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Ventilator associated events

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https://www.readbyqxmd.com/read/27918405/certified-registered-nurse-anesthetist-perceptions-of-factors-impacting-patient-safety
#1
Susan P McMullan, Charlotte Thomas-Hawkins, Maria R Shirey
Certified registered nurse anesthetists (CRNAs) provide more than 40 million anesthetics each year in the United States. This article describes a study that investigates relationships among CRNA organizational structures (CRNA practice models, work setting, workload, level of education, work experience), CRNA ratings of patient safety culture, and CRNA adverse anesthesia-related event (ARE) reporting. This is a cross-sectional survey study of 336 CRNAs randomly selected from American Association of Nurse Anesthetists database...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#2
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27908944/use-of-neuromuscular-blockers-during-therapeutic-hypothermia-after-cardiac-arrest-a-nursing-protocol
#3
Coraline Boulila, Samia Ben Abdallah, Aude Marincamp, Vincent Coic, Romuald Lauverjat, Nicole Ericher, Wulfran Bougouin, Jean-Paul Mira, Alain Cariou, Guillaume Geri
BACKGROUND: Neuromuscular blockers used to prevent shivering during therapeutic hypothermia in comatose patients after out-of-hospital cardiac arrest are associated with adverse events. OBJECTIVE: To assess the influence of a nurse-implemented protocol on use of neuromuscular blockers in patients treated with 24-hour therapeutic hypothermia after out-of-hospital cardiac arrest. METHODS: A before and after study was done in a 24-bed cardiac arrest center...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#4
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27883968/vitamin-d-and-outcomes-in-adult-critically-ill-patients-a-systematic-review-and-meta-analysis-of-randomized-trials
#5
REVIEW
Alessandro Putzu, Alessandro Belletti, Tiziano Cassina, Sara Clivio, Giacomo Monti, Alberto Zangrillo, Giovanni Landoni
PURPOSE: Low vitamin D blood levels are associated with high mortality in critically ill patients. There is controversy about vitamin D supplementation in this population. The objective of this meta-analysis was to evaluate if vitamin D administration reduces mortality in critically ill patients. MATERIALS AND METHODS: Online databases were searched up to September 1(st), 2016 for randomized placebo-controlled trials on the use of vitamin D in adult patients with critical illness...
November 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27876075/chlorhexidine-bathing-and-health-care-associated-infections-among-adult-intensive-care-patients-a-systematic-review-and-meta-analysis
#6
Steven A Frost, Mari-Cris Alogso, Lauren Metcalfe, Joan M Lynch, Leanne Hunt, Ritesh Sanghavi, Evan Alexandrou, Kenneth M Hillman
BACKGROUND: Health care-associated infections (HAI) have been shown to increase length of stay, the cost of care, and rates of hospital deaths (Kaye and Marchaim, J Am Geriatr Soc 62(2):306-11, 2014; Roberts and Scott, Med Care 48(11):1026-35, 2010; Warren and Quadir, Crit Care Med 34(8):2084-9, 2006; Zimlichman and Henderson, JAMA Intern Med 173(22):2039-46, 2013). Importantly, infections acquired during a hospital stay have been shown to be preventable (Loveday and Wilson, J Hosp Infect 86:S1-70, 2014)...
November 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27872996/surgical-repair-of-ventricular-septal-defect-contemporary-results-and-risk-factors-for-a-complicated-course
#7
Maartje Schipper, Martijn G Slieker, Paul H Schoof, Johannes M P J Breur
Surgical closure of the ventricular septal defect is the most commonly performed procedure in pediatric cardiac surgery. There are conflicting data on weight at operation as risk factor for a complicated course. We performed a retrospective evaluation of mortality and morbidity in all patients undergoing surgical ventricular septal defect closure at our institution between 2004 and 2012 to identify risk factor for a complicated course. Multivariate logistic regression modeling was performed to identify risk factors for a complicated course...
