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

Tara A Lynch, Courtney Olson-Chen, Sarah Colihan, Jeffrey Meyers, Conisha Holloman, Dongmei Li, Heather Link, Paola Torres, Annie Kim, Devon J King, Cari Eckman, Anna Varlamov, Scott Dexter, Eva K Pressman, Eleazar Soto-Torres, Amol Malshe
OBJECTIVE:  To evaluate outcomes with expectant management of preterm prelabor rupture of membranes (PROM) until 35 weeks versus immediate delivery at ≥34 weeks. STUDY DESIGN:  This was a multicenter retrospective cohort study of singletons with preterm PROM at >20 weeks from 2011 through 2017. Groups were defined as expectant management until 35 weeks versus immediate delivery at ≥34 weeks. Primary outcome was composite neonatal morbidity: need for respiratory support, culture positive neonatal sepsis, or antibiotic administration for >72 hours...
December 15, 2018: American Journal of Perinatology
Nikolaos Efstathiou, Wendy Walker, Alison Metcalfe, Brandi Vanderspank-Wright
PURPOSE: Despite advances in medical science, patient death and family bereavement are commonly encountered in adult intensive care units (ICUs). This is the first review to investigate the state of ICU bereavement support globally, and the availability and effectiveness of bereavement support interventions. METHODS: A systematic review and narrative synthesis. Medline, CINAHL Plus, PsycINFO, Web of Science, EMBASE were searched and inclusion/exclusion criteria were applied...
December 1, 2018: Journal of Critical Care
Gennaro De Pascale, Simone Carelli, Maria Sole Vallecoccia, Salvatore Lucio Cutuli, Temistocle Taccheri, Luca Montini, Giuseppe Bello, Teresa Spanu, Mario Tumbarello, Americo Cicchetti, Irene Urbina, Marco Oradei, Marco Marchetti, Massimo Antonelli
PURPOSE: To assess risk factors for 28-day mortality and cost implications in intensive care unit (ICU) patients with complicated intra-abdominal infections (cIAIs). METHODS: Single-center retrospective cohort study of prospectively collected data analysing ICU patients with a microbiologically confirmed complicated intra-abdominal infections. RESULTS: 137 complicated intra-abdominal infections were included and stratified according to the adequacy of antimicrobial therapy (initial inadequate antimicrobial therapy [IIAT], n = 44; initial adequate antimicrobial therapy [IAAT], n = 93)...
December 12, 2018: Journal of Critical Care
Weitie Wang, Hulin Piao, Yong Wang, Bo Li, Tiance Wang, Rihao Xu, Dan Li, Zhicheng Zhu, Maoxun Huang, Kexiang Liu
BACKGROUND: To evaluate the middle- and long- clinical outcomes of aortic implantation of stent-grafts under direct vision (hybrid surgical treatment). METHODS: From March 2009 to December 2014, 285 patients presented with type-B aortic dissection. Of these, 35 complicated patients underwent hybrid surgical treatment. Self-designed stent-grafts (Micropart Corp, Shanghai, China) were implanted under direct vision. Collected data included the surgical time, cerebral perfusion time, aortic clamping time, postoperative (before discharge) mechanical ventilation time, consciousness recovery time, time in intensive care unit, length of stay, computed tomography (CT) angiography before discharge, middle- and long-term complications, mortality, and endoleaks...
December 12, 2018: Annals of Thoracic Surgery
Jaspal Singh, Ronald F Sing
Percutaneous dilatational tracheotomy (PDT) has become increasingly popular and gained widespread acceptance. The modern PDT procedure has also evolved to whereby it can be safely performed by surgeons and non-surgeons in the intensive care unit (ICU). Moreover, bedside PDT has proven clinical outcomes and can save hospital resources. As such, PDT performed in the ICU is now a widely-performed procedure, often being the tracheostomy procedure of choice. Today, many pulmonologists and intensivists who can utilize bedside PDT do not perform this procedure; it is conceivable this practice may expand especially amongst pulmonologists and intensivists...
December 12, 2018: Chest
Daniella Gregoria Bomfim Prado da Silva, Flávia Jacqueline Almeida, Mariana Volpe Arnoni, Marco Aurélio Palazzi Sáfadi, Marcelo Jenne Mimica, Daniel Jarovsky, Gabriela Pereira de Almeida Rossetti, Mauricio Magalhães, Danielle Bruna Leal de Oliveira, Luciano Matsumiya Thomazelli, Thais Cristina Colmanetti, Edison Luiz Durigon, Eitan Naaman Berezin
OBJECTIVE: Respiratory syncytial virus is a pathogen frequently involved in nosocomial outbreaks. Although several studies have reported nosocomial outbreaks in neonatal intensive care units, molecular epidemiology data are scarce. Here, the authors describe two consecutive respiratory syncytial virus outbreaks caused by genotypes ON-1 and NA-2 in a neonatal intensive care unit in São Paulo, Brazil. METHODS: A prospective search for respiratory syncytial virus was performed after diagnosing the index case and four other symptomatic newborns in the neonatal intensive care unit...
