J Ter Horst, H Groen, T Nieuwenhuis, A F Bos, M W G van Dijk
OBJECTIVE: To determine the prevalence of oral feeding problems in neonatal intensive care unit (NICU) graduates at 1 to 2 years, and to identify clinical risk factors during NICU admission. STUDY DESIGN: Observational cohort study of 378 children, who received level III/IV NICU care for 4 days or more in 2011 to 2012, chromosomal abnormalities excluded. We detected feeding problems in four gestational age (GA) groups (<28, 28 to 31, 32 to 36 weeks, and term-borns) using the Dutch standardized Screeningslijst Eetgedrag Peuters, and collected clinical factors for logistic regression analyses...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28102852/anthropometric-trends-from-1997-to-2012-in-infants-born-at-%C3%A2-28-weeks-gestation-or-less
#19
N Wells, T A Stokes, K Ottolini, C H Olsen, A R Spitzer, C E Hunt
OBJECTIVE: Postnatal growth failure is common after preterm birth, in particular for infants born at ⩽28 weeks' gestation, but it is unknown if growth-to-term equivalent age has improved over the years as neonatal intensive care in general, and infant nutrition in particular, have improved. The objective of the study was to evaluate anthropometric trends at NICU discharge for infants born at ⩽28 weeks' gestation using a large national database. STUDY DESIGN: Analysis of growth in weight, length, head circumference and body mass index (kg m(2)) in 23 005 infants born in 1997 to 2012 who survived to neonatal intensive care unit discharge at ⩽41 weeks' postmenstrual age...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28102789/implications-for-research-and-practice-of-the-biographic-approach-for-storytelling
#20
Beverley Ewens, Joyce Hendricks, Deb Sundin
Background Intensive care unit survivors face many physical and psychological difficulties during their recovery following discharge from hospital. These difficulties can significantly affect their quality of life. Healthcare providers and survivors' families often do not understand what recovery means in this population, which may affect the support provided. Aim To consider the potential of the biographical method in helping to create stories that illustrate recovery in intensive care survivors and other populations...
January 23, 2017: Nurse Researcher
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