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https://www.readbyqxmd.com/read/29785938/decision-making-in-end-of-life-care-are-we-really-playing-together-in-the-same-team
#1
M M Lomero-Martínez, M F Jiménez-Herrera, M A Bodí-Saera, M Llauradó-Serra, N Masnou-Burrallo, E Oliver-Juan, A Sandiumenge-Camps
BACKGROUND: Limitation of life-sustaining treatment is increasingly common in critical care units, and controlled donation after circulatory death is starting to be included as an option within patient care plans. Lack of knowledge and misunderstandings can place a barrier between healthcare professionals. OBJECTIVE: To determine the perceptions, knowledge and attitudes of physicians and nurses working in intensive care units regarding Limitation of life-sustaining treatment and controlled donation after circulatory death...
May 18, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29784498/the-year-in-cardiothoracic-critical-care-selected-highlights-from-2017
#2
REVIEW
Jacob T Gutsche, Kamrouz Ghadimi, John G T Augoustides, Krzysztof Laudanski, Adam Evans, Menachem Weiner, Jesse Raiten, Emily Gordon, Rita Milewski, Jiri Horak, Prakash Patel, Harish Ramakrishna
No abstract text is available yet for this article.
April 10, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29784455/incidence-and-risk-factors-associated-with-30-day-post-operative-venous-thromboembolism-a-nsqip-pediatric-analysis
#3
Jennifer J Ahn, Paul A Merguerian, Margarett Shnorhavorian
INTRO: Venous thromboembolism (VTE) is a rare event in children, but can cause significant morbidity and mortality. The majority of research on pediatric VTE has been in the trauma and critical care populations. The incidence of VTE after surgery in children is not well-established. OBJECTIVE: The objective was to evaluate the incidence of VTE in the 30 days after surgery, as well as associated risk factors. STUDY DESIGN: All cases in the National Surgical Quality Improvement Program Pediatric (NSQIPP) database from 2012 to 2015 were assessed for presence of post-operative VTE...
May 8, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29784051/contributions-of-a-survey-and-retrospective-cohort-study-to-the-planning-of-a-randomised-controlled-trial-of-corticosteroids-in-the-treatment-of-paediatric-septic-shock
#4
Anna Liu, Kusum Menon
BACKGROUND: Randomised controlled trials (RCTs) are challenging to conduct in a paediatric critical-care environment. Background work, including surveys and observational studies, is often used to determine disease estimates, sample sizes and design protocols when planning such RCTs. Our objective was to determine the necessity of performing a survey or a retrospective chart review or both when planning an RCT on corticosteroids in the treatment of paediatric septic shock. METHODS: We compared information on corticosteroid use for moderate to severe paediatric septic shock obtained from a survey of physician beliefs and stated practices with that obtained from a retrospective cohort study...
May 21, 2018: Trials
https://www.readbyqxmd.com/read/29783090/inter-and-intra-disciplinary-collaboration-and-patient-safety-outcomes-in-u-s-acute-care-hospital-units-a-cross-sectional-study
#5
Chenjuan Ma, Shin Hye Park, Jingjing Shang
BACKGROUND: Collaboration among healthcare providers has been considered a promising strategy for improving care quality and patient outcomes. Despite mounting evidence demonstrating the impact of collaboration on outcomes of healthcare providers, there is little empirical evidence on the relationship between collaboration and patient safety outcomes, particularly at the patient care unit level. OBJECTIVES: The purpose of this study is to identify the extent to which interdisciplinary collaboration between nurses and physicians and intradisciplinary collaboration among nurses on patient care units are associated with patient safety outcomes...
May 2, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29782406/population-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine-in-children-undergoing-ambulatory-surgery
#6
María-Gabriela Pérez-Guillé, Alejandra Toledo-López, Liliana Rivera-Espinosa, Radames Alemon-Medina, Chiharu Murata, Ismael Lares-Asseff, Juan Luis Chávez-Pacheco, Josefina Gómez-Garduño, Ana-Lilia Zamora Gutiérrez, Claudia Orozco-Galicia, Karina Ramírez-Morales, Gustavo Lugo-Goytia
BACKGROUND: Dexmedetomidine (DEX) is an α-2 adrenergic agonist with sedative and analgesic properties. Although not approved for pediatric use by the Food and Drug Administration, DEX is increasingly used in pediatric anesthesia and critical care. However, very limited information is available regarding the pharmacokinetics of DEX in children. The aim of this study was to investigate DEX pharmacokinetics and pharmacodynamics (PK-PD) in Mexican children 2-18 years of age who were undergoing outpatient surgical procedures...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782388/glasgow-coma-scale-score-fluctuations-are-inversely-associated-with-a-nirs-based-index-of-cerebral-autoregulation-in-acutely-comatose-patients
#7
Ryan J Healy, Andres Zorrilla-Vaca, Wendy Ziai, Marek A Mirski, Charles W Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Lucia Rivera-Lara
BACKGROUND: The Glasgow Coma Scale (GCS) is an essential coma scale in critical care for determining the neurological status of patients and for estimating their long-term prognosis. Similarly, cerebral autoregulation (CA) monitoring has shown to be an accurate technique for predicting clinical outcomes. However, little is known about the relationship between CA measurements and GCS scores among neurological critically ill patients. This study aimed to explore the association between noninvasive CA multimodal monitoring measurements and GCS scores...
