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https://www.readbyqxmd.com/read/29163991/an-undiagnosed-paraganglioma-in-a-58-year-old-female-who-underwent-tumor-resection
#1
William C Fox, Matthew Read, Richard E Moon, Eugene W Moretti, Brian J Colin
Paragangliomas and pheochromocytomas are rare neuroendocrine tumors that can have high morbidity and mortality if undiagnosed. Here we report a case of an undiagnosed paraganglioma in a 58-year-old female who underwent tumor resection. The patient became severely hypertensive intraoperatively with paroxysmal swings in blood pressure and then later became acutely hypotensive after tumor removal. She was managed in the surgical intensive care unit (SICU) postoperatively and discharged from the hospital without acute complications...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29133567/risk-factors-and-outcomes-associated-with-multidrug-resistant-acinetobacter-baumannii-upon-icu-admission
#2
Natalia Blanco, Anthony D Harris, Clare Rock, J Kristie Johnson, Lisa Pineles, Robert A Bonomo, Arjun Srinivasan, Melinda M Pettigrew, Kerri A Thom
Introduction: Multi-drug resistant (MDR) Acinetobacter baumannii, associated with broad-spectrum antibiotic use, is an important nosocomial pathogen associated with morbidity and mortality. This study aimed to investigate the prevalence of MDR A. baumannii perirectal colonization among adult patients at ICU admission over a 5-year period, and to identify risk factors and outcomes associated with colonization.Methods: A retrospective cohort analysis of patients admitted to the medical (MICU) and surgical intensive care units (SICU) at the University of Maryland Medical Center from May 2005 to September 2009 was performed using perirectal surveillance cultures on admission...
November 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29132626/early-hospital-mortality-prediction-of-intensive-care-unit-patients-using-an-ensemble-learning-approach
#3
Aya Awad, Mohamed Bader-El-Den, James McNicholas, Jim Briggs
BACKGROUND: Mortality prediction of hospitalized patients is an important problem. Over the past few decades, several severity scoring systems and machine learning mortality prediction models have been developed for predicting hospital mortality. By contrast, early mortality prediction for intensive care unit patients remains an open challenge. Most research has focused on severity of illness scoring systems or data mining (DM) models designed for risk estimation at least 24 or 48h after ICU admission...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29074840/survey-regarding-attitude-of-family-about-organ-donation-after-brain-death-in-korea
#4
Hyun Ji Lee, Myung Jae Jin, Sang Youb Han, Kum Hyun Han, Se Won Oh, Hye-Yeon Jang, Ui Jun Park, Hyoung Tae Kim, Young-Nam Roh
BACKGROUND This study examined the attitude of patients' relatives in South Korea toward organ donation after brain death. MATERIAL AND METHODS A structured questionnaire was used to obtain the information on the attitude toward organ donation for relatives of patients who were admitted to the surgical intensive care unit (SICU) between March 1, 2014 and September 30, 2016. In total, 92 persons participated voluntarily. The investigation included general opinion about organ donation; and additional categorical analysis was performed...
October 27, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29028461/antibiotic-impregnated-central-venous-catheters-do-not-change-antibiotic-resistance-patterns
#5
Isaiah R Turnbull, Sara A Buckman, Christopher B Horn, Grant V Bochicchio, John E Mazuski
BACKGROUND: Antibiotic-impregnated central venous catheters (CVCs) decrease the incidence of infection in high-risk patients. However, use of these catheters carries the hypothetical risk of inducing antibiotic resistance. We hypothesized that routine use of minocycline and rifampin-impregnated catheters (MR-CVC) in a single intensive care unit (ICU) would change the resistance profile for Staphylococcus aureus. METHODS: We reviewed antibiotic susceptibilities of S...
October 13, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29028082/evaluation-of-the-role-of-8-iso-pgf-levels-at-multiple-sites-during-intracranial-hemorrhage-in-pediatric-patients
#6
B-X Qi, H Yao, L Shang, L-P Sheng, X-C Wang, L Zhu, X-X Zhang, J-P Wang, D-H Fang
OBJECTIVE: The present study was planned to explore the role of 8-isomeric-prostaglandinF2α (8-iso-PGF2α) levels at the multiple sites of cerebrospinal fluid in children with intracranial hemorrhage. PATIENTS AND METHODS: 90 children with intracranial hemorrhage were admitted to Surgery Intensive Care Unit (SICU) of our hospital from January to December 2013 and were selected as study subjects. They were divided into group A (n=30), group B (n=30) and group C (n=30)...
