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"Critical Care" OR "Intensive Care" OR "ICU"

Gensheng Zhang, Kai Zhang, Wei Cui, Yucai Hong, Zhongheng Zhang
STUDY OBJECTIVE: To analyze the effect of enteral nutrition compared with parenteral nutrition in critically ill patients. DESIGN: Systematic review and meta-analysis of randomized controlled trials. SETTING: Intensive care unit. PATIENTS: 23 trials containing 6478 patients met our inclusion criteria. INTERVENTION: A systematical literature search was conducted to identify eligible trials in electronic databases including PubMed, Embase, Scopus, EBSCO and Cochrane Library...
August 8, 2018: Journal of Clinical Anesthesia
Sarita March, Jessica Keim-Malpass
PURPOSE: Children with hypoplastic left heart syndrome (HLHS) experience numerous vulnerabilities during transitions from hospital to home during their first year of life. This paper examines the parents' responses to the situations they experience during the initial interstage transition as described through illness blogs. DESIGN AND METHODS: A qualitative descriptive design through inductive theme development using thematic analysis was performed for this study...
August 11, 2018: Journal for Specialists in Pediatric Nursing: JSPN
Jin-Hua Liao, Rong-Fang Hu, Li-Jing Su, Shuo Wang, Qin Xu, Xiao-Fang Qian, Hong-Gu He
BACKGROUND: Nonpharmacological interventions are often used to promote sleep among preterm infants in the neonatal intensive care unit (NICU). However, there is a lack of synthesis in the evidence of their effectiveness. AIM: To synthesize the evidence on the effectiveness of nonpharmacological interventions on NICU preterm infants' sleep during hospital stay. METHODS: Seven databases were searched, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Wan-fang database, China National Knowledge Infrastructure, China Biological Medicine Database, and VIP Journal Integration Platform from their inceptions to August 2017...
August 11, 2018: Worldviews on Evidence-based Nursing
Elizabeth Chloe Romanis
In 2017, a Philadelphia research team revealed the closest thing to an artificial womb (AW) the world had ever seen. The 'biobag', if as successful as early animal testing suggests, will change the face of neonatal intensive care. At present, premature neonates born earlier than 22 weeks have no hope of survival. For some time, there have been no significant improvements in mortality rates or incidences of long-term complications for preterms at the viability threshold. Artificial womb technology (AWT), that might change these odds, is eagerly anticipated for clinical application...
August 10, 2018: Journal of Medical Ethics
Chin-Jung Liu, Pei-Tseng Kung, Chia-Chen Chu, Wen-Yu Chou, Yueh-Hsin Wang, Wen-Chen Tsai
OBJECTIVES: An integrated delivery system with a prospective payment program (IPP) for prolonged mechanical ventilation (PMV) was launched by Taiwan's National Health Insurance (NHI) due to the costly and limited ICU resources. This study aimed to analyze the effectiveness of IPP and evaluate the factors associated with successful weaning and survival among patients with PMV. METHODS: Taiwan's NHI Research Database was searched to obtain the data of patients aged ≥17 years who had PMV from 2006 to 2010 (N=50,570)...
July 19, 2018: Health Policy
Athanasios Chalkias, Theodoros Xanthos, Effie Papageorgiou, Artemis Anania, Apostolos Beloukas, Fotios Pavlopoulos
PURPOSE: To assess the intraoperative initiation and feasibility of a modified NIH-NHLBI ARDS Network Mechanical Ventilation Protocol (mARDSNet protocol) in septic patients with severe ARDS. MATERIALS AND METHODS: This prospective observational study included consecutive adult septic patients with severe ARDS who underwent emergency abdominal surgery prior to intensive care unit (ICU) admission. The primary outcome was survival to hospital discharge and at 90 days...
August 7, 2018: Heart & Lung: the Journal of Critical Care
JoAnne M Youngblut, Dorothy Brooten
BACKGROUND: Losing a child is devastating for parents and grandparents. Family and friends generally focus on comforting and supporting the bereaved parents, unintentionally ignoring the bereaved grandparents. Grandmothers and grandfathers often struggle with wanting to help their adult children (deceased child's parents) without usurping the parents' responsibilities and decisions regarding the deceased child. Research on mothers' and grandmothers' health at about the same time after the same child's death in the neonatal or pediatric intensive care unit is lacking...
