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https://www.readbyqxmd.com/read/29792971/impact-of-active-surveillance-and-infection-control-measures-on-carbapenem-resistant-gram-negative-bacterial-colonization-and-infections-in-intensive-care
#1
T Karampatakis, K Tsergouli, E Iosifidis, C Antachopoulos, A Karapanagiotou, A Karyoti, N Gritsi-Gerogianni, A Tsakris, E Roilides
BACKGROUND: Carbapenem-resistant Gram-negative bacteria (CRGNB) infections constitute a global threat for critically ill patients and the outcome of their hospitalization. Early identification of CRGNB through rectal surveillance cultures and routine infection control measures including contact precautions, use of appropriate disinfectants, staff education on cleaning, and hand hygiene may reduce the dissemination of CRGNB. AIM: To assess the impact of enhanced infection control measures on CRGNB infections in a nine-bed polyvalent intensive care unit in a tertiary level hospital in an endemic area...
May 21, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29792461/teamwork-in-the-intensive-care-unit
#2
Jennifer N Ervin, Jeremy M Kahn, Taya R Cohen, Laurie R Weingart
Intensive care units (ICUs) provide care to the most severely ill hospitalized patients. Although ICUs increasingly rely on interprofessional teams to provide critical care, little about actual teamwork in this context is well understood. The ICU team is typically comprised of physicians or intensivists, clinical pharmacists, respiratory therapists, dieticians, bedside nurses, clinical psychologists, and clinicians-in-training. ICU teams are distinguished from other health care teams in that they are low in temporal stability, which can impede important team dynamics...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29791247/a-randomized-trial-of-a-family-support-intervention-in-intensive-care-units
#3
Douglas B White, Derek C Angus, Anne-Marie Shields, Praewpannarai Buddadhumaruk, Caroline Pidro, Cynthia Paner, Elizabeth Chaitin, Chung-Chou H Chang, Francis Pike, Lisa Weissfeld, Jeremy M Kahn, Joseph M Darby, Amy Kowinsky, Susan Martin, Robert M Arnold
Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients' preferences. Methods We conducted a stepped-wedge, cluster-randomized trial involving patients with a high risk of death and their surrogates in five intensive care units (ICUs) to compare a multicomponent family-support intervention delivered by the interprofessional ICU team with usual care...
May 23, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29790810/a-review-of-novel-technologies-and-techniques-associated-with-identification-of-bloodstream-infection-aetiologies-and-rapid-antimicrobial-genotypic-and-quantitative-phenotypic-determination
#4
Stephen Poole, Stephen P Kidd, Kordo Saeed
Introduction The antimicrobial aspect of management of patients with blood stream infections (BSI) and sepsis is time critical. In an era of increasing antimicrobial resistance, rapid detection and identification of bacteria with antimicrobial susceptibility is crucial to direct therapy early in the course of illness. Molecular techniques offer a potential solution to this. Areas covered In the present review the authors have discussed a number of novel solutions utilising a variety of molecular techniques for pathogen detection, identification and antimicrobial susceptibility...
May 23, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29790212/dopamine-in-transplantation-written-off-or-comeback-with-novel-indication
#5
REVIEW
Peter Schnuelle, Urs Benck, Benito A Yard
Renal-dose dopamine has fallen out of favor in the intensive care unit (ICU) during past years due to its ineffectiveness to prevent impending or to ameliorate overt renal failure in the critically ill. By contrast, growing evidence indicates that low-dose dopamine administered to the stable organ donor after brain death confirmation improves the clinical course of transplanted organs after kidney and heart transplantation. Ensuring a thorough monitoring for potential circulatory side effects, employment of dopamine at a dose of 4 μg/kg per minute is safe in the deceased donor...
May 23, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29789983/principles-of-fluid-management-and-stewardship-in-septic-shock-it-is-time-to-consider-the-four-d-s-and-the-four-phases-of-fluid-therapy
#6
REVIEW
Manu L N G Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W Rice, Monty Mythen, Xavier Monnet
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition...