May 18, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29782199/bacteriolysis-a-mere-laboratory-curiosity
#8
Isaac Ginsburg, Erez Koren
The role of bacteriolysis in the pathophysiology of microbial infections dates back to 1893 when Buchner and Pfeiffer reported for the first time the lysis of bacteria by immune serum and related this phenomenon to the immune response. Later on, basic anti-microbial peptides and certain beta-lactam antibiotics have been shown not only to kill microorganisms but also to induce bacteriolysis and the release of cell-wall components. In 2009, a novel paradigm was offered suggesting that the main cause of death in sepsis is due to the exclusive release from activated human phagocytic neutrophils (PMNs) traps adhering upon endothelial cells of highly toxic nuclear histone...
May 21, 2018: Critical Reviews in Microbiology
https://www.readbyqxmd.com/read/29781257/providing-nutritional-support-for-patients-in-critical-care
#9
Lorraine Mutrie, Barry Hill
The provision of nutritional support for patients who are critically ill is complex and multifaceted, in part because of the variety and complexity of potential clinical presentations. This article explores the importance of providing nutritional support for patients who are critically ill and explains the pathophysiology of nutrition in altered health states. It discusses nutritional screening and assessment, the various routes of nutrition administration and the nursing considerations involved in providing nutritional support in critical care...
May 21, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29780822/epidemiology-characteristics-and-outcomes-of-icu-managed-homeless-patients-a-population-based-study
#10
Lavi Oud
Background: The population-level demand for critical care services among the homeless (H) remains unknown, with only sparse data on the characteristics and outcomes of those managed in the ICU. Methods: The Texas Inpatient Public Use Data File and annual federal reports were used to identify H hospitalizations and annual estimates of the H population between 2007 and 2014. The incidence of ICU admissions in the H population, the characteristics of ICU-managed H, and factors associated with their short-term mortality were examined...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29780789/a-fundamentals-train-the-trainer-approach-to-building-pediatric-critical-care-expertise-in-the-developing-world
#11
Sheri S Crow, Beth A Ballinger, Mariela Rivera, David Tsibadze, Nino Gakhokidze, Nino Zavrashvili, Matthew J Ritter, Grace M Arteaga
Pediatric Fundamental Critical Care Support (PFCCS) is an educational tool for training non-intensivists, nurses, and critical care practitioners in diverse health-care settings to deal with the acute deterioration of pediatric patients. Our objective was to evaluate the PFCCS course as a tool for developing a uniform, reproducible, and sustainable model for educating local health-care workers in the optimal management of critically ill children in the Republic of Georgia. Over a period of 18 months and four visits to the country, we worked with Georgian pediatric critical care leadership to complete the following tasks: (1) survey health-care needs within the Republic of Georgia, (2) present representative PFCCS lectures and simulation scenarios to evaluate interest and obtain "buy-in" from key stakeholders throughout the Georgian educational infrastructure, and (3) identify PFCCS instructor candidates...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29779912/how-often-do-we-perform-painful-and-stressful-procedures-in-the-paediatric-intensive-care-unit-a-prospective-observational-study
#12
Manuel A Baarslag, Sharan Jhingoer, Erwin Ista, Karel Allegaert, Dick Tibboel, Monique van Dijk
BACKGROUND: Adequate analgesia and sedation is crucial in critical care. There is little knowledge on the extent of painful and stressful procedures on children admitted to a paediatric intensive care unit (PICU) and its analgesic and/or sedative management. OBJECTIVE: The primary objective was to determine the number of painful and stressful procedures per patient per day in our PICU patients, including the numbers of attempts. A secondary objective was to map PICU nurses' perceptions of the painfulness of the included procedures...
