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https://www.readbyqxmd.com/read/27922256/statins-in-critical-care-to-give-or-not-to-give
#1
Amr S Omar, Samy Hanoura, Haifa M Aljanubi, Ahmed Mahfouz
Owing to statin's immune modulatory, anti-inflammatory, antioxidant, antithrombotic and endothelial function actions, they are widely used in the critical care settings in diverse disease scenarios. We aim to explore the evidence to globalize the utilization of statins in the intensive care practice for different indications. We carried out a search of the PubMed, Cochrane and EMBASE databases up to January 2016. We included review articles, meta-analyses, and original trials on the effects of statin therapy in the intensive care unit (ICU) combining the following MESH terms: 'satins', 'intensive care, 'cardiac surgery', 'sepsis', 'acute respiratory distress syndrome' 'pneumonia', subarachnoid hemorrhage', traumatic brain injury and 'critical illness'...
December 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27922250/an-unusual-complication-of-endotracheal-intubation-ingestion-of-a-bulb-in-a-premature-neonate
#2
Özmert M A Özdemir, Ali Koçyiğit, Cem Çiçek, Uğur Koltuksuz, Hacer Ergin
Endotracheal intubation is a common daily procedure used for sustaining life in premature and term neonates in the neonatal intensive care unit. This procedure can be associated with some iatrogenic complications. One of these complications is ingesting a laryngoscope light bulb, and it is an extremely rare complication in neonates. The consequences of ingestion or aspiration may be serious and life-threatening. Herein, a male premature neonate, ingested a laryngoscope light bulb during endotracheal intubation because of surfactant replacement therapy, is reported...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#3
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27920421/a-missing-guide-wire-after-placement-of-peripherally-inserted-central-venous-catheter
#4
Muhammad Kashif, Hafiz Hashmi, Preeti Jadhav, Misbahuddin Khaja
BACKGROUND Central venous catheterization is a common tool used in critically ill patients to monitor central venous pressure and administer fluids and medications such as vasopressors. Here we present a case of a missing guide wire after placement of peripherally inserted central catheter (PICC), which was incidentally picked up by bedside ultrasound in the intensive care unit.  CASE REPORT A 50-year-old Hispanic male was admitted to the intensive care unit for alcohol intoxication. He was managed for septic shock and required placement of a peripherally inserted central line in his left upper extremity for antibiotics and vasopressor administration...
December 6, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27920417/intensive-care-unit-stress-ulcer-prophylaxis-is-it-still-needed
#5
EDITORIAL
Majid A Almadi, Alan N Barkun
No abstract text is available yet for this article.
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#6
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27919877/pharmacist-driven-respiratory-syncytial-virus-prophylaxis-stewardship-service-in-a-neonatal-intensive-care-unit
#7
Sara E Rostas, Christopher McPherson
PURPOSE: The development and implementation of a pharmacist-driven respiratory syncytial virus (RSV) prophylaxis stewardship program in a neonatal intensive care unit (NICU) are described. SUMMARY: An RSV prophylaxis stewardship service was created in the NICU at Brigham and Women's Hospital to align with the newly updated 2014 American Academy of Pediatrics (AAP) recommendations for palivizumab. The service comprised two NICU clinical pharmacists with oversight from the NICU medical director and the chair of the NICU infection control committee...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27919715/perioperative-brain-natriuretic-peptide-in-pediatric-cardiac-surgery-patients-its-association-with-postoperative-outcomes
#8
Tomoyuki Kanazawa, Moritoki Egi, Yuichiro Toda, Kazuyoshi Shimizu, Kentaro Sugimoto, Tatsuo Iwasaki, Hiroshi Morimatsu
OBJECTIVES: The aim of this study was to investigate the relationship between perioperative brain natriuretic peptide levels and the incidence of postoperative serious adverse events (SAEs) in pediatric cardiac patients. DESIGN: A prospective observational study. SETTING: A single-institution university hospital. PARTICIPANTS: Children under 15 years old who underwent cardiac surgery that required cardiopulmonary bypass from December 21, 2012 to February 26, 2014...
