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Monitoring critical care

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https://www.readbyqxmd.com/read/28631765/-noninvasive-ventilation-and-sedation-evidence-and-practical-tools-for-its-utilization
#1
Ilaria Battistoni, Marco Marini, Giorgio Caretta, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Alberto Lavorgna, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Nadia Aspromonte, Massimo Iacoviello, Renata De Maria, Serafina Valente, Michele Massimo Gulizia
Noninvasive ventilation (NIV) has gained increased acceptance inside the critical area, since it has been shown to be effective in reducing or avoiding the need for oro-tracheal intubation. NIV efficacy is dependent on the selection of the appropriate patients and on their compliance to therapy. Actually, full collaboration is not easily reached especially in agitated patients.Sedation during NIV is useful to reduce the rate of treatment failure, but robust data to guide the development of best practice are limited and sometimes local customs appear to exert a strong influence on patterns of care...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28630952/estimating-patient-s-health-state-using-latent-structure-inferred-from-clinical-time-series-and-text
#2
Aaron Zalewski, William Long, Alistair E W Johnson, Roger G Mark, Li-Wei H Lehman
Modern intensive care units (ICUs) collect large volumes of data in monitoring critically ill patients. Clinicians in the ICUs face the challenge of interpreting large volumes of high-dimensional data to diagnose and treat patients. In this work, we explore the use of Hierarchical Dirichlet Processes (HDP) as a Bayesian nonparametric framework to infer patients' states of health by combining multiple sources of data. In particular, we employ HDP to combine clinical time series and text from the nursing progress notes in a probabilistic topic modeling framework for patient risk stratification...
February 2017: IEEE-EMBS International Conference on Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28630519/strategies-for-improving-learner-metacognition-in-health-professional-education
#3
REVIEW
Melissa S Medina, Ashley N Castleberry, Adam M Persky
Metacognition is an essential skill in critical thinking and self-regulated, lifelong learning. It is important for learners to have skills in metacognition because they are used to monitor and regulate reasoning, comprehension, and problem-solving, which are fundamental components/outcomes of pharmacy curricula. Instructors can help learners develop metacognitive skills within the classroom and experiential setting by carefully designing learning activities within courses and the curriculum. These skills are developed through intentional questioning, modeling techniques, and reflection...
May 2017: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28625266/-risk-factors-of-deep-venous-thrombosis-associated-with-peripherally-inserted-central-venous-catheter-in-upper-extremity-in-icu
#4
Ning Zhao, Jiale Zhang, Ting Jiang, Xia Chen, Jianning Wang, Chengzhi Ding, Fen Liu, Kejian Qian, Rong Jiang
OBJECTIVE: To analyze the incidence and its risk factors of peripherally inserted central venous catheter related upper extremity deep venous thrombosis (PICC-UEDVT) in intensive care unit (ICU). METHODS: Clinical data of the patients received PICCs in ICU of the First Affiliated Hospital of Nanchang University from August 2013 to August 2016 were retrospectively analysed. The inclusion criteria in the study included: the age > 18 years old, catheter indwelling time > 1 week and the complete relevant information...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#5
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625248/-core-knowledge-and-skill-based-approach-to-subspecialty-construction-in-critical-intensive-care-medicine-with-distinct-chinese-peculiarity
#6
Lijun Wang, Fang Tian
With the rapid development of critical care medicine (CCM) in China, there are increases in the number of intensive care units (ICUs), the scale of one center ICU and the team. Subspecialty construction of CCM is of great concerns for personnel training as well as discipline development, and is currently one of the urgent problems that need to be resolved. Experience of CCM subspecialty construction from Europe and the United States is lacking and it is necessary to propose some opinions on innovation to construct CCM subspecialties with Chinese characteristics...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#7
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28624618/a-sample-to-answer-real-time-convective-polymerase-chain-reaction-system-for-point-of-care-diagnostics
#8
Bowen Shu, Chunsun Zhang, Da Xing
Timely and accurate molecular diagnostics at the point-of-care (POC) level is critical to global health. To this end, we propose a handheld convective-flow real-time polymerase chain reaction (PCR) system capable of direct sample-to-answer genetic analysis for the first time. Such a system mainly consists of a magnetic bead-assisted photothermolysis sample preparation, a closed-loop convective PCR reactor, and a wireless video camera-based real-time fluorescence detection. The sample preparation exploits the dual functionality of vancomycin-modified magnetic beads (VMBs) for bacteria enrichment and photothermal conversion, enabling cell pre-concentration and lysis to be finished in less than 3min...
