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https://www.readbyqxmd.com/read/28346681/obstructive-sleep-apnea-and-postoperative-complications-among-patients-undergoing-gynecologic-oncology-surgery
#1
Olumuyiwa A Bamgbade, Rong R Khaw, Raisah S Sawati, Cathrine M Holland
OBJECTIVE: To investigate the prevalence of obstructive sleep apnea (OSA), physiological or risk factors associated with OSA, and OSA-associated postoperative complications among patients undergoing gynecologic oncology surgery. METHODS: A prospective observational study was done of gynecologic oncology patients undergoing abdominal surgery at a center in the UK between August 2009 and January 2013. All patients underwent perioperative sleep oximetry for the diagnosis of OSA...
March 27, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28346013/the-physiology-of-blood-loss-and-shock-new-insights-from-a-human-laboratory-model-of-hemorrhage
#2
Alicia M Schiller, Jeffrey T Howard, Victor A Convertino
The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that have the ability to stave off hemodynamic collapse. This review provides new insights about the physiology that underlies blood loss and shock in humans through the development of a simulated model of hemorrhage using lower body negative pressure. In this review, we present controlled experimental results through utilization of the lower body negative pressure human hemorrhage model that provide novel insights on the integration of physiological mechanisms critical to the compensation for volume loss...
April 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28345481/cost-effectiveness-analysis-of-implementing-an-antimicrobial-stewardship-programme-in-critical-care-units
#3
Jesus Ruiz-Ramos, Juan Frasquet, Eva Romá, Jose Luis Poveda-Andres, Miguel Salavert-Leti, Alvaro Catellanos, Paula Ramirez
AIMS: To evaluate the cost-effectiveness of antimicrobial stewardship (AS) programme implementation focused on critical care units based on assumptions for the Spanish setting. MATERIAL AND METHODS: A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed...
March 26, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28342906/citation-analysis-a-new-approach-to-assess-the-uptake-of-core-outcome-sets
#4
Karen L Barnes, Jamie J Kirkham, Mike Clarke, Paula R Williamson
OBJECTIVE: To evaluate citation analysis as an approach to measuring core outcome set (COS) uptake, by assessing whether the number of citations for a COS report could be used as a surrogate measure of uptake of the COS by clinical trialists. STUDY DESIGN AND SETTING: Citation data were obtained for COS reports published before 2010 in five disease areas (systemic sclerosis, rheumatoid arthritis, eczema, sepsis and critical care, and female sexual dysfunction). Those publications identified as a report of a clinical trial were examined to identify whether or not all outcomes in the COS were measured in the trial...
March 22, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28342145/spiritual-experiences-of-muslim-critical-care-nurses
#5
Ercan Bakir, Sevgin Samancioglu, Serap Parlar Kilic
The purpose of this study was to determine the experiences and perceptions of intensive care nurses (ICNs) about spirituality and spiritual care, as well as the effective factors, and increase the sensitivity to the subject. In this study, we examined spiritual experiences, using McSherry et al. (Int J Nurs Stud 39:723-734, 2002) Spirituality and spiritual care rating scale (SSCRS), among 145 ICNs. 44.8% of the nurses stated that they received spiritual care training and 64.1% provided spiritual care to their patients...
March 24, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28342133/is-old-age-a-contraindication-to-elective-ventral-hernia-repair
#6
Ruel Neupane, Mojtaba Fayezizadeh, Arnab Majumder, Yuri W Novitsky
BACKGROUND: Ventral hernia repair (VHR) is a frequent problem in the expanding aging population. However, advanced age is often viewed as a contraindication to elective hernia surgery. We aimed to analyze outcomes of VHR in a large cohort of elderly patients. We hypothesized that elective VHR is safe and effective even in patients over 70 years old. METHODS: We conducted a retrospective review of consecutive patients over the age of 70 who underwent VHR at a at a tertiary care hospital...
March 24, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28340911/ultrasound-guided-vascular-cannulation-in-critical-care-patients-a-practical-review
#7
P Blanco
Vascular cannulation is common practice in critical care, and is traditionally performed using the landmark technique - though failures and complications are not uncommon. In this regard, ultrasound guided vascular cannulation (USGVC) has been shown to improve the procedure success rate and reduce its associated complications. This review addresses the fundamental aspects of USGVC and discusses some training issues related to this technique which is currently regarded as essential for intensivists.
December 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/28340603/blunt-cardiac-injury-due-to-trauma-associated-with-snowboarding-a-case-report
#8
Fuminori Yamaji, Hideshi Okada, Yasuhiro Nakajima, Kodai Suzuki, Takahiro Yoshida, Yosuke Mizuno, Haruka Okamoto, Yuichiro Kitagawa, Taku Tanaka, Shiho Nakano, Sho Nachi, Tomoaki Doi, Keisuke Kumada, Shozo Yoshida, Narihiro Ishida, Katsuya Shimabukuro, Hiroaki Ushikoshi, Izumi Toyoda, Kiyoshi Doi, Shinji Ogura
BACKGROUND: Cardiac trauma is associated with a much higher mortality rate than injuries to other organ systems, even though cardiac trauma is identified in less than 10% of all trauma admissions. Here we report blunt trauma of the left atrium due to snowboarding trauma. CASE PRESENTATION: A 45-year-old Asian man collided with a tree while he was snowboarding and drinking. He lost consciousness temporarily. An air ambulance was requested and he was transported to an advanced critical care center...
