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https://www.readbyqxmd.com/read/28214457/operative-fixation-of-rib-fractures-indications-techniques-and-outcomes
#1
David Galos, Benjamin Taylor, Toni McLaurin
Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214161/human-factors-related-to-time-dependent-infection-control-measures-scrub-the-hub-for-venous-catheters-and-feeding-tubes
#2
Lindsay Caspari, Elizabeth Epstein, Amy Blackman, Li Jin, David A Kaufman
BACKGROUND: The use of catheter hub decontamination protocols is a common practice to reduce central line-associated bloodstream infections. However, few data exist on the most effective disinfection procedure prior to hub access accounting for human factors and time-dependent practices in real time in the clinical setting. METHODS: An observational design with a multimodal intervention was used in this study in a neonatal intensive care unit. Direct observations on nurse compliance of scrub times with decontamination when accessing of venous catheter and feeding tube hubs were conducted during 3 phases: (1) baseline period prior to any interventions; (2) during an educational intervention phase; and (3) during a timer intervention period when using a timing device, either an actual timer or music button...
February 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28214083/the-effect-of-nonpharmacological-training-on-delirium-identification-and-intervention-strategies-of-intensive-care-nurses
#3
Ayşegül Öztürk Birge, Hatice Tel Aydin
OBJECTIVE: This study aims to investigate the effect of nonpharmacological intervention training on delirium recognition and the intervention strategies of intensive care (ICU) nurses. METHOD: This is a quasi-experimental study conducted using a pretest-posttest design. The study sample included a total of 95 patients staying in the medical ICU of a university hospital and 19 nurses working in these units. The data were collected using the Patient and Nurse Introduction, Confusion Assessment Method for the ICU, and Delirium Risk Factors, and Non-pharmacological Interventions in Delirium Prevention Forms...
February 14, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#4
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213808/genotyping-and-antifungal-susceptibility-of-dipodascus-capitatus-isolated-in-a-neonatal-intensive-care-unit-of-a-sicilian-hospital
#5
Teresa Fasciana, Mario Giuffrè, Cinzia Calà, Ingrid Anne Mandy Schierz, Giuseppe Aquilina, Giuseppa Pinello, Giuseppina Capra, Dario Lipari, Giovanni Corsello, Anna Giammanco
In August 2015, Dipodascus capitatus was isolated from two patients admitted to the neonatal intensive care unit. Nosocomial acquisition of the fungus was suspected and epidemiological studies were undertaken. The patients were simultaneously hospitalized, and the comparison of the two isolates by two independent molecular typing methods have confirmed clonal dissemination of a single strain of D. capitatus. Antimicrobial susceptibility testing was useful for identifying the appropriated antifungal therapy in micafungin...
February 18, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28213620/post-contrast-acute-kidney-injury-in-intensive-care-unit-patients-a-propensity-score-adjusted-study
#6
Jennifer S McDonald, Robert J McDonald, Eric E Williamson, David F Kallmes, Kianoush Kashani
PURPOSE: To examine the association of intravenous iodinated contrast material administration with the subsequent development of post-contrast AKI (PC-AKI), emergent dialysis, and short-term mortality using a propensity score-adjusted analysis of a cohort of intensive care unit (ICU) patients who underwent CT examination. METHODS: All ICU patients at our institution who received a contrast-enhanced (contrast group) or unenhanced (noncontrast group) CT scan from January 2006 to December 2014 were identified...
February 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28213382/pharmacist-involvement-on-a-rapid-response-team
#7
Joel Feih, William J Peppard, Michael Katz
PURPOSE: The effect of a pharmacist on a rapid response team (RRT) was investigated. METHODS: This study evaluated 234 patients before and 157 patients after pharmacist involvement on an RRT. The primary outcome was time to medication administration, with a goal turnaround time of less than 30 minutes. Secondary outcomes included most frequently used medications, readmissions to the intensive care unit (ICU) within 48 hours, number of rapid responses that resulted in ICU admission, length of hospital stay, and survival to hospital discharge...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28213266/noninvasivepositive-pressure-ventilation-vsinvasive-mechanical-ventilation-as-first-line-therapy-for-acute-hypoxemic-respiratory-failure-in-cancer-patients
#8
Nisha K Rathi, Sajid A Haque, Ron Nates, Alyssa Kosturakis, Hao Wang, Wenli Dong, Lei Feng, Rose J Erfe, Christina Guajardo, Laura Withers, Clarence Finch, Kristen J Price, Joseph L Nates
PURPOSE: The objective was to describe the characteristics and outcomes of critically ill cancer patients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure. MATERIAL AND METHODS: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancer patients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure...
