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https://www.readbyqxmd.com/read/28503124/factor-xiii-deficiency-and-thrombocytopenia-are-frequent-modulators-of-postoperative-clot-firmness-in-a-surgical-intensive-care-unit
#1
Sarah von Rappard, Corina Hinnen, Roger Lussmann, Manuela Rechsteiner, Wolfgang Korte
OBJECTIVE: Fibrinogen and factor XIII (FXIII) have been shown to critically influence clot firmness in the intraoperative setting and thus likely influence intraoperative bleeding. We were interested to identify potential modulators of postoperative clot firmness in a tertiary care hospital surgical intensive care unit setting, independent of their clinical course during surgery. METHODS: 272 day-shift consecutive patients were evaluated for whole blood clot firmness evaluated by the ROTEM® EXTEM thrombelastometric assay and various potential modulators of clot firmness upon arrival at the surgical intensive care unit (SICU)...
April 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28382850/are-predictive-energy-expenditure-equations-in-ventilated-surgery-patients-accurate
#2
Christopher J Tignanelli, Allan G Andrews, Kurt M Sieloff, Melissa R Pleva, Heidi A Reichert, Jennifer A Wooley, Lena M Napolitano, Jill R Cherry-Bukowiec
BACKGROUND: While indirect calorimetry (IC) is the gold standard used to calculate specific calorie needs in the critically ill, predictive equations are frequently utilized at many institutions for various reasons. Prior studies suggest these equations frequently misjudge actual resting energy expenditure (REE) in medical and mixed intensive care unit (ICU) patients; however, their utility for surgical ICU (SICU) patients has not been fully evaluated. Therefore, the objective of this study was to compare the REE measured by IC with REE calculated using specific calorie goals or predictive equations for nutritional support in ventilated adult SICU patients...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28339789/early-treatment-gains-for-antibiotic-administration-and-within-human-host-time-series-data
#3
Todd R Young, Erik M Boczko
As technological improvements continue to infiltrate and impact medical practice, it has become possible to non-invasively collect dense physiological time series data from individual patients in real time. These advances continue to improve physicians' ability to detect and to treat infections early. One important benefit of early detection and treatment of nascent infections is that it leads to earlier resolution. In response to current and anticipated advances in data capture, we introduce the Early Treatment Gain (ETG) as a measure to quantify this benefit...
February 18, 2017: Mathematical Medicine and Biology: a Journal of the IMA
https://www.readbyqxmd.com/read/28254728/serum-oxygen-radical-activity-and-total-antioxidation-capacity-are-related-with-severities-of-surgical-patient-with-sepsis-prospective-pilot-study
#4
Ji Young Jang, Seung Hwan Lee, Hongjin Shim, Jae Gil Lee
PURPOSE: The purpose of this pilot study was to evaluate the correlation between clinical severity and serum oxygen radical activity (ORA) and total antioxidation capacity (TAC) in critically ill surgical patients with sepsis. MATERIALS AND METHODS: The prospective observational study was performed in surgical intensive care unit (SICU) patients with intra-abdominal sepsis. Serum ORA and TAC levels were measured using a spectrophotometry-based antioxidant assay machine...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28250603/comparative-assessment-of-patient-care-expenses-among-intensive-care-units-of-a-tertiary-care-teaching-hospital-using-cost-block-method
#5
Kanakavalli Kiranmai Kundury, H K Mamatha, Divya Rao
INTRODUCTION: Intensive care services of a hospital are found to consume major chunk of hospital resources as well draining the savings of patients. Implementing proper control measures facilitates effective functioning of critical care services. AIM: Identify various costs involved in operating Surgical Intensive Care Unit (SICU) and Respiratory Intensive Care Unit (RICU); also find out the running cost of the same. METHODOLOGY: Retrospective data was collected for 12 months period and prospectively through informal interactions with staff...
