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https://www.readbyqxmd.com/read/29149384/brain-metabolism-and-severe-pediatric-traumatic-brain-injury
#1
Heidi Griffiths, Manu S Goyal, Jose A Pineda
Age-dependent changes in brain metabolism may influence the response to and tolerance of secondary insults, potentially affecting outcomes. More complete characterization of brain metabolism across the clinical trajectory of severe pediatric TBI is needed to improve our ability to measure and better mitigate the impact of secondary insults. Better management of secondary insults will impact clinical care and the probability of success of future neuroprotective clinical trials. Improved bedside monitoring and imaging technologies will be required to achieve these goals...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29149182/comparison-between-public-and-private-sectors-of-care-and-disparities-in-adverse-neonatal-outcomes-following-emergency-intrapartum-cesarean-at-term-a-retrospective-cohort-study
#2
Woonji Jang, Christopher Flatley, Ristan M Greer, Sailesh Kumar
BACKGROUND: Perinatal outcomes may be influenced by a variety of factors including maternal demographics and medical condition as well as socio-economic status. The evidence for disparities in health outcomes stratified by type of care (public or private) is lacking. The aim of this study was to investigate short term neonatal outcomes following category 1 and 2 emergency cesareans at term between publicly and privately funded women at a single major tertiary centre in Australia. Category 1-immediate threat to life (maternal or fetal); Category 2-maternal or fetal compromise that is not immediately life-threatening...
2017: PloS One
https://www.readbyqxmd.com/read/29148994/critical-care-resources-in-mainland-china-when-more-may-not-always-be-better
#3
Bin Du, Xiaoyun Hu, Ming Hou
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29148125/understanding-the-factors-which-promote-registered-nurses-intent-to-stay-in-critical-care-and-emergency-areas
#4
Mary Van Osch, Kathy Scarborough, Sarah Crowe, Angela C Wolff, Sheryl Reimer-Kirkham
BACKGROUND: Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29146105/content-validation-of-behaviours-and-autonomic-responses-for-the-assessment-of-pain-in-critically-ill-adults-with-a-brain-injury
#5
Céline Gélinas, Kathleen A Puntillo, Madalina Boitor, Mélanie Bérubé, Jane Topolovec-Vranic, Anne-Sylvie Ramelet, Aaron M Joffe, Melissa Richard-Lalonde, Francis Bernard, David L Streiner
BACKGROUND: The evidence shows that brain-injured patients express behaviours that are related to their level of consciousness (LOC), and different from other patients in the intensive care unit (ICU). Therefore, existing behavioural scales should be revised to enhance their content and validity for use in these patients. OBJECTIVES: The aim was to evaluate the content relevance of behaviours and autonomic responses for pain assessment of brain-injured ICU patients from the perspective of critical care clinicians...
November 13, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29145705/review-article-critical-care-airway-management-elearning-modules
#6
REVIEW
Deepak Doshi, Sally McCarthy, Elizabeth Mowatt, Angela Cahill, Bronwyn Peirce, Geoff Hawking, Ruth Osborne, Belinda Hibble, Katharine Ebbs
The Australasian College for Emergency Medicine (ACEM) has recently launched the Critical Care Airway Management eLearning modules to support emergency medicine trainees in developing their airway management skills in the ED. A team of emergency physicians and trainees worked collaboratively to develop the eLearning resources ensuring extensive stakeholder consultation. A comprehensive resource manual was written to provide learners with knowledge that underpins the modules. ACEM provided project coordination as well as administrative and technical team support to the production...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29144515/detection-of-sepsis-in-patient-blood-samples-using-cd64-expression-in-a-microfluidic-cell-separation-device
#7
Ye Zhang, Wenjie Li, Yun Zhou, Amanda Johnson, Amanda Venable, Ahmed Hassan, John Griswold, Dimitri Pappas
A microfluidic affinity separation device was developed for the detection of sepsis in critical care patients. An affinity capture method was developed to capture cells based on changes in CD64 expression in a single, simple microfluidic chip for sepsis detection. Both sepsis patient samples and a laboratory CD64+ expression model were used to validate the microfluidic assay. Flow cytometry analysis showed that the chip cell capture had a linear relationship with CD64 expression in laboratory models. The Sepsis Chip detected an increase in upregulated neutrophil-like cells when the upregulated cell population is as low as 10% of total cells spiked into commercially available aseptic blood samples...
November 16, 2017: Analyst
https://www.readbyqxmd.com/read/29144490/neonatal-lung-ultrasound-exam-guidelines
#8
D Kurepa, N Zaghloul, L Watkins, J Liu
Point-of-care ultrasound (POC-US) is increasingly used especially in emergency and critical-care medicine. It is focused, quick and does not expose patients to ionizing radiation. It encompasses all organ systems and has well-defined indications. Lung ultrasound (LUS) represents one of the most exciting applications in the field of POC-US. It is particularly important to emphasize the role of LUS in neonatology due to the specific pathology inherent in lung immaturity as well as in the particular sensitivity of neonates to repeated radiation exposure...
