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https://www.readbyqxmd.com/read/30074024/-principios-y-modalidades-en-terapia-de-reemplazo-renal-continua
#1
Jonathan Samuel Chávez-Iñiguez, Jorge Cerdá
La terapia de reemplazo renal continuo (CRRT, por sus siglas en inglés) se utiliza en pacientes críticamente enfermos con lesión renal aguda (LRA). Este tratamiento tiene una historia cargada de tintes pasionales y ambiciosos que han revolucionado el tratamiento en las Unidades de terapia intensiva. Avances tecnológicos permiten remover toxinas y ajustar líquidos y moléculas de manera paulatina y segura, lo que que plausiblemente mejora el pronóstico clínico. Las terapias continuas requieren una estrecha colaboración del equipo multidisciplinario...
2018: Gaceta Médica de México
https://www.readbyqxmd.com/read/30050609/pattern-of-road-traffic-injuries-in-yemen-a-hospital-based-study
#2
Eshrak Alfalahi, Ali Assabri, Yousef Khader
Introduction: Road traffic injuries (RTIs) are the eighth leading cause of death globally and the leading cause of death for young people. This study aimed to present time-limited trial surveillance in two referral hospitals to describe the pattern of RTIs in Sana'a, Yemen and determine road traffic crashes (RTCs) associated factors. Methods: All RTIs presented to Emergency Departments (ED) of the two Sanaa city hospitals between August and October, 2015 were studied and described...
2018: Pan African Medical Journal
https://www.readbyqxmd.com/read/30041910/accuracy-of-pre-hospital-trauma-notification-calls
#3
Melissa K James, Lavonne A Clarke, Rose M Simpson, Anthony J Noto, Joshua R Sclair, Geoffrey K Doughlin, Shi-Wen Lee
STUDY OBJECTIVE: The aim of this study is to determine the accuracy of pre-hospital trauma notifications and the effects of inaccurate information on trauma triage. METHODS: This study was conducted at a level-1 trauma center over a two-year period. Data was collected from pre-notification forms on trauma activations that arrived to the emergency department via ambulance. Trauma activations with pre-notification were compared to those without notification and pre-notification forms were assessed for accuracy and completeness...
June 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30016565/improving-the-handover-and-transport-of-critically-ill-pediatric-patients
#4
Brigit VanGraafeiland, Cynthia Foronda, Sarah Vanderwagen, Laura Allan, Meghan Bernier, Jennifer Fishe, Elizabeth A Hunt, Justin M Jeffers
AIMS AND OBJECTIVES: The aims of this project were to 1) determine barriers to current handover and transport process, 2) develop a new protocol and process for team-to team handover, and 3) evaluate staff satisfaction with the new process. BACKGROUND: The handover and transport of critically ill patients from the pediatric emergency department to the pediatric intensive care unit is a period of vulnerability associated with adverse events. DESIGN: A mixed methods study using a quasi-experimental design and qualitative approach...
July 17, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/30001461/feeding-during-phases-of-altered-mitochondrial-activity-a-theory
#5
REVIEW
Liam McKeever, Marcelo Bonini, Carol Braunschweig
Decisions surrounding the timing and dosing of nutrition support are made for thousands of ICU patients daily and yet remain a topic of controversy. Nutrition support designed to replenish resting energy expenditure (REE) early in critical illness has led to worse clinical outcomes in at least three recent prospective randomized clinical trials. Producing sufficient energy from nutrient substrates requires use of the mitochondrial electron transport chain (ETC). This process is functionally linked to the creation of a tightly regulated series of chemical messengers known as reactive oxygen species (ROS)...
July 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29987806/hamilton-donate-a-city-wide-pilot-observational-study-of-the-icu-management-of-deceased-organ-donors
#6
Frederick D'Aragon, Deborah Cook, Sony Dhanani, Christine Ribic, Karen E A Burns, Aemal Akhtar, Lori Hand, Erika Arseneau, Cynthia Cupido, Heather Whittigham, Andrew Healey, Anne Julie Frenette, François Lamontagne, Maureen O Meade
PURPOSE: Improving the medical care of deceased organ donors to increase transplant rates and improve allograft function requires an understanding of the current epidemiology and clinical practices of deceased donation within intensive care units (ICUs). Herein, we report the results of our investigation into the feasibility of a multicentre prospective cohort study addressing the afformentioned issues. METHODS: We conducted a 12-month prospective observational cohort study in six ICUs and one coronary care unit in Hamilton, Canada...
July 9, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29981630/analysis-of-helicopter-transported-trauma-patients-at-a-regional-trauma-center
#7
Christina Sebastian, Kevin Collopy, Thomas V Clancy, Elizabeth Acquista
Our medical center's regional helicopter emergency medical service (HEMS) serves southeastern North Carolina. Judicious HEMS use is vital to ensure that the resource is available for critically injured patients and to reduce morbidity and mortality by providing timely access to definitive care. We reviewed HEMS use, clinical outcomes, and overtriage rates. The data included airlifted trauma patients from January 2004 to December 2012. Of 1210 total patients, 733 were flown directly from the scene (FS) and 477 from referring hospitals (FH)...