January 20, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28212906/utility-of-failure-mode-and-effect-analysis-to-improve-safety-in-suctioning-by-orotracheal-tube
#9
Agustín Vázquez-Valencia, Andrés Santiago-Sáez, Bernardo Perea-Pérez, Elena Labajo-González, Maria Elena Albarrán-Juan
OBJECTIVE: The objective of the study was to use the Failure Mode and Effect Analysis (FMEA) tool to analyze the technique of secretion suctioning on patients with an endotracheal tube who were admitted into an intensive care unit. MATERIALS AND METHODS: Brainstorming was carried out within the service to determine the potential errors most frequent in the process. After this, the FMEA was applied, including its stages, prioritizing risk in accordance with the risk prioritization number (RPN), selecting improvement actions in which they have an RPN of more than 300...
February 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28212589/a-multicenter-initiative-for-critical-congenital-heart-disease-newborn-screening-in-texas-neonatal-intensive-care-units
#10
Alice Gong, Charleta Guillory, Liza Creel, Judith Ellen Livingtson, Tiffany M McKee-Garrett, Regine Fortunov
Objective The objective of this study was to implement a strategy for critical congenital heart disease (CCHD) newborn screening in the neonatal intensive care unit (NICU). Design A NICU-specific curriculum, screening algorithm, slide presentations, and templates of orders, policies, and procedures were developed into a toolkit for training NICU personnel. Screening was conducted on first and second screen pre- and postductal oxygen saturations (SpO2) on newborns admitted or transferred to the NICU. Results We trained 347 NICU personnel in 13 Texas hospitals, representing rural, suburban, and metropolitan settings...
February 17, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28211647/clinical-characteristics-predicting-abnormal-brain-magnetic-resonance-image-findings-in-hypoxic-ischemic-encephalopathy-infants
#11
Sook K Yum, Cheong-Jun Moon, Young-Ah Youn, In K Sung
BACKGROUND: The aim of this study was to elucidate the specific clinical characteristics associated with abnormal brain magnetic resonance image(MRI) findings in hypoxic ischemic encephalopathy(HIE) infants in order to discern how to predict poorer outcomes more accurately. METHODS: A retrospective data analysis of HIE infants admitted to the neonatal intensive care unit of a tertiary hospital was performed. Baseline perinatal information and physical and neurological findings were compared in HIE infants according to the presence of abnormal brain MRI findings...
February 17, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28211096/monocyte-and-lymphocyte-surface-molecules-in-severe-sepsis-and-non-septic-critically-ill-patients
#12
Joel Jämsä, Hannu Syrjälä, Virva Huotari, Eeva-Riitta Savolainen, Tero Ala-Kokko
The aim of the present study was to investigate whether expression of monocyte and lymphocyte surface molecules differs between patients with severe sepsis and non-septic patients treated in the intensive care unit (ICU). The expression of monocyte CD14, CD40, CD80 and HLA-DR, and lymphocyte CD69 were analyzed using quantitative flow cytometry on three consecutive days in 27 patients with severe sepsis and in 15 non-septic patients. Receiver operating characteristic analyses were performed and each corresponding area under the curve (AUC) was determined...
February 17, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28210934/adarri-a-novel-method-to-detect-spurious-r-peaks-in-the-electrocardiogram-for-heart-rate-variability-analysis-in-the-intensive-care-unit
#13
Dennis J Rebergen, Sunil B Nagaraj, Eric S Rosenthal, Matt T Bianchi, Michel J A M van Putten, M Brandon Westover
We developed a simple and fully automated method for detecting artifacts in the R-R interval (RRI) time series of the ECG that is tailored to the intensive care unit (ICU) setting. From ECG recordings of 50 adult ICU-subjects we selected 60 epochs with valid R-peak detections and 60 epochs containing artifacts leading to missed or false positive R-peak detections. Next, we calculated the absolute value of the difference between two adjacent RRIs (adRRI), and obtained the empirical probability distributions of adRRI values for valid R-peaks and artifacts...