December 12, 2018: Jornal de Pediatria
Takafumi Nakayama, Atsushi Okada, Takuya Hasegawa, Yoshiaki Morita, Hideaki Kanzaki, Kizuku Yamashita, Yusuke Shimahara, Tomoyuki Fujita, Satoshi Yasuda, Junjiro Kobayashi
OBJECTIVE: The standard treatment of prosthetic paravalvular leakage (PVL) accompanied by heart failure or hemolytic anemia is repeat open surgery. Although favorable outcomes for transcatheter prosthetic PVL closure in patients with a high surgical risk for repeat open surgery have been reported, procedural feasibility has not been examined in Japan. METHODS: From March 2015 to November 2015, transcatheter PVL closure in mitral position was performed in four patients (age range 41-78, three females) with high surgical risk due to history of repeated surgeries, chest radiation and reconstruction of the mitral annulus after debridement of abscess owing to infective endocarditis...
December 14, 2018: General Thoracic and Cardiovascular Surgery
Renato Rocha Martins, Lunara Teles Silva, Flavio Marques Lopes
Background Drug-related problems are mostly preventable or predictable circumstances that may impact on health outcomes. Clinical pharmacy activities such as medication therapy management can identify and solve these problems, with potential to improve medication safety and effectiveness. Objective To evaluate ability of medication therapy management service to detect drug-related problems and prevent adverse drug events. This study also aimed to assess the risk factors for drugrelated problem occurrence. Setting Medical intensive care unit of a public tertiary hospital in Brazil...
December 15, 2018: International Journal of Clinical Pharmacy
Júlia Coelho França Quintanilha, Natalia da Costa Duarte, Gustavo Rafaini Lloret, Marília Berlofa Visacri, Karen Prado Herzer Mattos, Desanka Dragosavac, Antonio Luis Eiras Falcão, Patricia Moriel
Background The emergence and rapid spread of multidrug-resistant gram-negative bacteria related to nosocomial infections is a growing worldwide problem, and polymyxins have become important due to the lack of new antibiotics. Objectives To evaluate the outcomes and pharmacoeconomic impact of using colistin and polymyxin B to treat nosocomial infections. Setting Neurosurgical, cardiovascular, or transplantation intensive care unit (ICU) at the Clinical Hospital of the University of Campinas (São Paulo, Brazil)...
December 15, 2018: International Journal of Clinical Pharmacy
Walter Basso, Lisa-Maria Grandt, Anne-Laure Magnenat, Bruno Gottstein, Miguel Campos
Strongyloides stercoralis is a worldwide-distributed intestinal nematode affecting mainly humans and dogs. Canine strongyloidosis is generally characterised by diarrhoea, malabsorption and bronchopneumonia, and may be fatal in cases of impaired immunity. In recent years, molecular and epidemiological studies suggested that host-adapted populations of S. stercoralis with different zoonotic potential may exist. Clinical and subclinical cases of S. stercoralis infection have been increasingly diagnosed in imported (France, Belgium, Bulgaria) and locally born dogs in Switzerland, showing that this parasite is currently circulating in Europe...
December 14, 2018: Parasitology Research
Amin T Turki, Wolfgang Lamm, Christoph Schmitt, Evren Bayraktar, Ferras Alashkar, Martin Metzenmacher, Philipp Wohlfarth, Dietrich W Beelen, Tobias Liebregts
The author name Philipp Wohlfarth was incorrectly spelled as Philipp Wohlfahrth in the original version of this article.
December 14, 2018: Annals of Hematology
S-O Kuhn, K Hahnenkamp
The shortage of donor organs has not improved in recent years. To increase the number and success of transplantation it is crucial to optimize the processes of early identification of potential organ donors and structured critical care management. The therapy starts long before brain death is diagnosed. Structured in-house organ donor management protocols ensure a highly qualified critical care that has a direct impact on the transplantation outcome. The therapy is based on the established standards. The main focus is on differentiated catecholamine and volume therapy...
December 14, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Xiaohua Xie, Wenlong Huang, Qiongling Liu, Wei Tan, Lu Pan, Lei Wang, Jian Zhang, Yunyun Wang, Yingchun Zeng
OBJECTIVES: This study aimed to validate the performance of the Modified Early Warning Score (MEWS) in a Chinese emergency department and to determine the best cut-off value for in-hospital mortality prediction. DESIGN: A prospective, single-centred observational cohort study. SETTING: This study was conducted at a tertiary hospital in South China. PARTICIPANTS: A total of 383 patients aged 18 years or older who presented to the emergency department from 17 May 2017 through 27 September 2017, triaged as category 1, 2 or 3, were enrolled...