June 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29971820/development-of-a-novel-reference-nomogram-for-endotracheal-intubation-in-neonatal-emergency-transport-setting
#8
Carlo Bellini, Giulia Turolla, Laura C De Angelis, Maria Grazia Calevo, Luca A Ramenghi
AIM: Neonatal endotracheal intubation is a challenging procedure during transport. The aim of this study was to evaluate the effectiveness of the emergency intubation guidelines followed by our Neonatal Emergency Transport Service (NETS). METHODS: Our transport intubation guidelines follows a weight-based nomogram for nasal intubation, and the tube position is clinically verified after intubation, while the postintubation chest X-ray is postponed to Neonatal Intensive Care Unit (NICU) admission...
July 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29942511/evaluating-the-use-of-high-fidelity-simulators-during-mock-neonatal-resuscitation-scenarios-in-trying-to-improve-confidence-in-residents
#9
Deena Hossino, Christina Hensley, Karen Lewis, Marie Frazier, Renee Domanico, Melissa Burley, Jeffrey Harris, Bobby Miller, Susan L Flesher
Objective: The purpose of this study was to investigate the effect of the use of high-fidelity simulators with multidisciplinary teaching on self-reported confidence in residents. Methods: A total of 26 residents participated in a session led by a pediatric faculty member and a Neonatal Intensive Care Unit transport nurse using a high-fidelity pediatric simulator. Multiple scenarios were presented and each resident took turns in various roles. Pre-intervention surveys based on a 5-point Likert-type scale were given before the scenarios and were compared to the results of identical post-intervention surveys...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29931071/impact-of-prehospital-hypothermia-on-the-outcomes-of-severely-burned-patients
#10
Denis Ehrl, Paul I Heidekrueger, Johannes Rubenbauger, Milomir Ninkovic, P Niclas Broer
When treating burn injuries, to date, there still remains significant disagreement whether presence of hypothermia (HT) on burn centers' intensive care unit (BICU) admission improves or worsens outcomes. The presented single burn center experiences set out to further evaluate the incidence, cause, and potential effects of HT on outcomes in severely burned patients. Between January 2015 and February 2017, 142 severely burned patients were admitted to a BICU. Temperature at BICU admission of <36.0°C was defined as HT and ≥36...
February 2, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29891035/antibiotic-timing-and-outcomes-in-sepsis
#11
Richard Y Kim, Alex M Ng, Annuradha K Persaud, Stephen P Furmanek, Yash N Kothari, John D Price, Timothy L Wiemken, Mohamed A Saad, Juan J Guardiola, Rodrigo S Cavallazzi
BACKGROUND: We evaluated the effect of time spent in the emergency department (ED) and process of care on mortality and length of hospital stay in patients with sepsis or septic shock. METHODS: An observational cohort study was conducted on 117 patients who came through the University of Louisville Hospital ED and subsequently were directly admitted to the intensive care unit (ICU). Variables of interest were time in the ED from triage to physical transport to the ICU, from triage to antibiotic(s) ordered, and from triage to antibiotic(s) administered...
June 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29803894/impact-of-selective-serotonin-reuptake-inhibitors-ssris-during-pregnancy-and-lactation-a-focus-on-short-and-long-term-vascular-effects
#12
REVIEW
S Zullino, T Simoncini
SSRIs are the first choice for the treatment of mood disorders during pregnancy and lactation. Despite the known side effects, the benefits/risks balance suggests their use. Hypertensive disorders of pregnancy (HDP) and Intrauterine growth restriction (IUGR) are the main vascular effects of these drugs, with mechanisms that involves endothelial dysfunction in feto-placental system. These data are supported by animal models, even if preliminary findings are not yet adequately supported by molecular and clinical data...
September 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29800291/saxitoxin-exposure-confirmed-by-human-urine-and-food-analysis
#13
R M Coleman, G Ojeda-Torres, W Bragg, D Fearey, P McKinney, L Castrodale, D Verbrugge, K Stryker, E DeHart, M Cooper, E Hamelin, J Thomas, R C Johnson
A case of an elderly female with suspected paralytic shellfish poisoning (PSP) is presented. The patient shared a meal of recreationally-harvested shellfish with her family and soon began to experience nausea and weakness. She was taken to the local emergency department and then transported to a larger hospital in Anchorage where she was admitted to the intensive care unit with respiratory depression and shock. Her condition improved, and she was discharged from the hospital 6 days later. No others who shared the meal reported symptoms of PSP...