September 13, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27919645/empirical-mono-versus-combination-antibiotic-therapy-in-adult-intensive-care-patients-with-severe-sepsis-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#9
REVIEW
Fredrik Sjövall, Anders Perner, Morten Hylander Møller
OBJECTIVES: To assess benefits and harms of empirical mono- vs. combination antibiotic therapy in adult patients with severe sepsis in the intensive care unit (ICU). METHODS: We performed a systematic review according to the Cochrane Collaboration methodology, including meta-analysis, risk of bias assessment and trial sequential analysis (TSA). We included randomised clinical trials (RCT) assessing empirical mono-antibiotic therapy versus a combination of two or more antibiotics in adult ICU patients with severe sepsis...
December 2, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27919400/a-novel-concept-for-integrating-and-delivering-health-information-using-a-comprehensive-digital-dashboard-an-analysis-of-healthcare-professionals-intention-to-adopt-a-new-system-and-the-trend-of-its-real-usage
#10
Keehyuck Lee, Se Young Jung, Hee Hwang, Sooyoung Yoo, Hyun Young Baek, Rong-Min Baek, Seok Kim
OBJECTIVE: To introduce a new concept of medical dashboard system called BESTBoard. Such a system was implemented in all wards in a tertiary academic hospital to explore the development process, core designs, functions, usability and feasibility. METHODS: The task-force team made user interface designs for 6 months based on a need analysis. Hardware configuration and software development was carried out for 3 months. We conducted a survey of 383 physicians and nurses to determine the usability and feasibility of the system...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919270/delayed-hyperbaric-oxygen-therapy-for-air-emboli-after-open-heart-surgery-case-report-and-review-of-a-success-story
#11
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27919201/complicated-inguino-scrotal-bladder-hernia-a-case-of-two-step-repair
#12
Jules François, Barbara Defoort, Filip Muysoms
BACKGROUND: Inguino-scrotal sliding hernia of the bladder (IBH) is a rare condition. Frequently, it is asymptomatic but sometimes it can be complicated by urosepsis and incarceration. CASE PRESENTATION: A 74-year-old male with an IBH was admitted to the intensive care unit with urosepsis, acute renal insufficiency and incarceration of the herniated bladder. A two-step approach was performed to repair this complicated hernia. Firstly, the incarcerated bladder was reduced during a laparoscopic, trans-abdominal approach...
December 5, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27918902/development-of-an-intensive-care-unit-resource-assessment-survey-for-the-care-of-critically-ill-patients-in-resource-limited-settings
#13
Aleksandra Leligdowicz, Satish Bhagwanjee, Janet V Diaz, Wei Xiong, John C Marshall, Robert A Fowler, Neill Kj Adhikari
PURPOSE: Capacity to provide critical care in resource-limited settings is poorly understood because of lack of data about resources available to manage critically ill patients. Our objective was to develop a survey to address this issue. METHODS: We developed and piloted a cross-sectional self-administered survey in 9 resource-limited countries. The survey consisted of 8 domains; specific items within domains were modified from previously developed survey tools...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27918901/clinical-utility-of-methicillin-resistant-staphylococcus-aureus-nasal-polymerase-chain-reaction-assay-in-critically-ill-patients-with-nosocomial-pneumonia
#14
Melanie N Smith, Michael J Erdman, Jason A Ferreira, Petra Aldridge, Christopher A Jankowski
PURPOSE: This study investigated the diagnostic performance characteristics of a methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) assay in critically ill patients with nosocomial pneumonia. MATERIALS AND METHODS: This retrospective, single-center study included adult patients admitted to an intensive care unit with suspected nosocomial pneumonia. Patients must have received an MRSA nasal PCR assay and respiratory culture within predetermined time intervals...