February 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28210835/a-10-year-review-of-cannabis-exposure-in-children-under-3-years-of-age-do-we-need-a-more-global-approach
#14
Isabelle Claudet, Mathilde Le Breton, Camille Bréhin, Nicolas Franchitto
: Pediatricians working in an emergency environment are confronted with children admitted to emergency departments for intoxication on a daily basis. We carried out a retrospective cohort study of children admitted to a pediatric emergency department due to unintentional cannabis exposure over a 10-year period from 2004 to 2014. Twenty-nine children under the age of 3 were admitted with a positive cannabis urine test. Eighty-seven percent of intoxications occurred at the family home. Resin was the main form of ingested cannabis (69%)...
February 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28210523/complete-recovery-from-cardiac-arrest-caused-by-risperidone-induced-hypothermia
#15
Takahiko Nagamine
Hypothermia is a rare adverse effect of risperidone and is associated with ventricular arrhythmias, which may lead to intensive care unit admission and sometimes death. We describe a patient with schizophrenia who was taking risperidone and who, after falling into a hypothermic state, suffered cardiac arrest. Observations of the case and a brief literature review are provided.
November 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28210519/achondroplasia-in-the-premature-infant-an-elusive-diagnosis-in-the-neonatal-intensive-care-unit
#16
Kimberly E Fagen, Anna R Blask, Eva I Rubio, Dorothy I Bulas
Achondroplasia is a difficult prenatal diagnosis to make before the late second and third trimester. We describe two cases where an infant was born prematurely with no overt signs of achondroplasia. Despite multiple chest and abdominal radiographs during the neonatal course, the diagnosis was not made until term equivalent age was reached. We retrospectively reviewed these two cases to highlight the elusive findings of achondroplasia in the premature infant.
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28210101/acute-kidney-injury-in-elderly-intensive-care-patients-from-a-developing-country-clinical-features-and-outcome
#17
Laís Gabriela Yokota, Beatriz Motta Sampaio, Erica Rocha, André Luís Balbi, Daniela Ponce
AIM: The elderly are at high risk of acute kidney injury (AKI) because of structural and functional degeneration over time and with the aging of the population, the demand for intensive care unit (ICU) admission for older patients has risen recently. However, data from developing countries are scarce. This study aimed to describe the incidence of AKI in elderly patients admitted to ICU from a developing country, to determine the most frequent etiologies for renal impairment and identify its risk factors and outcome...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28209998/cervical-pessary-for-prevention-of-preterm-birth-a-meta-analysis
#18
Xin-Hang Jin, Dan Li, Li-Li Huang
To investigate the efficacy of cervical pessary placement in preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton pregnancy and a short cervix, we searched literature in relevant databases. The meta-analysis of the 3 included trials (1412 women) showed cervical pessary placement did not reduce the risk of spontaneous preterm birth <34 weeks in these women (risk ratio (RR), 0.71; 95% confidence interval (CI), 0.21-2.43, P = 0.59; I(2) = 90%). The sensitivity analyses by excluding one trial at one time showed the same results...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28209637/the-impact-of-payer-source-on-trauma-outcomes-in-a-pediatric-population
#19
Felecia A Lee, Ashley M Hervey, Arash Sattarin, Aaron Deeds, Gina M Berg, Kimberly Molik
OBJECTIVES: Determine if there were differences in conclusions drawn regarding disparities in trauma outcomes based on literature-derived payer source definitions in a pediatric population. PATIENTS AND METHODS: Retrospective registry review of admitted pediatric trauma patients (≤17 years of age) at a level II pediatric trauma facility. Eligible patients were categorized into 3 payer source definitions: definition 1: commercially insured, Medicaid, uninsured; definition 2: insured, uninsured; definition 3: commercially insured, underinsured...
February 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28209517/inadvertent-hypothermia-and-mortality-in-critically-ill-adults-systematic-review-and-meta-analysis
#20
REVIEW
Panagiotis Kiekkas, Fotini Fligou, Michael Igoumenidis, Nikolaos Stefanopoulos, Evangelos Konstantinou, Vasilios Karamouzos, Diamanto Aretha
OBJECTIVE: Considering that inadvertent hypothermia (IH) is common in Intensive Care Unit (ICU) patients and can be followed by severe complications, this systematic review identified, appraised and synthesized the published literature about the association between IH and mortality in adults admitted to the ICU. DATA SOURCES: By using key terms, literature searches were conducted in Pubmed, CINAHL, Cochrane Library, Web of Science and EMBASE. REVIEW METHODS: According to PRISMA guidelines, articles published between 1980-2016 in English-language, peer-reviewed journals were considered...
February 13, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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