May 25, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29799613/the-canadian-paediatric-triage-and-acuity-scale-algorithm-for-interfacility-transport
#14
Tanya Holt, Michael Prodanuk, Gregory Hansen
OBJECTIVE: Determining pediatric severity of illness in referring centers may be useful for establishing appropriate patient disposition and interfacility transport. For this retrospective review, the authors evaluated the Canadian Paediatric Triage and Acuity Scale (PaedCTAS) tool in regards to individual patient disposition and outcomes. METHODS: A disposition score using the PaedCTAS algorithm was retrospectively calculated from referring center data at the time our transport team was consulted...
2018: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/29781549/administration-of-platelets-to-ruptured-abdominal-aortic-aneurysm-patients-before-open-surgery-a-prospective-single-blinded-randomised-study
#15
T B Lunen, P I Johansson, L P Jensen, K M Homburg, O C Roeder, L Lonn, N H Secher, U Helgstrand, M Carstensen, K B Jensen, T Lange, H Sillesen, F Swiatek, H B Nielsen
BACKGROUND: In patients undergoing open surgery for a ruptured abdominal aortic aneurysm (rAAA), survivors demonstrate a high platelet count, and proactive administration of platelets (and fresh frozen plasma) appears to influence mortality. OBJECTIVES: This trial investigated the effect of platelets administered before transport to surgery. METHODS: In a prospective study design, patients were randomised to receive platelets (intervention; n = 61) or no platelets (control; n = 61) before transport to vascular surgery from 11 local hospitals...
May 21, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29732456/a-quality-initiative-for-optimal-therapeutic-hypothermia-during-transport-for-neonates-with-neonatal-encephalopathy
#16
Stephanie L Bourque, Stephanie A Meier, Claire Palmer, Diane L Melara, Theresa R Grover, Cassidy A Delaney
Introduction: Neuroprotection with therapeutic hypothermia (TH) is standard of care for neonatal encephalopathy (NE) and decreases death and neurodevelopmental disability. TH initiated shortly after birth insult results in greater neuroprotection compared with delayed initiation. Methods: Quality improvement methodology was used to improve temperature control during transport to a level IV neonatal intensive care unit. We included neonates with NE transported to a single institution for TH from 2010 to 2016...
March 2018: Pediatric quality & safety
https://www.readbyqxmd.com/read/29725174/clinico-radiologic-profile-of-pediatric-traumatic-brain-injury-in-western-rajasthan
#17
Pawan Kumar Dara, Manish Parakh, Shyama Choudhary, Hemant Jangid, Priyanka Kumari, Satyendra Khichar
Objective: The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI). Design: Prospective observational study. Setting: Intensive Care Unit, ward and OPD of Pediatrics, Dr. S. N. Medical College, Jodhpur (tertiary care hospital). Participants: A total of 188 children (1 month-18 years) were enrolled and 108 admitted. Intervention: TBI classified as mild, moderate, or severe TBI...
April 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29705763/development-of-prediction-models-of-stress-and-long-term-disability-among-claimants-to-injury-compensation-systems-a-cohort-study
#18
Matthew J Spittal, Genevieve Grant, Meaghan O'Donnell, Alexander C McFarlane, David M Studdert
OBJECTIVES: We sought to develop prognostic risk scores for compensation-related stress and long-term disability using markers collected within 3 months of a serious injury. DESIGN: Cohort study. Predictors were collected at baseline and at 3 months postinjury. Outcome data were collected at 72 months postinjury. SETTING: Hospitalised patients with serious injuries recruited from four major trauma hospitals in Australia. PARTICIPANTS: 332 participants who made claims for compensation for their injuries to a transport accident scheme or a workers' compensation scheme...
April 28, 2018: BMJ Open
https://www.readbyqxmd.com/read/29698865/mopeds-the-high-cost-of-cheap-and-poorly-legislated-transportation-for-negligent-drivers
#19
Gabriella Ode, Ronald Sing, Joseph Hsu, Rachel Seymour, Michael Bosse
INTRODUCTION: This study evaluates the impact of moped crashes in North Carolina, a state with lenient moped legislation by(1) describing the characteristics of moped crashes and (2) estimating the cost burden of moped-related injuries. METHODS: Health and public records of moped crash subjects treated at our hospital were reviewed. Direct costs were billed hospital charges. Indirect costs based on age and outcomes were calculated. RESULTS: Between 2008-2013, 368 subjects were involved in 373 moped crashes...
August 2018: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/29698341/early-hospital-discharge-after-helicopter-transport-of-pediatric-trauma-patients-analysis-of-rates-of-over-and-undertriage
#20
Aodhnait S Fahy, Stephanie F Polites, Cornelius A Thiels, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, Scott P Zietlow, Donald H Jenkins, Martin D Zielinski
OBJECTIVES: Helicopter air ambulance (HAA) of pediatric trauma patients is a life-saving intervention. Triage remains a challenge for both scene transport and interhospital transfer of injured children. We aimed to understand whether overtriage or undertriage was a feature of scene or interhospital transfer and how in or out of state transfers affected these rates. METHODS: Children (<18 years) who underwent trauma activation at a level I trauma center between 2011 and 2013 were identified and reviewed...
April 24, 2018: Pediatric Emergency Care
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