May 22, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29789798/the-relation-between-sarcopenia-and-mortality-in-patients-at-intensive-care-unit
#7
Mehmet Toptas, Mazhar Yalcin, İbrahim Akkoc, Eren Demir, Cagatay Metin, Yildiray Savas, Muhsin Kalyoncuoglu, Mehmet Mustafa Can
Background and Aim: Psoas muscle area (PMA) can reflect the status of skeletal muscle in the whole body. It has been also reported that decreased PMA was associated with postoperative mortality or morbidity after several surgical procedures. In this study, we aimed to investigate the relation between PMA and mortality in all age groups in intensive care unit (UNIT). Materials and Method: The study consists of 362 consecutive patients. The demographic characteristics of patients, indications for ICU hospitalization, laboratory parameters, and clinical parameters consist of mortality and length of stay, and surgery history was obtained from intensive care archive records...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29789779/outcomes-in-cardiogenic-shock-patients-with-extracorporeal-membrane-oxygenation-use-a-matched-cohort-study-in-hospitals-across-the-united-states
#8
Rayan El Sibai, Rana Bachir, Mazen El Sayed
Background: ECMO is increasingly used for patients with critical illnesses. This study examines ECMO use in patients with cardiogenic shock in US hospitals and associated outcomes (mortality, hospital length of stay, and total hospital charges). Methods: A matched cohort retrospective study was conducted using the 2013 Nationwide Emergency Department Sample. Cardiogenic shock visits were matched (1 : 1) and compared based on ECMO use. Results: Patients with ECMO ( N = 802) were compared to patients without ECMO ( N = 805)...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29789511/the-place-of-social-recovery-in-mental-health-and-related-services
#9
REVIEW
Shulamit Ramon
This article looks at the place of social recovery in mental health and social care services, alongside personal recovery. Despite its conceptual and practice centrality to the new meaning of recovery, social recovery has remained a relatively neglected dimension. This article attempts to provide an updated critical commentary based on findings from fifty nine studies, including a variety of research methodologies and methods. Definitions of social recovery within the new meaning of recovery are looked at. This is followed by outlining the development and significance of this dimension as reflected in the key areas of shared decision making, co-production and active citizenship, re-entering employment after experiencing mental ill health, being in employment, poverty and coping with poverty, the economic and the scientific cases for social recovery...
May 23, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29789183/-do-not-do-recommendations-of-the-working-groups-of-the-spanish-society-of-intensive-and-critical-care-medicine-and-coronary-units-semicyuc-for-the-management-of-critically-ill-patients
#10
F J González de Molina Ortiz, F Gordó Vidal, A Estella García, P Morrondo Valdeolmillos, J F Fernández Ortega, J Caballero López, P V Pérez Villares, M A Ballesteros Sanz, C de Haro López, J A Sanchez-Izquierdo Riera, A Serrano Lázaro, M P Fuset Cabanes, L J Terceros Almanza, X Nuvials Casals, J Baldirà Martínez de Irujo
The project "Commitment to Quality of Scientific Societies", promoted since 2013 by the Spanish Ministry of Health, seeks to reduce unnecessary health interventions that have not proven effective, have little or doubtful effectiveness, or are not cost-effective. The objective is to establish the "do not do" recommendations for the management of critically ill patients. A panel of experts from the 13 working groups (WGs) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) was selected and nominated by virtue of clinical expertise and/or scientific experience to carry out the recommendations...
May 19, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29788912/association-between-troponin-i-levels-and-outcome-in-critically-ill-patients-admitted-to-non-cardiac-intensive-care-unit-with-high-prevalence-of-cardiovascular-risk-factors
#11
Abdulaleem Alatassi, Mohamad Habbal, Hani Tamim, Musharaf Sadat, Eman Al Qasim, Yaseen M Arabi
BACKGROUND: The association of troponin-I levels and outcome in medical-surgical ICU patients has been studied before in populations with low to moderate prevalence of cardiovascular risk factors. The objective in this article is to examine the association of troponin-I levels with hospital mortality in patients with high prevalence of cardiovascular risk factors who were admitted with medical-surgical indications to a non-cardiac intensive care unit. METHODS: This was a retrospective study of adult patients admitted to a tertiary medical-surgical ICU between July 2001 and November 2011...
May 22, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29788841/heparin-induced-thrombocytopenia-complicating-extracorporeal-membrane-oxygenation-support-in-pediatric-patients-review-of-the-literature-and-alternative-anticoagulants
#12
Uri Pollak
Heparin-induced thrombocytopenia (HIT) is a prothrombotic, immune-mediated complication of unfractionated heparin (UFH) and low molecular weight heparin therapy. HIT is characterized by moderate thrombocytopenia 5-10 days after initial heparin exposure, detection of platelet-activating anti-platelet factor 4/heparin antibodies and an increased risk of venous and arterial thrombosis. Extracorporeal membrane oxygenation (ECMO) is a form of mechanical circulatory support used in critically ill patients with respiratory or cardiac failure...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788815/effect-of-magnesium-loading-dose-on-insulin-resistance-in-patients-with-stress-induced-hyperglycemia-a-randomized-clinical-trial
#13
Zinat Heidary, Hossein Khalili, Mostafa Mohammadi, Mohammad-Taghi Beigmohammadi, Alireza Abdollahi
OBJECTIVES: There is currently no evidence that whether magnesium supplementation would improve stress-induced hyperglycemia (SIH) in critically ill patients. In this study, effects of magnesium loading dose on insulin resistance (IR) indices were evaluated in critically ill patients without diabetes having SIH. METHODS: Seventy critically ill patients with SIH were assigned to receive a loading dose of magnesium (7.5 g of magnesium sulfate in 500 mL normal saline as intravenous infusion over an 8-hour period) or placebo...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29788548/health-perception-and-adherence-with-blood-pressure-control-among-rural-chinese-adults-with-hypertension
#14
Lili Yang, Elizabeth Taylor, Betty Winslow, Patricia Pothier
AIM: To examine associations among blood pressure, personal and illness characteristics, illness perception and medication and self-management adherence among adults with hypertension in rural mainland China. BACKGROUND: Despite the high prevalence of hypertension in China, the control rate is only 20%. Identifying factors associated with blood pressure control is critical. DESIGN: Cross-sectional survey. METHODS: Data were collected from 163 hypertensive adults in two rural villages in mainland China...