June 8, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28623557/proving-value-in-radiology-experience-developing-and-implementing-a-shareable-open-source-registry-platform-driven-by-radiology-workflow
#9
Judy Wawira Gichoya, Marc D Kohli, Paul Haste, Elizabeth Mills Abigail, Matthew S Johnson
Numerous initiatives are in place to support value based care in radiology including decision support using appropriateness criteria, quality metrics like radiation dose monitoring, and efforts to improve the quality of the radiology report for consumption by referring providers. These initiatives are largely data driven. Organizations can choose to purchase proprietary registry systems, pay for software as a service solution, or deploy/build their own registry systems. Traditionally, registries are created for a single purpose like radiation dosage or specific disease tracking like diabetes registry...
June 16, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28620595/the-predicting-ability-of-serum-phosphorus-to-assess-the-duration-of-mechanical-ventilation-in-critically-ill-patients
#10
Reihanak Talakoub, Mahshid Bahrami, Azim Honarmand, Saeed Abbasi, Hamideh Gerami
BACKGROUND: No previous study exists to evaluate serum phosphorus (Ph) level as a predictor of the need to mechanical ventilation (MV). This study was designed to determine the predictive ability of admission serum Ph level on MV in patients admitted in Intensive Care Unit (ICU). MATERIALS AND METHODS: This prospective study was conducted on 100 patients (>16 years old), admitted to our ICU over 1-year. Patients were classified into two groups according to the days of the need to MV...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28618388/simultaneous-determination-of-nine-%C3%AE-lactam-antibiotics-in-human-plasma-by-an-ultrafast-hydrophilic-interaction-chromatography-tandem-mass-spectrometry
#11
Alan Abdulla, Soma Bahmany, Rixt A Wijma, Bart C H van der Nagel, Birgit C P Koch
Contemporary β-lactam antibiotic dosing is debatable in severely ill patients, since the occurrence of pathophysiological changes in critical illness can result in great inter-individual variability. Therapeutic drug monitoring (TDM) is a commonly used dosing strategy to optimize exposure and thereby minimize toxicity and maximize the efficacy. Currently, TDM of β-lactam antibiotics is rarely performed, due to poor availability in clinical practice. We describe an ultrafast Hydrophilic-Interaction Chromatography (HILIC) based UPLC-MS/MS method for the determination of amoxicillin, benzylpenicillin, cefotaxime, cefuroxime, ceftazidime, flucloxacillin, imipenem, meropenem and piperacillin in human plasma...
June 8, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28614762/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-pediatrics-a-review
#12
REVIEW
Farah Chedly Thabet, Janeth Chiaka Ejike
PURPOSE: To consolidate pediatric intensivists' understanding of the pathophysiology, definition, incidence, monitoring, and management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS); and to highlight the characteristics related to the pediatric population. METHODS: This is a narrative review article that utilized a systematic search of the medical literature published in the English language between January 1990 and august 2016. Studies were identified by conducting a comprehensive search of Pub Med databases...
June 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28613389/continuous-non-invasive-pco2-monitoring-in-weaning-patients-transcutaneous-is-advantageous-over-end-tidal-pco2
#13
Sarah B Schwarz, Wolfram Windisch, Friederike S Magnet, Claudia Schmoor, Christian Karagiannidis, Jens Callegari, Sophie E Huttmann, Jan H Storre
BACKGROUND AND OBJECTIVE: Continuous partial pressure of carbon dioxide (PCO2 ) assessment is essential for the success of mechanical ventilation (MV). Non-invasive end-tidal PCO2 (PetCO2 ) and transcutaneous PCO2 (PtcCO2 ) measurements serve as alternatives to the gold standard arterial PCO2 (PaCO2 ) method, but their eligibility in critical care is unclear. METHODS: The present study therefore performed methodological comparisons of PaCO2 versus PetCO2 and PtcCO2 , respectively, in weaning patients receiving invasive MV via tracheal cannulas...