November 15, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27918475/association-between-the-osteoporosis-self-assessment-tool-for-asians-score-and-mortality-in-patients-with-isolated-moderate-and-severe-traumatic-brain-injury-a-propensity-score-matched-analysis
#15
Cheng-Shyuan Rau, Pao-Jen Kuo, Shao-Chun Wu, Yi-Chun Chen, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study population comprised 7855 patients aged ≥40 years who were hospitalized for treatment of isolated moderate and severe TBI (an Abbreviated Injury Scale (AIS) ≥3 points only in the head and not in other regions of the body) between 1 January 2009 and 31 December 2014...
December 3, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27918381/outbreak-of-piv-3-in-a-neonatal-intensive-care-unit-in-england
#16
Gemma Louise Dunn, Helen Tapson, Jonathan Davis, Maya Gobin
An outbreak of PIV-3 in a neonatal intensive care unit was investigated using a retrospective cohort study. Risk of infection increased with lower birth weight and gestational age. Contact with sick visitor(s)/staff was not associated with infection (P= 0.212, P=0.299). Transmission routes are difficult to identify, and the importance of visiting restrictions and sickness absence during outbreaks is recommended.
November 30, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27918377/utility-of-emergency-department-observation-units-for-neurologically-intact-children-with-head-ct-abnormalities-secondary-to-acute-closed-head-injury
#17
Roxanna Lefort, Jill V Hunter, Andrea T Cruz, A Chantal Caviness, Thomas G Luerssen, Aderonke Adekunle-Ojo
OBJECTIVE: The aim of the study was to evaluate the utility of the emergency department observation unit (EDOU) for neurologically intact children with closed head injuries (CHIs) and computed tomography (CT) abnormalities. METHODS: A retrospective cohort study of children aged 0 to 18 years with acute CHI, abnormal head CT, and a Glasgow Coma Scales score of 14 or higher admitted to the EDOU of a tertiary care children's hospital from 2007 to 2010. Children with multisystem trauma, nonaccidental trauma, and previous neurosurgical or coagulopathic conditions were excluded...
December 1, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27918369/preadministration-of-hydrogen-rich-water-protects-against-lipopolysaccharide-induced-sepsis-and-attenuates-liver-injury
#18
Masumi Iketani, Jumi Ohshiro, Takuya Urushibara, Mayumi Takahashi, Tomio Arai, Hideo Kawaguchi, Ikuroh Ohsawa
Despite significant advances in antibiotic therapy and intensive care, sepsis remains the most common cause of death in intensive care units. We previously reported that molecular hydrogen (H2) acts as a therapeutic and preventive antioxidant. Here, we show that preadministration of H2-dissolved water (HW) suppresses lipopolysaccharide (LPS)-induced endotoxin shock in mice. Drinking HW for 3 days before LPS injection prolonged survival in a mouse model of sepsis. The H2 concentration immediately increased in the liver but not in the kidney after drinking HW...
December 1, 2016: Shock
https://www.readbyqxmd.com/read/27918334/challenges-of-anesthesia-in-low-and-middle-income-countries-a-cross-sectional-survey-of-access-to-safe-obstetric-anesthesia-in-east-africa
#19
Isabella Epiu, Jossy Verel Bahe Tindimwebwa, Cephas Mijumbi, Thomas M Chokwe, Edwin Lugazia, Francois Ndarugirire, Theogene Twagirumugabe, Gerald Dubowitz
BACKGROUND: The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa. METHODS: A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918269/prevention-of-hospital-acquired-bloodstream-infections-through-chlorhexidine-gluconate-impregnated-washcloth-bathing-in-intensive-care-units-a-systematic-review-and-meta-analysis-of-randomised-crossover-trials
#20
Elsa Afonso, Koen Blot, Stijn Blot
We assessed the impact of 2% daily patient bathing with chlorhexidine gluconate (CHG) washcloths on the incidence of hospital-acquired (HA) and central line-associated (CLA) bloodstream infections (BSI) in intensive care units (ICUs). We searched randomised studies in Medline, EMBASE, Cochrane Library (CENTRAL) and Web of Science databases up to April 2015. Primary outcomes were total HABSI, central line, and non-central line-associated BSI rates per patient-days. Secondary outcomes included Gram-negative and Gram-positive BSI rates and adverse events...
November 17, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
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