March 25, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28339379/stability-of-sodium-nitroprusside-in-5-dextrose-stored-at-4%C3%A2-c-in-polypropylene-syringes-protected-from-light
#9
Collin R Anderson, Deborah Collins, Trevor Laursen, Trevor Arave, Michael Helm
Sodium nitroprusside is a potent vasodilator employed intraoperatively and within critical care areas. The photolabile pharmaceutical agent has been used for decades and various stability studies have been executed. Due to potential shortages and the desire to batch compound sodium nitroprusside at a concentration of 1 mg/mL in polypropylene syringes, a new stability study was performed. Chromatographic analysis was conducted on a C18 column, with elution via an aqueous phase of 0.01 M sodium phosphate monobasic, adjusted to pH 6...
September 2016: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28338497/using-selective-serotonin-reuptake-inhibitors-and-serotonin-norepinephrine-reuptake-inhibitors-in-critical-care-a-systematic-review-of-the-evidence-for-benefit-or-harm
#10
John M Kelly, Gordon D Rubenfeld, Neil Masson, Arimie Min, Neill K J Adhikari
OBJECTIVE: Selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitors are among the most commonly prescribed drugs in patients admitted to the ICU. Our objective was to systematically review available literature for evidence of benefit or harm in ICU patients resulting from chronic effects, continued use, or withdrawal. DATA SOURCES: Medline, Embase, and Cochrane Central Register of Controlled Trials (1990 to November 2014). STUDY SELECTION: We searched for studies of ICU patients with recorded selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor prescription before or during admission, and reporting morbidity, mortality, adverse events, and resource measures like ICU length of stay...
March 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28338416/impact-of-a-complex-care-management-model-on-cost-and-utilization-among-adolescents-and-young-adults-with-special-care-and-health-needs
#11
Daniel D Maeng, Susan R Snyder, Thomas W Davis, Janet F Tomcavage
Adolescents and young adults with special care and health needs in the United States-many of whom have Medicaid coverage-at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model-referred to as Comprehensive Care Clinic (CCC)-has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case manager, that develops and closely follows a coordinated care plan...
March 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28337769/accuracy-intra-and-inter-rater-reliability-of-three-scoring-systems-for-the-glottic-view-at-videolaryngoscopy
#12
E J O'Loughlin, A D Swann, J D English, R Ramadas
An accurate and reproducible recording of laryngoscopic view at tracheal intubation is an important aspect of anaesthetic practice. Unlike direct laryngoscopy, in which the view achieved by the line of sight directly relates to the ease of intubating the trachea, videolaryngoscopy can create a situation in which the view is good, but intubation difficult or impossible. Communicating this to a subsequent anaesthetist is important. We compared three scoring systems: Cormack and Lehane; POGO (percentage of glottic opening); and the Fremantle score, as used by 74 critical care doctors rating 30 anonymised videos of videolaryngoscopic intubations...
March 24, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28336015/ten-years-of-en-route-critical-care-training
#13
Mathieu Boutonnet, Pierre Pasquier, Laurent Raynaud, Laurent Vitiello, Jérôme Bancarel, Sébastien Coste, Guillaume Pelée de Saint Maurice, Sylvain Ausset
OBJECTIVE: The French Military Health Service (FMHS) has developed a training program for medical evacuation (MEDEVAC) of critical care patients on fixed wing aircraft. METHODS: We conducted a 10-year retrospective analysis (2006-2015) of the data from the FMHS Academy. The number of trainees was listed according to the different courses and medical specialties. The number of MEDEVACs recorded during the period was described. RESULTS: Since 2006, the FMHS has developed training courses designed for MEDEVAC of critical care patients...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28336009/case-study-in-critical-care-transport-a-51-year-old-male-with-ludwig-angina
#14
Brittney Bernardoni, Riley Grosso, Elizabeth Powell, Peter V R Tilney
No abstract text is available yet for this article.
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28333820/committee-opinion-no-692-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#15
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333812/committee-opinion-no-692-summary-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#16
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#17
Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt, Philipp Kümpers
BACKGROUND: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28330440/prevalence-and-predictors-of-intra-abdominal-hypertension-and-compartment-syndrome-in-surgical-patients-in-critical-care-units-at-kenyatta-national-hospital
#18
A Muturi, P Ndaguatha, Daniel Ojuka, A Kibet
BACKGROUND: Intra-abdominal hypertension (IAH) affects almost every organ sytem.If it is not detected early and corrected, mortality would be high. The prevalence of IAH and abdominal compartment syndrome (ACS) at Kenyatta National Hospital (KNH) critical care units is not known. The aim of this sudy was to determine the prevalence and factors associated with development of IAH/ACS among critically ill surgical patients. METHODS: This was a cross sectional descriptive study involving surgical patients in critical care units at KNH, carried out from March 2015 to October 2015...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#19
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328786/high-quality-randomized-controlled-trials-in-pediatric-critical-care-a-survey-of-barriers-and-facilitators
#20
Mark Duffett, Karen Choong, Jennifer Foster, Maureen Meade, Kusum Menon, Melissa Parker, Deborah J Cook
OBJECTIVES: High-quality, adequately powered, randomized controlled trials are needed to inform the care of critically ill children. Unfortunately, such evidence is not always available. Our objective was to identify barriers and facilitators of conducting high-quality randomized controlled trials in pediatric critical care, from the perspective of trialists in this field. DESIGN: Self-administered online survey. Respondents rated the importance of barriers and effectiveness of facilitators on seven-point scales...
March 21, 2017: Pediatric Critical Care Medicine
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