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https://www.readbyqxmd.com/read/28324982/multi-task-transfer-learning-for-in-hospital-death-prediction-of-icu-patients
#1
Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh
Multi-Task Transfer Learning (MTTL) is an efficient approach for learning from inter-related tasks with small sample size and imbalanced class distribution. Since the intensive care unit (ICU) data set (publicly available in Physionet) has subjects from four different ICU types, we hypothesize that there is an underlying relatedness amongst various ICU types. Therefore, this study aims to explore MTTL model for in-hospital mortality prediction of ICU patients. We used single-task learning (STL) approach on the augmented data as well as individual ICU data and compared the performance with the proposed MTTL model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#2
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28318952/glycaemic-variability-in-patients-with-severe-sepsis-or-septic-shock-admitted-to-an-intensive-care-unit
#3
L M Silveira, A Basile-Filho, E A Nicolini, C A M Dessotte, G C S Aguiar, A M Stabile
BACKGROUND: Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. OBJECTIVE: To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. METHOD: Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores...
March 15, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28318531/national-survey-on-postoperative-care-and-treatment-circuits-in-neurosurgery
#4
R Valero, E Carrero, N Fàbregas, F Iturri, N Saiz-Sapena, L Valencia
INTRODUCTION: The analysis of surgical processes should be a standard of health systems. We describe the circuit of care and postoperative treatment for neurosurgical interventions in the centres of our country. MATERIAL AND METHODS: From June to October 2014, a survey dealing with perioperative treatments and postoperative circuits after neurosurgical procedures was sent to the chiefs of Anaesthesiology of 73 Spanish hospitals with neurosurgery and members of the Neuroscience Section of SEDAR...
March 16, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28303021/age-and-surgical-complexity-impact-on-renoprotection-by-remote-ischemic-preconditioning-during-adult-cardiac-surgery-a-meta-analysis
#5
Chenghui Zhou, Heerajnarain Bulluck, Nengxin Fang, Lihuan Li, Derek J Hausenloy
We aimed to conduct an up-to-date meta-analysis to comprehensively assess the renoprotective effect of remote ischemic preconditioning (RIPC) in patients undergoing adult cardiac surgery. 21 randomized controlled trials (RCTs) with a total of 6302 patients were selected and identified. Compared with controls, RIPC significantly reduced the incidence of acute kidney injury (AKI) [odds ratio (OR) = 0.79; P = 0.02; I(2) = 38%], and in particular, AKI stage I (OR = 0.65; P = 0.01; I(2) = 55%)...
March 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28302475/safety-and-effectiveness-of-a-percutaneous-first-approach-to-endovascular-aortic-aneurysm-repair
#6
Christopher Agrusa, Andrew Meltzer, Darren Schneider, Peter Connolly
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been increasingly employed in the endovascular treatment of abdominal aortic aneurysms. Furthermore, the percutaneous approach can be used with minimal sedation and local anesthesia in the majority of cases. The purpose of this study is to assess the safety and effectiveness of a "percutaneous first" approach to femoral access for EVAR. METHOD: From 2012 to 2014, PEVAR has been the preferred approach to femoral access for EVAR at our institution...
March 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28299212/hemorrhagic-shock-as-complication-of-intramural-intestinal-bleeding
#7
Asma Ben Ali, Mohamed Ali Cherif, Walid Mhajba, Hamdi Hamdène Doghri, Malek Hassouna, Youssef Zied El Hechmi, Zouheir Jerbi, Ines Ben Hassen, Mohamed Habib Daghfous
Introduction. Mural intestinal hematoma (MIH) is an uncommon complication of anticoagulant therapy. Hemorrhagic shock has been rarely reported as a revealing modality. Results. We report two cases of shock induced by mural intestinal hematoma in patients under oral anticoagulant for aortic prosthetic valve and atrial fibrillation. Patients were admitted to the ICU for gastrointestinal tract bleeding associated with hemodynamic instability. After resuscitation, an abdominal CT scan has confirmed the diagnosis showing an extensive hematoma...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28298660/hyperlactatemia-and-cardiac-surgery
#8
REVIEW
Jonathon Minton, David A Sidebotham
The normal blood lactate level is 0-2 mmol/L, and a value above 3-5 mmol/L is variably used to define hyperlactatemia. In cardiac surgical patients, hyperlactatemia can arise from both hypoxic and non-hypoxic mechanisms. The major non-hypoxic mechanism is likely stress-induced accelerated aerobic metabolism, in which elevated lactate results from a mass effect on the lactate/pyruvate equilibrium. The lactate/pyruvate ratio is normal (<20) in this circumstance. Hyperlactatemia can also result from impaired global or regional oxygen delivery, in which case the lactate/pyruvate ratio is typically elevated (>20)...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28298034/a-protocol-for-postoperative-admission-of-elective-craniotomy-patients-to-a-non-icu-or-step-down-setting