February 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28156629/a-whole-greater-than-the-sum-of-the-parts-close-collaboration-between-palliative-care-and-clinical-ethics
#6
(no author information available yet)
53 Background: The disciplines of palliative care (PC) and clinical ethics (CE) share common content but also important distinctions in method, skill set, and clinical role in a given patient encounter. Particularly in cases of advance care planning, complex decision-making, and clarifying goals oncology teams may be challenged to know which consultation service to involve. METHODS: Case report and commentary. RESULTS: A 60 year-old man with a 3-year history of glioblastoma multiforme presented with sudden onset right-sided weakness and altered mental status...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28144607/clinical-utility-of-chest-computed-tomography-in-patients-with-rib-fractures-ct-chest-and-rib-fractures
#7
Brandon C Chapman, Douglas M Overbey, Feven Tesfalidet, Kristofer Schramm, Robert T Stovall, Andrew French, Jeffrey L Johnson, Clay C Burlew, Carlton Barnett, Ernest E Moore, Fredric M Pieracci
BACKGROUND: Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. OBJECTIVES: The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. METHODS: Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest...
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28060212/urinary-mitochondrial-dna-levels-identify-acute-kidney-injury-in-surgical-critical-illness-patients
#8
Qiongyuan Hu, Jianan Ren, Jie Wu, Guanwei Li, Xiuwen Wu, Song Liu, Gefei Wang, Guosheng Gu, Huajian Ren, Zhiwu Hong, Jieshou Li
BACKGROUND: Recent studies showed that mitochondrial injury and mitochondrial DNA (mtDNA) damage are associated with the initiation and progression of acute kidney injury (AKI). However, practical limitations of existing assays of mitochondrial function have limited our ability to study the link between mitochondrial dysfunction and renal injury. Therefore, we evaluated urinary mtDNA (UmtDNA) as a biomarker of AKI in critical illness patients. METHODS: DNA was isolated from urine samples in surgical intensive care unit (SICU) patients and quantified by quantitative polymerase chain reaction (PCR)...
January 4, 2017: Shock
https://www.readbyqxmd.com/read/28042016/spontaneous-intraventricular-hemorrhage-a-rare-presentation-of-a-skull-base-mesenchymal-chondrosarcoma
#9
Altaf Ali Laghari, Gohar Javed, Muhammad Faheem Khan, Syed Ijlal Ahmed, Karim Rizwan Nathani, Riyasat Ahmed
BACKGROUND: Chondrosarcomas are very rare malignant, slow-growing tumors that develop in or near the petroclival region of the brain. We report a very rare case in which the tumor originated from left petrous bone and induced intraventricular hemorrhage leading to an acute comatose presentation. CASE DESCRIPTION: A 28-year-old man initially presented to the outpatient department with a 1-month history of headache, vomiting, vertigo, and left facial numbness. A lesion at the cerebellopontine angle with extension into the middle cranial fossa was demonstrated on computed tomography and magnetic resonance imaging...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28004856/effect-of-early-allograft-dysfunction-on-outcomes-following-liver-transplantation
#10
Jana Hudcova, Caitlin Scopa, Jawad Rashid, Ahsan Waqas, Robin Ruthazer, Roman Schumann
Early allograft dysfunction (EAD) following liver transplantation (LT) remains a challenge for patients and clinicians. We retrospectively analyzed the effect of pre-defined EAD on outcomes in a 10-year cohort of deceased-donor LT recipients with clearly defined exclusion criteria. EAD was defined by at least one of the following: AST or ALT >2000 IU/L within first-week post-LT, total bilirubin ≥10 mg/dL, and/or INR ≥1.6 on post-operative day 7. Ten patients developed primary graft failure and were analyzed separately...