December 14, 2018: BMJ Open
Chiara Ventre, Sian Nowell, Catriona Graham, Doug Kidd, Christos Skouras, Damian J Mole
INTRODUCTION: Severe acute pancreatitis (AP) requiring critical care admission (ccAP) impacts negatively on long-term survival. OBJECTIVE: To document organ-specific new morbidity and identify risk factors associated with premature mortality after an episode of ccAP. DESIGN: Cohort study. SETTING: Electronic healthcare registries in Scotland. PARTICIPANTS: The ccAP cohort included 1471 patients admitted to critical care with AP between 1 January 2008 and 31 December 2010 followed up until 31 December 2014...
December 14, 2018: BMJ Open
Savannah Norman, Frank DeCicco, Jennifer Sampson, Ian M Fraser
OBJECTIVES: Ensure early identification and timely management of patient deterioration as essential components of safe effective healthcare. Prompted by analyses of incident reports and deterioration events, a multicomponent organisational rescue from danger system was redesigned to decrease unexpected inpatient deterioration. DESIGN: Quality improvement before-after unblinded trial. SETTING: 430-bed Canadian community teaching hospital. PARTICIPANTS: All admitted adult medical-surgical patients in a before-after 12-month interventional study...
December 14, 2018: BMJ Open
Tony Li, Ranjeeta Mallick, Arleigh McCurdy, Sunita Mulpuru, Lothar Huebsch, Chris Bredeson, David Allan, Natasha Kekre
INTRODUCTION: Despite the risk of morbidity and mortality associated with autologous hematopoietic cell transplantation (ASCT), there are no clear guidelines as to how to screen for these risks. This study sought to determine the utility of pulmonary function tests (PFTs) prior to ASCT on predicting posttransplant clinical outcomes. PATIENTS AND METHODS: Patients undergoing ASCT between 2010 and 2012 at the Ottawa Hospital (n = 172) were reviewed. PFT results prior to ASCT were retrieved...
November 12, 2018: Clinical Lymphoma, Myeloma & Leukemia
Chul-Hoon Kim, Myoung Soo Kim, Myung Ja Kang, Hyun Hee Kim, Nam Jung Park, Hyun Kyeong Jung
PURPOSE: This study examined the incidence of oral mucosa pressure ulcers (PUs) in intensive care unit (ICU) patients and the relationship between biomechanical and physiological variables in onset of PUs. METHODS: A prospective observational descriptive study design was used. We recruited patients over 18 years of age with endotracheal tube (ETT) insertion in three ICUs in a tertiary hospital in Korea. We analysed 113 patient-days of data. Patient assessments and medical record reviews were conducted to gather biomechanical and physiological data...
December 5, 2018: Journal of Tissue Viability
Marcelo Cerullo, Faiz Gani, Sophia Y Chen, Joseph K Canner, Mary Dillhoff, Jordan Cloyd, Timothy M Pawlik
BACKGROUND: An understanding of the overall routine intensive care unit utilization, and characterization of the factors associated with a routine intensive care unit stay, may help identify ways to decrease overutilization of this resource after pancreatic surgery. METHODS: Patients undergoing major pancreatic resection were identified in the Truven Health Analytics (Ann Arbor, MI) MarketScan Commercial Claims and Encounters Database from 2010 to 2014. Routine postoperative intensive care unit admission was defined as an admission to the intensive care unit of 24 hours or less on postoperative day zero...
December 11, 2018: Surgery
Sarah Stankiewicz, Craig Larsen, Francesca Sullivan, Cristina Zullo, Suzanne C Pugh, Miroslav Kopp
BACKGROUND: ED boarding is a major issue in many hospitals. ED boarding occurs when there is insufficient hospital capacity to supply inpatient beds for admitted patients. ED boarding is not only a problem because of increased wait times for patients but also because it results in delays in administration of medication, higher rates of complications, and increased mortality. METHODS: In an attempt to improve patient flow and reduce time spent in the emergency department for patients requiring admission to the surgical intensive care unit (SICU), the emergency department, trauma service, and SICU collaborated on a guideline...
December 11, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Ai-Wu Shi, Xiao-Feng Shen, Hong-Juan Ding, Yao-Qiu Liu, Li Meng, Bill Kalionis
BACKGROUND: Gestational diabetes mellitus is strongly related to the risk of pancreatic cancer in pregnant women, but gestational diabetes can precede a diagnosis of pancreatic cancer by many years. Women with a history of gestational diabetes showed a relative risk of pancreatic cancer of 7.1. Pancreatic adenocarcinoma is one of the most common malignancies associated with thromboembolic events. A clinical study showed that thromboembolic events were detected in 36% of patients diagnosed as having pancreatic cancer...
December 15, 2018: Journal of Medical Case Reports
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