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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
#1
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...
November 17, 2016: 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
#2
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 AAST 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 preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. METHODS: In 2004 we initiated a PPP protocol for pelvic fracture hemorrhage...
November 23, 2016: 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27727096/predicting-the-clinical-manifestations-in-necrotizing-acute-pancreatitis-patients-with-splanchnic-vein-thrombosis
#11
Jing Zhou, Lu Ke, Dongliang Yang, Yizhe Chen, Gang Li, Zhihui Tong, Weiqin Li, Jieshou Li
BACKGROUND: Splanchnic venous thrombosis (SVT) is a relatively rare but important complication of necrotizing acute pancreatitis (NAP). Clinical manifestations and severity of this complication in different patients vary greatly, ranging from mild abdominal discomfort even asymptomatic to lethal gastrorrhagia or hepatic failure. The aim of the present study was to develop a model to predict the clinical manifestations of SVT in NAP patients. METHODS: This retrospective cohort study was conducted in the surgical intensive care unit (SICU) of Jinling Hospital...
November 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27707496/early-goal-directed-mobilisation-in-the-surgical-intensive-care-unit-a-randomised-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Stefan J Schaller, Matthew Anstey, Manfred Blobner, Thomas Edrich, Stephanie D Grabitz, Ilse Gradwohl-Matis, Markus Heim, Timothy Houle, Tobias Kurth, Nicola Latronico, Jarone Lee, Matthew J Meyer, Thomas Peponis, Daniel Talmor, George C Velmahos, Karen Waak, J Matthias Walz, Ross Zafonte, Matthias Eikermann
BACKGROUND: Immobilisation predicts adverse outcomes in patients in the surgical intensive care unit (SICU). Attempts to mobilise critically ill patients early after surgery are frequently restricted, but we tested whether early mobilisation leads to improved mobility, decreased SICU length of stay, and increased functional independence of patients at hospital discharge. METHODS: We did a multicentre, international, parallel-group, assessor-blinded, randomised controlled trial in SICUs of five university hospitals in Austria (n=1), Germany (n=1), and the USA (n=3)...
October 1, 2016: Lancet
https://www.readbyqxmd.com/read/27704172/improvement-of-postoperative-pain-control-processes-and-outcomes-in-veterans-of-a-surgical-intensive-care-unit
#13
Melissa S D'Andrea, P Marco Fisichella
BACKGROUND: Postoperative pain remains undertreated in critically ill patients. We hypothesized that the adequacy of pain control in our Surgical Intensive Care Unit (SICU) was above the reported average of 71 % in the literature and that the introduction of the critical care pain observation tool (CPOT) could improve it. We used a Lean Six Sigma methodology to improve our processes and quantify our improvement. PATIENTS AND METHODS: We retrospectively review 713 consecutive veterans admitted to our SICU...
October 4, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27652209/enteral-nutrition-administration-in-a-surgical-intensive-care-unit-achieving-goals-with-better-strategies
#14
Sara Wilson, Nagendra Y Madisi, Adel Bassily-Marcus, Anthony Manasia, John Oropello, Roopa Kohli-Seth
AIM: To evaluate the impact of an enteral feeding protocol on administration of nutrition to surgical intensive care unit (SICU) patients. METHODS: A retrospective chart review was conducted on patients initiated on enteral nutrition (EN) support during their stay in a 14 bed SICU. Data collected over a seven-day period included date of tube feed initiation, rate initiated, subsequent hourly rates, volume provided daily, and the nature and length of interruptions...
August 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27579592/epidemiology-and-cytokine-levels-among-children-with-nosocomial-multidrug-resistant-acinetobacter-baumannii-complex-in-a-tertiary-hospital-of-eastern-china
#15
Chao Fang, Xuejun Chen, Mingming Zhou
BACKGROUND AND AIM: The present study was aimed at assessing the characteristics of children with nosocomial multidrug-resistant Acinetobacter baumannii complex (MDR ABC) in a tertiary hospital of eastern China. MDR ABC poses a serious threat to public health. However, information on nosocomial MDR ABC in children is lacking. METHOD: This study retrospectively reviewed the cases in a tertiary hospital of eastern China between January 1, 2011, and December 31, 2014 (excluding outpatients)...