May 22, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29788457/the-reliability-of-the-clinical-examination-in-predicting-hemodynamic-status-in-acute-febrile-illness-in-a-tropical-resource-limited-setting
#15
Felix Moek, Poe Poe, Prakaykaew Charunwatthana, Wirichada Pan-Ngum, Yupaporn Wattanagoon, Wirongrong Chierakul
Introduction: The clinical examination alone is widely considered unreliable when assessing fluid responsiveness in critically ill patients. Little evidence exists on the performance of the clinical examination to predict other hemodynamic derangements or more complex hemodynamic states. Materials and methods: Patients with acute febrile illness were assessed on admission, both clinically and per non-invasive hemodynamic measurement. Correlations between clinical signs and hemodynamics patterns were analyzed, and the predictive capacity of the clinical signs was examined...
May 19, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29788286/extracorporeal-life-support-for-primary-graft-dysfunction-after-heart-transplantation
#16
Matteo Pozzi, Chiara Bottin, Xavier Armoiry, Laurent Sebbag, Pascale Boissonnat, Elisabeth Hugon-Vallet, Catherine Koffel, Claire Flamens, Sylvie Paulus, Jean Luc Fellahi, Jean Francois Obadia
OBJECTIVES: Survival after heart transplantation is steadily improving but primary graft dysfunction (PGD) is still a leading cause of death. Medical management seems useful in mild or moderate PGD, whereas extracorporeal life support (ECLS) could be suggested for severe PGD refractory to conventional treatment. Our aim is to present the results of ECLS for PGD after heart transplantation at a single-centre experience. METHODS: We performed an observational analysis of our local database...
May 17, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29787416/cecal-ligation-and-puncture-alters-glucocorticoid-receptor-expression
#17
Mabel N Abraham, Daniela M Jimenez, Tiago D Fernandes, Clifford S Deutschman
OBJECTIVES: Interventional trials on glucocorticoids in sepsis have yielded capricious results. Recent studies have identified multiple glucocorticoid receptor isoforms. The relative abundance of these isoforms in septic patients and following murine cecal ligation and puncture is unknown. The objective of this study is to determine the effects of cecal ligation and puncture on glucocorticoid receptor isoform abundance. DESIGN: Determination of effects of cecal ligation and puncture on glucocorticoid receptor isoform subtype abundance in C57BL/6 mice...
May 21, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29787415/cooccurrence-of-post-intensive-care-syndrome-problems-among-406-survivors-of-critical-illness
#18
Annachiara Marra, Pratik P Pandharipande, Timothy D Girard, Mayur B Patel, Christopher G Hughes, James C Jackson, Jennifer L Thompson, Rameela Chandrasekhar, Eugene Wesley Ely, Nathan E Brummel
OBJECTIVES: To describe the frequency of cooccurring newly acquired cognitive impairment, disability in activities of daily livings, and depression among survivors of a critical illness and to evaluate predictors of being free of post-intensive care syndrome problems. DESIGN: Prospective cohort study. SETTING: Medical and surgical ICUs from five U.S. centers. PATIENTS: Patients with respiratory failure or shock, excluding those with preexisting cognitive impairment or disability in activities of daily livings...
May 21, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29787327/establishing-and-evaluating-autoverification-rules-with-intelligent-guidelines-for-arterial-blood-gas-analysis-in-a-clinical-laboratory
#19
Jie Wu, Meichen Pan, Huizhen Ouyang, Zhili Yang, Qiaoxin Zhang, Yingmu Cai
Arterial blood gas (ABG) analysis is important for acutely ill patients and should be performed by qualified laboratorians. The existing manual verifications are tedious, time-consuming, and prone to send wrong reports. Autoverification uses computer-based rules to verify clinical laboratory test results without manual review. To date, no data are available on the use of autoverification for ABG analysis. All autoverification rules were established according to AUTO10-A. Additionally, the rules were established using retrospective patient data, and then validated by actual clinical samples in a "live" environment before go-live...
May 1, 2018: SLAS Technology
https://www.readbyqxmd.com/read/29787309/predicting-intensive-care-unit-readmission-with-machine-learning-using-electronic-health-record-data
#20
Juan C Rojas, Kyle A Carey, Dana P Edelson, Laura R Venable, Michael D Howell, Matthew M Churpek
RATIONALE: Patients transferred from the intensive care unit (ICU) to the wards who are later readmitted to the ICU have increased length of stay, healthcare expenditure, and mortality compared to those who are never readmitted. Improving risk-stratification for patients transferred to the wards could have important benefits for critically ill hospitalized patients. OBJECTIVE: We aimed to use a machine-learning technique to derive and validate an ICU readmission prediction model with variables available in the electronic health record (EHR) in real-time and compare it to previously published algorithms...
May 22, 2018: Annals of the American Thoracic Society
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