September 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29026536/implementation-of-central-line-associated-bloodstream-infection-prevention-bundles-in-a-surgical-intensive-care-unit-using-peer-tutoring
#7
Sang-Won Park, Suhui Ko, Hye-Sun An, Ji Hwan Bang, Woo-Young Chung
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) can be prevented through well-coordinated, multifaceted programs. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. Peer tutoring may be an efficient and effective method that is applicable in such settings. METHODS: A prospective intervention was performed to reduce CLABSIs in a surgical intensive care unit (SICU) at a tertiary hospital...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28985864/ultrasonography-training-and-utilization-in-surgical-critical-care-fellowships-a-program-director-s-survey
#8
Brian K Yorkgitis, Elizabeth A Bryant, Gabriel A Brat, Edward Kelly, Reza Askari, Jin H Ra
BACKGROUND: Intensivist-performed ultrasound (IPUS) is an adjunctive tool used to assist in resuscitation and management of critically ill patients. It allows clinicians real-time information through noninvasive methods. We aimed to evaluate the types of IPUS performed and the methods surgical critical care (SCC) fellows are trained along with challenges in training. METHODS: One hundred SCC fellowship directors were successfully sent an email inviting them to participate in a short Web-based survey...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28932561/the-predictive-value-of-plasma-cytokines-on-gastroesophageal-anastomotic-leakage-at-an-early-stage-in-patients-undergoing-esophagectomy
#9
Jie-Qiong Song, Yi-Zhou He, Yuan Fang, Wei Wu, Ming Zhong
BACKGROUND: It's difficult to diagnose gastroesophageal anastomotic leakage (GAL) at early postoperative stage. This study was conducted to evaluate the early predictive value of plasma cytokines levels on GAL in patients undergoing esophagectomy. METHODS: Consecutive esophageal cancer patients who underwent esophagectomy and admitted to Surgical Intensive Care Unit (SICU) just after surgery were retrospectively analyzed. The baseline and postoperative 1 day plasma cytokine levels were collected and analyzed to evaluate the predictive value for clinically important anastomotic leakage...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28912909/the-use-of-tranexamic-acid-for-upper-gastrointestinal-bleeding-by-medical-and-surgical-intensivists-a-single-center-experience
#10
Jason Chertoff, Grant Lowther, Hassan Alnuaimat, Ali Ataya
BACKGROUND: Tranexamic acid (TXA) may be beneficial in the management of upper gastrointestinal bleeding (UGIB). We sought to investigate how frequently intensivists at our academic institution use TXA for patients with UGIB, and to investigate whether the utilization rate of TXA differs between surgical and medical intensivists, and provide an updated literature review on the subject. METHODS: We performed a retrospective cohort study of patients admitted for UGIB to the surgical intensive care unit (SICU) and the medical intensive care unit (MICU) at our academic healthcare facility (University of Florida Health - Shands Hospital) from January 1, 2013 to December 31, 2016...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28832270/evaluation-of-a-short-course-of-antimicrobial-therapy-for-complicated-intra-abdominal-infections-in-critically-ill-surgical-patients
#11
Susan E Smith, Kelli A Rumbaugh, Addison K May
BACKGROUND: The optimal duration of antimicrobial therapy for treatment of complicated intra-abdominal infections (cIAI) in critically ill surgical patients is unknown. Recent evidence suggests that a short (four-day) course of therapy may be effective, however data in severely critically ill patients are limited. PATIENTS AND METHODS: A single-center, retrospective, cohort study was conducted at a tertiary academic medical center. Adult patients admitted to the surgical intensive care unit (SICU) with cIAI between December 2011 and July 2015 were enrolled...
August 2017: Surgical Infections
https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#12
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
November 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28699492/adverse-drug-reactions-in-critical-care-setting-a-systematic-review
#13
Joshua Lisha, Velu Annalakshmi, Jose Maria, Devi Padmini
BACKGROUND: The prevalence of adverse drug reactions (ADRs) is reported to be high in critical care units. We conducted a systematic review to study the prevalence, drugs implicated, preventability, predictability, severity and determinants of ADRs in critical care settings. METHODS: We searched MEDLINE, EMBASE, PROQUEST and OVID (January 1995 to June 2015) using pre-specified appropriate medical subject heading (MeSH) terms. Of 1552 studies, 34 studies were included for data extraction and synthesis...
July 10, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28636702/analysis-of-survival-after-initiation-of-continuous-renal-replacement-therapy-in-a-surgical-intensive-care-unit
#14
James M Tatum, Galinos Barmparas, Ara Ko, Navpreet Dhillon, Eric Smith, Daniel R Margulies, Eric J Ley
Importance: Continuous renal replacement therapy (CRRT) benefits patients with renal failure who are too hemodynamically unstable for intermittent hemodialysis. The duration of therapy beyond which continued use is futile, particularly in a population of patients admitted to and primarily cared for by a surgical service (hereinafter referred to as surgical patients), is unclear. Objective: To analyze proportions of and independent risk factors for survival to discharge after initiation of CRRT among patients in a surgical intensive care unit (SICU)...
October 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28610934/boarding-icu-patients-are-our-rounding-practices-subpar
#15
Andrew M Nunn, Justin S Hatchimonji, Daniel N Holena, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Niels D Martin, Patrick M Reilly, C William Schwab, Jose L Pascual
INTRODUCTION: Surgical Intensive Care Unit (SICU) patients "boarding" in ICUs other than the designated home unit have been shown to suffer increased rates of complications. We hypothesized that ICU rounding practices are different when SICU patients are housed in home vs. boarding ICUs. MATERIAL AND METHODS: SICU rounds were observed at an academic quaternary medical center. Individual patient rounding time and order seen on rounds along with patient data and demographics were recorded...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28503124/factor-xiii-deficiency-and-thrombocytopenia-are-frequent-modulators-of-postoperative-clot-firmness-in-a-surgical-intensive-care-unit
#16
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
#17
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
#18
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
#19
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
#20
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
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