November 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29143891/in-search-of-the-ideal-promotility-agent-optimal-use-of-currently-available-promotility-agents-for-nutrition-therapy-of-the-critically-ill-patient
#9
REVIEW
Sarah J Diamond, Endashaw Omer, Laszlo Kiraly
PURPOSE OF REVIEW: Enteral nutrition therapy is essential in the management of critically ill patients. Prokinetic agents have been used successfully to aid in the delivery of nutrition and improve feeding tolerance in patients in the intensive care unit (ICU). The aim of this report is to review the existing promotility agents available for use in the critically ill as well as outline the role of potential investigative drugs in order to provide a guide to the management of this difficult and important clinical dilemma...
November 16, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29142540/clinical-audit-of-dengue-related-deaths-in-2011-mayo-hospital-lahore-pakistan
#10
Somia Iqtadar, Nabeel Akbar, Mehreen Mehmood, Sajid Abaidullah
Background and Objective: Dengue infection has evolved into an epidemic during last few years in Pakistan and has been associated with poor outcomes. Literature with respect to mortality risk factors in Dengue infection is not sufficient. This compelled us to conduct this study to find out major contributory factors to death in patients with dengue viral infection at one of Asia's ancient hospital setting with an aim to recognize complications at earliest and improve case management in future...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29142376/intensive-care-nurses-attitude-on-palliative-and-end-of-life-care
#11
Swagata Tripathy, Pragyan K Routray, Jagdish C Mishra
Background: Intensive Care Unit (ICU) nurses have a vital role in the implementation of end of life (EOL) care. There is limited data on the attitude of ICU nurses toward EOL and palliation. Aim: This study aimed to investigate knowledge, attitude, and beliefs of intensive care nurses in eastern India toward EOL. Materials and Methods: A self-administered questionnaire was distributed to delegates in two regional critical care nurses' training programs...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29142372/mapping-the-characteristics-of-critical-care-facilities-assessment-distribution-and-level-of-critical-care-facilities-from-central-india
#12
Saurabh Saigal, Jai Prakash Sharma, Abhijit Pakhare, Santosh Bhaskar, Sanjay Dhanuka, Sanjay Kumar, Yogesh Sabde, Pradip Bhattacharya, Rajnish Joshi
Background: In low- and middle-income countries such as India, where health systems are weak, the number of available Critical Care Unit (Intensive Care Unit [ICU]) beds is expected to be low. There is no study from the Indian subcontinent that has reported the characteristics and distribution of existing ICUs. We performed this study to understand the characteristics and distribution of ICUs in Madhya Pradesh (MP) state of Central India. We also aimed to develop a consensus scoring system and internally validate it to define levels of care and to improve health system planning and to strengthen referral networks in the state...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29140950/development-of-clinical-process-measures-for-pediatric-burn-care-understanding-variation-in-practice-patterns
#13
Lewis E Kazis, Robert L Sheridan, Gabriel D Shapiro, Austin F Lee, Matthew H Liang, Colleen M Ryan, Jeffrey C Schneider, Martha Lydon, Marina Soley-Bori, Lily A Sonis, Emily C Dore, Tina Palmieri, David Herndon, Walter Meyer, Petra Warner, Richard Kagan, Frederick J Stoddard, Michael Murphy, Ronald G Tompkins
BACKGROUND: There has been little systematic examination of variation in pediatric burn care clinical practices and its effect on outcomes. As a first step, current clinical care processes need to be operationally defined. The highly specialized burn care units of the Shriners Hospitals for Children system present an opportunity to describe the processes of care. The aim of this study was to develop a set of process-based measures for pediatric burn care and examine adherence to them by providers in a cohort of pediatric burn patients...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29139549/elevated-potassium-outward-currents-in-hyperoxia-treated-atrial-cardiomyocytes
#14
Z Vysotskaya, B Chidipi, J L Rodgers, X Tang, E Samal, N Kolliputi, S Mohapatra, E S Bennett, S K Panguluri
Supplementation of 100% oxygen is a very common intervention in intensive care units (ICU) and critical care centers for patients with dysfunctional lung and lung disorders. Although there is advantage in delivering sufficient levels of oxygen, hyperoxia is reported to be directly associated with increasing in-hospital deaths. Our previous studies reported ventricular and electrical remodeling in hyperoxia treated mouse hearts, and in this article, for the first time, we are investigating the effects of hyperoxia on atrial electrophysiology using whole-cell patch-clamp electrophysiology experiments along with assessment of Kv1...