June 14, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28612302/a-simplified-lung-ultrasound-approach-to-detect-increased-extravascular-lung-water-in-critically-ill-patients
#14
Antonio Anile, Jole Russo, Giacomo Castiglione, Giovanni Volpicelli
BACKGROUND: The quantification of B-lines at lung ultrasonography is a valid tool to estimate the extravascular lung water (EVLW) in patients after major cardiac surgery. However, there is still uncertainty about the correlation between B-lines and EVLW in a general population of critically ill. AIM: To evaluate a simplified lung ultrasonographic assessment as a tool to estimate the EVLW in critically ill patients admitted to a polyvalent intensive care unit (ICU)...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28607334/interhospital-transfer-of-critically-ill-patients
#15
Thomas Kiss, Alisa Bölke, Peter M Spieth
Transportation of a patient between medical facilities without interruption of the medical treatment can be a challenging task. This review aims to define the term "interhospital transport" and give a general overview of the steps for organizing a transfer. Furthermore we discuss the team qualification, equipment standards and how to manage adverse events before and during transport by means of patient triage. The advanced interhospital transport of the critically ill patient can be defined as follows: "transportation of a patient between medical facilities without interruption of the medical treatment and monitoring due to the underlying disease by means of specific medical, technical equipment and knowledge with the objective of improved patient care"...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28603550/health-system-governance-to-support-scale-up-of-mental-health-care-in-ethiopia-a-qualitative-study
#16
Charlotte Hanlon, Tigist Eshetu, Daniel Alemayehu, Abebaw Fekadu, Maya Semrau, Graham Thornicroft, Fred Kigozi, Debra Leigh Marais, Inge Petersen, Atalay Alem
BACKGROUND: Ethiopia is embarking upon a ground-breaking plan to address the high levels of unmet need for mental health care by scaling up mental health care integrated within primary care. Health system governance is expected to impact critically upon the success or otherwise of this important initiative. The objective of the study was to explore the barriers, facilitators and potential strategies to promote good health system governance in relation to scale-up of mental health care in Ethiopia...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28601142/medical-complications-of-psychiatric-treatment-an-update
#17
REVIEW
Sheila C Lahijani, Kirk A Harris
Psychiatric medications are used commonly in hospitalized patients and are particularly indicated in patients who are critically ill to manage many conditions. Due to their many indications in the intensive care unit (ICU), psychiatric medications should be closely monitored in these medically compromised patients for adverse reactions and medical complications because they may affect essentially all organ systems. These range from life-threatening reactions to other less significant effects, such as sedation, to other detrimental complications, such as pancreatitis...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28600736/blood-pressure-management-in-children-on-dialysis
#18
F Paglialonga, S Consolo, A Edefonti, G Montini
Hypertension is a leading cause of cardiovascular complications in children on dialysis. Volume overload and activation of the renin-angiotensin-aldosterone system play a major role in the pathophysiology of hypertension. The first step in managing blood pressure (BP) is the careful assessment of ambulatory BP monitoring. Volume control is essential and should start with the accurate identification of dry weight, based on a comprehensive assessment, including bioimpedance analysis and intradialytic blood volume monitoring (BVM)...
June 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28600109/the-cardio-respiratory-effects-of-intra-abdominal-hypertension-considerations-for-critical-care-nursing-practice
#19
REVIEW
Martin Christensen, Judy Craft
Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondaryintra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
June 6, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28595621/transthoracic-echocardiography-an-accurate-and-precise-method-for-estimating-cardiac-output-in-the-critically-ill-patient
#20
Pablo Mercado, Julien Maizel, Christophe Beyls, Dimitri Titeca-Beauport, Magalie Joris, Loay Kontar, Antoine Riviere, Olivier Bonef, Thierry Soupison, Christophe Tribouilloy, Bertrand de Cagny, Michel Slama
BACKGROUND: Cardiac output (CO) monitoring is a valuable tool for the diagnosis and management of critically ill patients. In the critical care setting, few studies have evaluated the level of agreement between CO estimated by transthoracic echocardiography (CO-TTE) and that measured by the reference method, pulmonary artery catheter (CO-PAC). The objective of the present study was to evaluate the precision and accuracy of CO-TTE relative to CO-PAC and the ability of transthoracic echocardiography to track variations in CO, in critically ill mechanically ventilated patients...
June 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
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