August 10, 2018: Italian Journal of Pediatrics
Wan-Ling Chen, Wei-Ting Lin, Shu-Chen Kung, Chih-Cheng Lai, Chien-Ming Chao
This study aims to investigate the association between oxygenation saturation index (OSI) and the outcome of acute respiratory distress syndrome (ARDS) patients, and assess the predictive performance of OSI for ARDS patients' mortality. This study was conducted at one regional hospital with 66 adult intensive care unit (ICU) beds. All patients with ARDS were identified between November 1 2016 and May 31 2018, and their clinical information was retrospectively collected. The lowest PaO₂/FiO₂ ratio and SpO₂/FiO₂ ratio and highest mean airway pressure (MAP) were recorded on the first day of ARDS; and oxygen index (OI) and OSI were calculated as (FiO₂ × MAP × 100)/PaO₂, and (FiO₂ × MAP × 100) /SpO₂ accordingly...
August 8, 2018: Journal of Clinical Medicine
Kelly Powers, Charlie L Reeve
BACKGROUND: Family presence during resuscitation is not widely implemented in clinical practice. Prior research about nurse factors that may influence their decision to invite family members to remain in the room during resuscitation is contradictory and inconclusive. OBJECTIVES: To describe intensive care unit nurses' perceptions, self-confidence, and invitations of family presence during resuscitation, and to evaluate differences according to nurse factors. DESIGN: A cross-sectional survey design was used for descriptive and correlational analyses...
June 28, 2018: International Journal of Nursing Studies
Martin B Brodsky, Matthew J Levy, Erin Jedlanek, Vinciya Pandian, Brendan Blackford, Carrie Price, Gai Cole, Alexander T Hillel, Simon R Best, Lee M Akst
OBJECTIVES: To systematically review the symptoms and types of laryngeal injuries resulting from endotracheal intubation in mechanically ventilated patients in the ICU. DATA SOURCES: PubMed, Embase, CINAHL, and Cochrane Library from database inception to September 2017. STUDY SELECTION: Studies of adult patients who were endotracheally intubated with mechanical ventilation in the ICU and completed postextubation laryngeal examinations with either direct or indirect visualization...
August 9, 2018: Critical Care Medicine
Adrian Alexis Ruiz, Patrycja K Wyszyńska, Krzysztof Laudanski
Several theories describing the decision-making process in the intensive care unit (ICU) have been formulated. However, none of them appreciate the complexities of the process in an eclectic way by unifying several miscellaneous variables in 1 comprehensive theory. The purpose of this review is to highlight the key intricacies associated with the decision-making process in the ICU, to describe the theoretical frameworks with a special emphasis on gaps of knowledge, and to offer some avenues for improvement...
August 9, 2018: Anesthesia and Analgesia
Desi M Newberry, Tracey Robertson Bell
BACKGROUND: Congenital tuberculosis (TB) is rare in the United States. Recent immigration patterns to the United States have made the diagnosis of congenital TB an important public health issue. PURPOSE: To explore the epidemiology, pathophysiology, diagnostic evaluation, treatment, and prognosis for congenital TB. The implications for exposed healthcare professionals in the neonatal intensive care unit (NICU) setting are also explored. METHODS/SEARCH STRATEGY: Relevant articles were accessed via PubMed, CINAHL, and Google Scholar...
August 9, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Rebecca Sternschein, Matthew Moll, Julie Ng, Carolyn D'Ambrosio
No abstract text is available yet for this article.
August 10, 2018: American Journal of Respiratory and Critical Care Medicine
Lindsay Lief, David A Berlin, Renee C Maciejewski, Li Westman, Amanda Su, Zara R Cooper, Daniel J Ouyang, Geraldine Epping, Heather Derry, David Russell, Eliza Gentzler, Paul K Maciejewski, Holly G Prigerson
RATIONALE: Caring for patients at the end of life is emotionally taxing and may contribute to burnout. Nevertheless, little is known about the factors associated with emotional distress in ICU nurses. OBJECTIVE: To identify patient and family factors associated with nurses' emotional distress in caring for dying patients in the intensive care unit (ICU). METHODS: One hundred nurses who cared for 200 deceased ICU patients at two large, academic medical centers in the Northeast United States were interviewed about patients' psychological and physical symptoms, their reactions to those patient experiences (e...