May 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29779828/followership-a-review-of-the-literature-in-healthcare-and-beyond
#13
REVIEW
Caleb Leung, Amanda Lucas, Peter Brindley, Shellie Anderson, Jason Park, Ashley Vergis, Lawrence M Gillman
INTRODUCTION: Research in healthcare leadership has focused on leaders. In contrast, organizational success may be more influenced by followers. Kelley described five followership styles based on two characteristics: active engagement and independent critical thinking. We examined the literature on the association between followership style and workplace outcomes. METHODS: Articles from MEDLINE, CINAHL, and EMBASE were searched. Given the paucity of studies, we expanded our search to non-healthcare databases...
May 6, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29779827/zika-virus-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#14
Gisele Sampaio Silva, Guy A Richards, Tim Baker, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Pravin Amin
Zika fever is an acute infectious disease caused by the Zika virus (ZIKV), an RNA virus belonging to the genus Flavivirus. ZIKV can be transmitted by bites from Aedes aegypti and Aedes albopictus species, sexual activity, blood transfusion and from mother to fetus during pregnancy and delivery. A total of 50 territories and countries in the Americas had reported ZIKV infections. For those with symptoms, the presentation is similar to dengue fever with body aches, joint pain, fatigue, malaise, fever and conjunctivitis lasting up to seven days...
April 5, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29779815/use-of-standard-enteral-formula-versus-enteric-formula-with-prebiotic-content-in-nutrition-therapy-a-randomized-controlled-study-among-neuro-critical-care-patients
#15
Piril Tuncay, Fatma Arpaci, Mutlu Doganay, Deniz Erdem, Arzu Sahna, Hulya Ergun, Dilek Atabey
OBJECTIVE: To compare use of standard enteral formula versus enteric formula with prebiotic content in terms of nutrition therapy related outcomes among neurocritical care patients. METHODS: A total of 46 adult neurocritical care patients who received nutrition therapy with standard enteral formula (SEF group; n = 23) or enteral formula with prebiotic content (EFPC group; n = 23) during their hospitalization in intensive care unit (ICU) were included in this prospective randomized controlled study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29777262/intensive-care-medicine-in-2050-towards-critical-care-without-central-lines
#16
Jean-Louis Vincent, Frederic Michard, Bernd Saugel
No abstract text is available yet for this article.
May 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29776707/unplanned-extubations-in-an-intensive-care-unit-findings-from-a-critical-incident-technique
#17
Matteo Danielis, Simona Chiaruttini, Alvisa Palese
BACKGROUND: Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. OBJECTIVES: To gain a greater understanding of the antecedents of unplanned extubations...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29773353/nurses-knowledge-and-attitudes-regarding-pediatric-pain-management-in-western-australia
#18
Deborah Peirce, Victoria Corkish, Margie Lane, Sally Wilson
Despite clinical guidelines, suboptimal pediatric pain management persists. A local audit found poor guideline compliance. Inadequate knowledge is a recognized barrier to the delivery of evidence-based care. The aim of the study was to investigate nurses' knowledge and attitudes regarding pain management at an Australian tertiary pediatric hospital. A cross-sectional, descriptive study using the Pediatric Pain Knowledge and Attitudes Questionnaire (Revised) was distributed to 590 nurses in an Australian pediatric hospital...
May 14, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29771712/regression-the-apple-does-not-fall-far-from-the-tree
#19
Thomas R Vetter, Patrick Schober
Researchers and clinicians are frequently interested in either: (1) assessing whether there is a relationship or association between 2 or more variables and quantifying this association; or (2) determining whether 1 or more variables can predict another variable. The strength of such an association is mainly described by the correlation. However, regression analysis and regression models can be used not only to identify whether there is a significant relationship or association between variables but also to generate estimations of such a predictive relationship between variables...
May 15, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29771534/nitroxyl-modified-tobacco-mosaic-virus-as-a-metal-free-high-relaxivity-mri-and-epr-active-superoxide-sensor
#20
Madushani Dharmarwardana, Andre F Martins, Zhuo Chen, Philip Palacios, Chance M Nowak, Raymond P Welch, Shaobo Li, Michael Andrew Luzuriaga, Leonidas Bleris, Brad S Pierce, A Dean Sherry, Jeremiah J Gassensmith
Superoxide overproduction is known to occur in multiple disease states requiring critical care yet non-invasive detection of superoxide in deep tissue remains a challenge. Herein, we report a metal-free magnetic resonance imaging (MRI) and electron paramagnetic resonance (EPR) active contrast agent prepared by "click conjugating" paramagnetic organic radical contrast agents (ORCAs) to the surface of tobacco mosaic virus (TMV). While ORCAs are known to be reduced in vivo to an MRI/EPR silent state, their oxidation is facilitated specifically by reactive oxygen species-in particular superoxide-and are largely unaffected by peroxides and molecular oxygen...
May 17, 2018: Molecular Pharmaceutics
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