February 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/27898352/management-of-the-open-abdomen-using-negative-pressure-wound-therapy-with-instillation-in-severe-abdominal-sepsis-a-review-of-48-cases-in-hospital-mexico-costa-rica
#11
Pablo Sibaja, Alfredo Sanchez, Guillermo Villegas, Alvaro Apestegui, Esteban Mora
INTRODUCTION: Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27893645/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#12
Clay Cothren Burlew, Ernest E Moore, Philip F Stahel, Andrea E Geddes, Amy E Wagenaar, Fredric M Pieracci, Charles J Fox, Eric M Campion, Jeffrey L Johnson, Cyril Mauffrey
BACKGROUND: A 2015 American Association for the Surgery of Trauma trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized that preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27851327/1692-when-the-decision-is-indecision-an-ethical-dilemma-in-the-sicu
#13
Lauren Sparber, Renee McLeod-Sordjan, Vihas Patel, William Doscher, Rafael Barrera
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851102/1466-probability-for-postoperative-infection-utilizing-a-decision-tree-in-the-sicu
#14
Hussam Ghabra, William White, Vu Ngoc, Katherine Jennings, Michael Townsend, Joshua Goldberg, Philip Boysen, Bobby Nossaman
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850762/1125-critical-care-observation-of-motor-activity-a-routine-bedside-exam-on-sicu-outcomes
#15
Sandra Muse, Colleen Arsenault, Tharusan Thevathasan, Annop Piriyapatsom, Karen Waak, Ulrich Schmidt, Matthias Eikermann
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850732/1095-using-a-modified-frailty-index-to-predict-morbidity-and-mortality-in-the-sicu-a-prospective-study
#16
Jenna Watson, Kaori Ito, Matthew Goodwin, Efstathios Karamanos, Amy Li, Nathan Schmoekel, Dionne Blyden, Arielle Gupta
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850315/676-factors-associated-with-survival-in-sicu-patients-with-multidrug-resistant-gram-negative-infections
#17
Andrew Jarrell, Rachel Kruer, Peter Pronovost, L Diana Berescu, Julie Trivedi
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850195/555-changing-the-culture-in-the-sicu-integrating-palliative-care-and-ethics-a-novel-initiative
#18
Lauren Sparber, Kathleen Kilkullen, Ashley Warman, Renee McLeod-Sordjan, Alex Rimar, Vihas Patel, William Doscher, Rafael Barrera
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27833483/acquired-hypernatremia-in-a-general-surgical-intensive-care-unit-incidence-and-prognosis
#19
Mariam A Alansari, Ahmed Abdulmomen, Mohammed Hussein, Ahmad Mohmmad Zubaidi, Jalal T Alswaiti
PURPOSE: Intensive Care Unit (ICU)-acquired hypernatremia (IAH) is a serious electrolyte disturbance that recently was shown to present an independent risk factor for mortality in critically ill patients. IAH has not been widely investigated in Surgical ICU (SICU) patients. No study has specifically investigated IAH epidemiology in the Kingdome of Saudi Arabia (KSA) in general SICU. The objectives of this study are to assess the epidemiological characteristics and prognostic impact of IAH on SICU mortality and outcome in KSA and compare it with international figures...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27769542/clinical-relevance-of-the-routine-daily-chest-x-ray-in-the-surgical-intensive-care-unit
#20
Shelby Resnick, Kenji Inaba, Efstathios Karamanos, Dimitra Skiada, James A Dollahite, Obi Okoye, Peep Talving, Demetrios Demetriades
INTRODUCTION: A daily Chest X-ray (CXR) is obtained in many surgical intensive care units (SICU). This study implemented a selective CXR protocol in a high volume, academic SICU and evaluated its impact on clinical outcomes. METHODS: All SICU patients admitted in 2/2010 were compared with patients admitted in 2/2012. Between the time periods, a protocol eliminating the routine daily CXRs was instituted. RESULTS: In 02/2010 and 02/2012, 107 and 90 patients were admitted to the SICU, respectively, for a total of 1384 patient days...
October 10, 2016: American Journal of Surgery
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