November 15, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29139480/position-paper-the-potential-role-of-optical-biopsy-in-the-study-and-diagnosis-of-environmental-enteric-dysfunction
#15
REVIEW
Alex J Thompson, Michael Hughes, Salzitsa Anastasova, Laurie S Conklin, Tudor Thomas, Cadman Leggett, William A Faubion, Thomas J Miller, Peter Delaney, François Lacombe, Sacha Loiseau, Alexander Meining, Rebecca Richards-Kortum, Guillermo J Tearney, Paul Kelly, Guang-Zhong Yang
Environmental enteric dysfunction (EED) is a disease of the small intestine affecting children and adults in low and middle income countries. Arising as a consequence of repeated infections, gut inflammation results in impaired intestinal absorptive and barrier function, leading to poor nutrient uptake and ultimately to stunting and other developmental limitations. Progress towards new biomarkers and interventions for EED is hampered by the practical and ethical difficulties of cross-validation with the gold standard of biopsy and histology...
November 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29138206/monitor-ic-study-a-mixed-methods-prospective-multicentre-controlled-cohort-study-assessing-5-year-outcomes-of-icu-survivors-and-related-healthcare-costs-a-study-protocol
#16
Wytske Geense, Marieke Zegers, Hester Vermeulen, Mark van den Boogaard, Johannes van der Hoeven
INTRODUCTION: Due to advances in critical care medicine, more patients survive their critical illness. However, intensive care unit (ICU) survivors often experience long-term physical, cognitive and mental problems, summarised as post-intensive care syndrome (PICS), impacting their health-related quality of life (HRQoL). In what frequency PICS occurs, and to what extent this influences ICU survivors' HRQoL, is mostly unknown. The aims of this study are therefore to study the: (1) 5-year patient outcomes, (2) predictors for PICS, (3) ratio between HRQoL of ICU survivors and healthcare-related costs, and (4) care and support needs...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29136716/-the-impact-of-goal-directed-analgesia-on-mechanical-ventilated-patients-s-outcomes-in-intensive-care-unit-a-clinical-observational-study
#17
Q D Li, X Y Wan, Y L Zhang, S W Li, L L Han, W W Li, H Y Shi
To investigate the impact of goal directed analgesia on the outcome of patients with mechanical ventilation in intensive care unit.A total of 126 patients who needed mechanical ventilation were recruited.With a method of before and after paired comparison, they were divided into two group: (1) analgesia with empirical administration or control group; (2) goal directed analgesia based on critical-care pain observation tool (CPOT). Compared with the control group, after goal directed analgesia was applied, the consumption of midazolam significantly dropped from (368...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29135898/acute-illness-protocol-for-urea-cycle-disorders
#18
Lance H Rodan, Saud H Aldubayan, Gerard T Berry, Harvey L Levy
Inborn errors of metabolism (IEMs) are genetic disorders that disrupt enzyme activity, cellular transport, or energy production. They are individually rare but collectively have an incidence of 1:1000. Most patients with IEMs are followed up by a physician with expertise in biochemical genetics (metabolism), but may present outside this setting. Because IEMs can present acutely with life-threatening crises that require specific interventions, it is critical for the emergency physician, internist, and critical care physician as well as the biochemical geneticist to have information on the initial assessment and management of patients with these disorders...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29135521/the-effect-of-icu-out-of-hours-admission-on-mortality-a-systematic-review-and-meta-analysis
#19
Megan Galloway, Aoife Hegarty, Sarah McGill, Nishkantha Arulkumaran, Stephen J Brett, David Harrison
OBJECTIVES: Organizational factors are associated with outcome of critically ill patients and may vary by time of day and day of week. We aimed to identify the association between out-of-hours admission to critical care and mortality. DATA SOURCES: MEDLINE (via Ovid) and EMBASE (via Ovid). STUDY SELECTION: We performed a systematic search of the literature for studies on out-of-hours adult general ICU admission on patient mortality. DATA EXTRACTION: Meta-analyses were performed and Forest plots drawn using RevMan software...
November 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29135501/temperature-variability-in-a-modern-targeted-temperature-management-trial
#20
Ahmad Abu-Arafeh, Aryelly Rodriguez, Ross L Paterson, Peter J D Andrews
OBJECTIVES: The Eurotherm3235 trial showed that therapeutic hypothermia was deleterious in patients with raised intracranial pressure following traumatic brain injury. We sought to ascertain if increased temperature variability within the first 48 hours, or for 7 days post randomization, were modifiable risk factors associated with poorer outcome. DESIGN: Eurotherm3235 was a multicenter randomized controlled trial. Patients were randomized to receive either therapeutic hypothermia in addition to standard care or the later only...
November 10, 2017: Critical Care Medicine
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