November 21, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27871314/a-mixed-methods-systematic-review-protocol-to-examine-the-use-of-physical-restraint-with-critically-ill-adults-and-strategies-for-minimizing-their-use
#8
Louise Rose, Craig Dale, Orla M Smith, Lisa Burry, Glenn Enright, Dean Fergusson, Samir Sinha, Lesley Wiesenfeld, Tasnim Sinuff, Sangeeta Mehta
BACKGROUND: Critically ill patients frequently experience severe agitation placing them at risk of harm. Physical restraint is common in intensive care units (ICUs) for clinician concerns about safety. However, physical restraint may not prevent medical device removal and has been associated with negative physical and psychological consequences. While professional society guidelines, legislation, and accreditation standards recommend physical restraint minimization, guidelines for critically ill patients are over a decade old, with recommendations that are non-specific...
November 21, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27861340/prognostic-factors-associated-with-mortality-and-major-in-hospital-complications-in-patients-with-bacteremic-pneumococcal-pneumonia-population-based-study
#9
Jessica A Beatty, Sumit R Majumdar, Gregory J Tyrrell, Thomas J Marrie, Dean T Eurich
Bacteremic pneumococcal pneumonia (BPP) causes considerable mortality and morbidity. We aimed to identify prognostic factors associated with mortality and major in-hospital complications in BPP.A prospective, population-based clinical registry of 1636 hospitalized adult patients (≥18 years) with BPP was established between 2000 and 2010 in Northern Alberta, Canada. Prognostic factors for mortality and major in-hospital complications (e.g., cardiac events, mechanical ventilation, aspiration) were evaluated using multivariable logistic regression...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858812/defining-the-current-landscape-of-ventilator-associated-events-significant-burden-and-potential-to-improve
#10
Jesse T Jacob, David J Murphy
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27856933/predictors-of-extubation-outcomes-following-myasthenic-crisis
#11
Zhenguo Liu, Shiyuan Yao, Qian Zhou, Zhensheng Deng, Jianyong Zou, Huiyu Feng, Hua Zhu, Chao Cheng
OBJECTIVE: Myasthenic crisis (MC) is considered the most severe adverse event in patients with myasthenia gravis. The present retrospective study was performed to evaluate the predictors of clinical outcomes in patients with MC. METHODS: The medical charts of 33 patients (19 women, 14 men) with 76 MC attacks from 2002 to 2014 were retrospectively reviewed. Early extubation (≤7 days) and prolonged ventilation (>15 days) during the MC were used to assess patient outcomes...
November 17, 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27856390/a-comparison-of-balanced-and-unbalanced-crystalloid-solutions-in-surgery-patient-outcomes
#12
Tomas Kuca, Michael B Butler, Mete Erdogan, Robert S Green
INTRODUCTION: The objective of this study was to evaluate adverse patient outcomes associated with the choice of intravenous fluid administered during general anaesthesia. METHODS: This study was a retrospective chart review of vascular surgery patients at a Canadian tertiary care hospital. Patients were separated into three groups: those who were intraoperatively administered normal saline (NS), balanced crystalloids, or a combination of both solutions. Multivariate analysis was performed to determine association between volume of each fluid type administered and adverse outcomes including in-hospital mortality, prolonged intensive care unit admission, vasopressor requirement, ventilator requirement, hemodialysis requirement, and a composite endpoint of any of these adverse events occurring...
November 14, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27854123/a-retrospective-analysis-of-cardiovascular-outcomes-in-patients-treated-with-asv
#13
Arild Hetland, Kristina H Haugaa, Maria Vistnes, Kristian Hovde Liland, Margareth Olseng, Morten B Jacobsen, Thor Edvardsen
Objectives- The effect of long term adaptive servo-ventilation (ASV) on cardiovascular mortality and admission rates in patients with chronic heart failure (CHF) and Cheyne-Stokes respiration (CSR) has not been much studied. The aim of this study was primarily to investigate whether ASV therapy significantly reduced these parameters. Design- We included 75 CHF patients on optimal medication and CSR ≥25% of sleeping time, in New York Heart Association (NYHA) class II-IV and left ventricular ejection fraction (LVEF) ≤ 45%...