2016: PloS One
https://www.readbyqxmd.com/read/27562444/hypophosphatemia-in-enterally-fed-patients-in-the-surgical-intensive-care-unit-common-but-unrelated-to-timing-of-initiation-or-aggressiveness-of-nutrition-delivery
#16
Eva Fuentes, Daniel Dante Yeh, Sadeq A Quraishi, Emily A Johnson, Haytham Kaafarani, Jarone Lee, David R King, Marc DeMoya, Peter Fagenholz, Kathryn Butler, Yuchiao Chang, George Velmahos
INTRODUCTION: Hypophosphatemia has been associated with refeeding malnourished patients, but its clinical significance is unclear. We investigated the incidence of refeeding hypophosphatemia (RH) in the surgical intensive care unit (SICU) and its association with early enteral nutrition (EN) administration and clinical outcomes. METHODS: We performed a retrospective review of a 2-year database of patients receiving EN in the SICU. RH was defined as a post-EN phosphorus (PHOS) level decrement of >0...
August 25, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27535457/operating-room-to-icu-patient-handovers-a-multidisciplinary-human-centered-design-approach
#17
Noa Segall, Alberto S Bonifacio, Atilio Barbeito, Rebecca A Schroeder, Sharon R Perfect, Melanie C Wright, James D Emery, B Zane Atkins, Jeffrey M Taekman, Jonathan B Mark
BACKGROUND: Patient handovers (handoffs) following surgery have often been characterized by poor teamwork, unclear procedures, unstructured processes, and distractions. A study was conducted to apply a human-centered approach to the redesign of operating room (OR)-to-ICU patient handovers in a broad surgical ICU (SICU) population. This approach entailed (1) the study of existing practices, (2) the redesign of the handover on the basis of the input of hand over participants and evidence in the medical literature, and (3) the study of the effects of this change on processes and communication...
September 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/27531996/outbreak-by-ventilator-associated-st11-k-pneumoniae-with-co-production-of-ctx-m-24-and-kpc-2-in-a-sicu-of-a-tertiary-teaching-hospital-in-central-china
#18
Longhua Hu, Yanling Liu, Linqiang Deng, Qiaoshi Zhong, Yaping Hang, Zengzeng Wang, Lingling Zhan, Liangxing Wang, Fangyou Yu
The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) often responsible for numerous hospital-associated outbreaks has become an important public health problem. From January 2013 to February 2014, a total of 41 non-duplicate K. pneumoniae isolates with carbapenem resistance, were collected at a tertiary teaching hospital in Nanchang, central China. Among 41 K. pneumoniae isolates, 28 were isolated from hospitalized patients including 19 from the patients in surgery intensive care unit (SICU) and 13 were isolated from ventilators...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27365321/telemedicine-coverage-for-post-operative-icu-patients
#19
Tara Ann Collins, Matthew P Robertson, Corinna P Sicoutris, Michael A Pisa, Daniel N Holena, Patrick M Reilly, Benjamin A Kohl
INTRODUCTION: There is an increased demand for intensive care unit (ICU) beds. We sought to determine if we could create a safe surge capacity model to increase ICU capacity by treating ICU patients in the post-anaesthesia care unit (PACU) utilizing a collaborative model between an ICU service and a telemedicine service during peak ICU bed demand. METHODS: We evaluated patients managed by the surgical critical care service in the surgical intensive care unit (SICU) compared to patients managed in the virtual intensive care unit (VICU) located within the PACU...
June 30, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27363312/daily-vancomycin-dose-requirements-as-a-continuous-infusion-in-obese-versus-non-obese-sicu-patients
#20
Hsin Lin, Daniel Dante Yeh, Alexander R Levine
BACKGROUND: Limited data are available assessing vancomycin concentrations in obese critically ill patients. Currently, there are no studies evaluating dosing requirements in this population who receive vancomycin administered as a continuous infusion (CI). The aim of this study was to assess whether there was a difference in the weight-based maintenance dose required to reach a therapeutic vancomycin concentration at 24 hours when given as a CI in obese versus non-obese critically ill patients...
2016: Critical Care: the Official Journal of the Critical Care Forum
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