August 10, 2018: Annals of the American Thoracic Society
Benjamin Khechen, Brittany E Haws, Mundeep S Bawa, Dil V Patel, Kaitlyn L Cardinal, Jordan A Guntin, Simon P Lalehzarian, Kern Singh
STUDY DESIGN: Retrospective Cohort OBJECTIVE.: To determine if comorbidity as determined by Charlson Comorbidity Index (CCI) is associated with inpatient complication rate, length of stay (LOS), or direct hospital costs after minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF). SUMMARY OF BACKGROUND DATA: In the spine literature, comorbidity burden has been associated with an increased risk for complications, prolonged LOS, and greater hospital costs...
August 7, 2018: Spine
Robert M Rossi, Carri R Warshak
OBJECTIVE: To quantify the rising prevalence of maternal hepatitis C virus (HCV) infection in Ohio during the peak of the opioid epidemic and to identify maternal characteristics and obstetric outcomes associated with maternal HCV infection. METHODS: We conducted a population-based retrospective cohort study of all live births in Ohio (2006-2015). Frequency of maternal HCV infection as reported on birth certificates was compared across each year of the study period...
August 6, 2018: Obstetrics and Gynecology
Fouad Atallah, Peter S Bernstein, Danilo Acosta Diaz, Howard Minkoff
The Adverse Outcome Index, originally designed to provide an objective inventory of adverse outcomes, is often promoted as a tool for assessing the quality of inpatient obstetric care. Although the Adverse Outcome Index is well described, and its outcomes are easy to collect, it has notable drawbacks such as "paradoxical measures" (eg, blood transfusions are counted as adverse measures even when they are used appropriately) and the dominance of certain measures within the Adverse Outcome Index that can drive scores (eg, neonatal intensive care unit admissions)...
August 6, 2018: Obstetrics and Gynecology
John D Hoover, William W Wong, Iki Adachi, Paige Brandt, Aamir Jeewa
OBJECTIVES: Up to one third of children with heart failure exhibit growth failure. Limited data exists reporting energy requirements in this population. A study was designed to characterize the energy intake and total daily energy expenditure of children with heart failure using the doubly labeled water method. DESIGN: Prospective study using doubly labeled water to measure total daily energy expenditure in children with heart failure. Doubly labeled water was administered orally and daily urine samples collected for 10 days...
August 7, 2018: Pediatric Critical Care Medicine
Katherine Cashen, John M Costello, Lisa M Grimaldi, Keshava Murty Narayana Gowda, Elizabeth A S Moser, Kurt D Piggott, Michael Wilhelm, Christopher W Mastropietro
OBJECTIVES: We sought to validate the Vasoactive-Ventilation-Renal score, a novel disease severity index, as a predictor of outcome in a multicenter cohort of neonates who underwent cardiac surgery. DESIGN: Retrospective chart review. SETTING: Seven tertiary-care referral centers. PATIENTS: Neonates defined as age less than or equal to 30 days at the time of cardiac surgery. INTERVENTIONS: Ventilation index, Vasoactive-Inotrope Score, serum lactate, and Vasoactive-Ventilation-Renal score were recorded for three postoperative time points: ICU admission, 6 hours, and 12 hours...
August 7, 2018: Pediatric Critical Care Medicine
Mark J Peters, Rachel Agbeko, Peter Davis, Nigel Klein, Zohra Zenasi, Amy Jones, Christine Mackerness, Susan George, Paul Veys, Samiran Ray, Paul R Mouncey, David A Harrison, Kathy Rowan
OBJECTIVES: Previous trials in adults with impaired immunity and respiratory failure suggest that early noninvasive ventilation avoids endotracheal intubation and improves survival. No randomized clinical trials have addressed this question in children. DESIGN: We undertook an open, parallel-group randomized trial in three pediatric hospitals. SUBJECTS: Children with impaired immunity and acute respiratory failure defined as tachypnoea (> 90th centile); a new requirement for supplemental oxygen; and new chest radiograph infiltrates...
August 7, 2018: Pediatric Critical Care Medicine
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