November 17, 2016: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/27850661/1023-determining-effects-of-fluid-overload-and-kidney-injury-variables-on-ventilator-associated-events
#14
Jarin Vaewpanich, Raeley Guess, Curtis Kennedy, Ayse Arikan, Jorge Coss Bu, Jeffrey Starke, Satid Thammasitboon
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843786/diffuse-alveolar-hemorrhage-in-patients-undergoing-neurointervention-a-case-report
#15
Yun Suk Choe, Na Young Kim, Ae Ryoung Lee
INTRODUCTION: Diffuse alveolar hemorrhage (DAH) is a very rare complication but acute and life-threatening event. Clopidogrel has generally administered for neurointerventional surgery, but there were no reports of DAH related to clopidogrel in patients undergoing neurointervention. CASE PRESENTATION: A 70-year-old male presented with DAH associated with clopidogrel after transfemoral cerebral angiography and coil embolization for cerebral aneurysm. The chest radiography showed bilateral symmetric peribronchial consolidation and bronchoscopy revealed diffuse hemorrhage on the bronchial wall at the bilateral lung...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27842748/preventing-ventilator-associated-infections
#16
REVIEW
Avani Mehta, Rajesh Bhagat
Mechanical ventilator use is fraught with risk of complications. Ventilator-associated pneumonia (VAP) is a common complication that prolongs stays on the ventilator and increases mortality and costs. The Centers for Disease Control and Prevention recommend the use of the term, ventilator-associated event. Prevention and/or interruption of cycle of inflammation, colonization of respiratory tract, and ventilator-associated tracheobronchitis are key to managing VAP. Modifying risk factors using a ventilator bundle is considered standard of care...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27842540/the-impact-of-low-frequency-low-force-cyclic-stretching-of-human-bronchi-on-airway-responsiveness
#17
Morgan Le Guen, Stanislas Grassin-Delyle, Emmanuel Naline, Amparo Buenestado, Marion Brollo, Elisabeth Longchampt, Philippe Kleinmann, Philippe Devillier, Christophe Faisy
BACKGROUND: In vivo, the airways are constantly subjected to oscillatory strain (due to tidal breathing during spontaneous respiration) and (in the event of mechanical ventilation) positive pressure. This exposure is especially problematic for the cartilage-free bronchial tree. The effects of cyclic stretching (other than high-force stretching) have not been extensively characterized. Hence, the objective of the present study was to investigate the functional and transcriptional response of human bronchi to repetitive mechanical stress caused by low-frequency, low-force cyclic stretching...
November 14, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27837045/pharmacologic-stress-gastropathy-prophylaxis-may-not-be-necessary-in-at-risk-surgical-trauma-icu-patients-tolerating-enteral-nutrition
#18
Nicole M Palm, Brian McKinzie, Pamela L Ferguson, Emily Chapman, Margaret Dorlon, Evert A Eriksson, Brent Jewett, Stuart M Leon, Alicia R Privette, Samir M Fakhry
OBJECTIVE: Stress gastropathy is a rare complication of the intensive care unit stay with high morbidity and mortality. There are data that support the concept that patients tolerating enteral nutrition have sufficient gut blood flow to obviate the need for prophylaxis; however, no robust studies exist. This study assesses the incidence of clinically significant gastrointestinal bleeding in surgical trauma intensive care unit (STICU) patients at risk of stress gastropathy secondary to mechanical ventilation receiving enteral nutrition without pharmacologic prophylaxis...
November 10, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27836871/patient-safety-events-in-out-of-hospital-paediatric-airway-management-a-medical-record-review-by-the-csi-ems
#19
Matthew Hansen, Garth Meckler, William Lambert, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: To describe the frequency and characterise the nature of patient safety events in paediatric out-of-hospital airway management. METHODS: We conducted a retrospective cross-sectional medical record review of all 'lights and sirens' emergency medicine services transports from 2008 to 2011 in patients <18 years of age in the Portland Oregon metropolitan area. A chart review tool (see online supplementary appendix) was adapted from landmark patient safety studies and revised after pilot testing...
November 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27826584/sedation-in-mechanically-ventilated-patients-time-to-stay-awake
#20
COMMENT
Fabio Tanzillo Moreira, Ary Serpa Neto
On June, 2016, Klompas and colleagues published an article in the Chest entitled "Associations between different sedatives and ventilator-associated events, length of stay, and mortality in patients who were mechanically ventilated", which investigated the effects of different sedatives on ventilator-associated events (VAEs), length of stay, and mortality in patients who were mechanically ventilated. This study used data of over 9,603 patients in order to investigate patients over the age of 18 who underwent mechanical ventilation for more than 3 days over a 7-year period in a large academic medical center...
October 2016: Annals of Translational Medicine
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