#9
Jeffrey E Florman, Deborah Cushing, Lynne A Keller, Anand I Rughani
OBJECTIVE Selecting the appropriate patients undergoing craniotomy who can safely forgo postoperative intensive care unit (ICU) monitoring remains a source of debate. Through a multidisciplinary work group, the authors redefined their institutional care process for postoperative monitoring of patients undergoing elective craniotomy to include transfer from the postanesthesia care unit (PACU) to the neurosurgical floor. The hypothesis was that an appropriately selected group of patients undergoing craniotomy could be safely managed outside the ICU in the postoperative period...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28296811/new-onset-atrial-fibrillation-in-the-critically-ill
#10
Travis J Moss, James Forrest Calland, Kyle B Enfield, Diana C Gomez-Manjarres, Caroline Ruminski, John P DiMarco, Douglas E Lake, J Randall Moorman
OBJECTIVE: To determine the association of new-onset atrial fibrillation with outcomes, including ICU length of stay and survival. DESIGN: Retrospective cohort of ICU admissions. We found atrial fibrillation using automated detection (≥ 90s in 30 min) and classed as new-onset if there was no prior diagnosis of atrial fibrillation. We identified determinants of new-onset atrial fibrillation and, using propensity matching, characterized its impact on outcomes. SETTING: Tertiary care academic center...
March 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28292397/mortality-prediction-in-patients-admitted-in-surgical-intensive-care-unit-by-using-apache-iv
#11
Hassan Shoukat, Yar Muhammad, Khalid Masood Gondal, Imran Aslam
OBJECTIVE: To predict the mortality by the mean Acute Physiology and Chronic Health Evaluation (APACHE) IV score of all the patients admitted in a Surgical Intensive Care Unit (ICU) and comparing the score of the survivors and non-survivors. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Surgical Intensive Care Unit, Mayo Hospital, Lahore, from June 2013 to November 2014. METHODOLOGY: All adult patients admitted in the Surgical ICU were included in this study...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28291105/escalation-of-commitment-in-the-surgical-icu
#12
Carla C Braxton, Celia N Robinson, Samir S Awad
OBJECTIVES: Escalation of commitment is a business term that describes the continued investment of resources into a project even after there is objective evidence of the project's impending failure. Escalation of commitment may be a contributor to high healthcare costs associated with critically ill patients as it has been shown that, despite almost certain futility, most ICU costs are incurred in the last week of life. Our objective was to determine if escalation of commitment occurs in healthcare settings, specifically in the surgical ICU...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28291092/measuring-patient-mobility-in-the-icu-using-a-novel-noninvasive-sensor
#13
Andy J Ma, Nishi Rawat, Austin Reiter, Christine Shrock, Andong Zhan, Alex Stone, Anahita Rabiee, Stephanie Griffin, Dale M Needham, Suchi Saria
OBJECTIVES: To develop and validate a noninvasive mobility sensor to automatically and continuously detect and measure patient mobility in the ICU. DESIGN: Prospective, observational study. SETTING: Surgical ICU at an academic hospital. PATIENTS: Three hundred sixty-two hours of sensor color and depth image data were recorded and curated into 109 segments, each containing 1,000 images, from eight patients. INTERVENTIONS: None...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28289613/effect-of-perioperative-management-on-outcome-of-patients-after-craniosynostosis-surgery
#14
Abdoljalil Kalantar Hormozi, Nastaran Mahdavi, Mohammad Mehdi Foroozanfar, Seyed Sajad Razavi, Razavi Mohajerani, Ahmad Eghbali, Amir Ali Mafi, Haleh Hashemzadeh, Alireza Mahdavi
BACKGROUND: Craniosynostosis results from premature closure of one or more cranial sutures, leading to deformed calvaria and craniofacial skeleton at birth. Postoperative complications and outcome in intensive care unit (ICU) is related to surgical method and perioperative management. This study determined the perioperative risk factors, which affect outcome of patients after craniosynostosis surgery. METHODS: In a retrospective study, 178 patients with craniosynostosis who underwent primary cranial reconstruction were included...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28288777/outcomes-after-pediatric-open-laparoscopic-and-robotic-pyeloplasty-at-academic-institutions
#15
Yvonne Y Chan, Blythe Durbin-Johnson, Renea M Sturm, Eric A Kurzrock
INTRODUCTION: Patient age and hospital volume have been shown to affect perioperative outcomes after pediatric pyeloplasty. However, there are few multicenter studies that focus on outcomes at teaching hospitals, where many of the operations are performed. OBJECTIVE: The goal was to determine if surgical approach, age, case volume, or other factors influence perioperative outcomes in a large contemporary cohort. STUDY DESIGN: Using the clinical database/resource manager (CDB/RM) of the University Health-System Consortium (UHC), children who underwent open, laparoscopic, or robotic pyeloplasty from 2011 to 2014 were identified at 102 academic institutions...
February 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28288027/cumulative-probability-and-time-to-reintubation-in-u-s-icus
#16
Andrea N Miltiades, Hayley B Gershengorn, May Hua, Andrew A Kramer, Guohua Li, Hannah Wunsch
OBJECTIVE: Reintubation after liberation from mechanical ventilation is viewed as an adverse event in ICUs. We sought to describe the frequency of reintubations across U.S. ICUs and to propose a standard, appropriate time cutoff for reporting of reintubation events. DESIGN AND SETTING: We conducted a cohort study using data from the Project IMPACT database of 185 diverse ICUs in the United States. PATIENTS: We included patients who received mechanical ventilation and excluded patients who received a tracheostomy, had a do-not-resuscitate order placed, or died prior to first extubation...
March 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28286820/deep-vein-thrombosis-among-intensive-care-unit-patients-an-epidemiologic-study
#17
MirMohammad Miri, Reza Goharani, Mohammad Sistanizad
INTRODUCTION: Deep vein thrombosis (DVT) is a major cause of morbidity and mortality in intensive care unit (ICU) patients despite use of prophylactic anticoagulant therapy. The aim of the present study was to determine the incidence of DVT among medical and surgical ICU patients. METHODS: In this cross sectional study, patients older than 18 years who were hospitalized in the ICU of Imam Hossein educational Hospital, Tehran, Iran, for ≥ 2 days, during August 2008 to July 2011 were evaluated regarding DVT incidence...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285725/universal-versus-targeted-additional-contact-precautions-for-multidrug-resistant-organism-carriage-for-patients-admitted-to-an-intensive-care-unit
#18
Michel Djibré, Samuel Fedun, Pierre Le Guen, Sophie Vimont, Mehdi Hafiani, Jean-Pierre Fulgencio, Antoine Parrot, Michel Denis, Muriel Fartoukh
BACKGROUND: Although additional contact precautions (ACPs) are routinely used to reduce cross-transmission of multidrug-resistant organisms (MDROs), the relevance of isolation precautions remains debated. We hypothesized that the collection of recognized risk factors for MDRO carriage on intensive care unit (ICU) admission might be helpful to target ACPs without increasing MDRO acquisition during ICU stays, compared with universal ACPs. MATERIALS AND METHODS: This is a sequential single-center observational study performed in consecutive patients admitted to a French medical and surgical ICU...
March 10, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28284096/prevalence-of-graduated-compression-stocking-associated-pressure-injuries-in-surgical-intensive-care-units
#19
Deborah B Hobson, Tracy Y Chang, Jonathan K Aboagye, Brandyn D Lau, Hasan M Shihab, Betsy Fisher, Samantha Young, Nancy Sujeta, Dauryne L Shaffer, Victor O Popoola, Peggy S Kraus, Gina Knorr, Norma E Farrow, Michael B Streiff, Elliott R Haut
PURPOSE: This study aimed to determine the prevalence of static graduated compression stocking (sGCS)-associated pressure injury among patients in surgical intensive care units (ICUs). METHODS: We retrospectively reviewed data from wound care rounds between April 2011 and June 2012 at 3 surgical ICUs at an urban, tertiary care hospital. Patients with sGCS-associated pressure injury were identified and descriptive analysis was performed on their demographic, perioperative, and postoperative characteristics...
February 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28282377/before-the-bombing-high-burden-of-traumatic-injuries-in-kunduz-trauma-center-kunduz-afghanistan
#20
Hamayoun Hemat, Safieh Shah, Petros Isaakidis, Mrinalini Das, Nang Thu Thu Kyaw, Sattar Zaheer, Abdul Qayeum Qasemy, Mutallib Zakir, Gbane Mahama, Catherine Van Overloop, Lynette Dominguez
BACKGROUND: Médecins Sans Frontières (MSF) has been providing healthcare in Afghanistan since 1981 including specialized health services for trauma patients in Kunduz Trauma Center (KTC) from 2011. On October 3rd, 2015, a US airstrike hit the KTC, killing 42 people including 14 MSF staff. This study aims to demonstrate the impact on healthcare provision, after hospital destruction, by assessing the extent of care provided for trauma and injuries by the MSF KTC and to report on treatment outcomes from January 2014 to June 2015, three months prior to the bombing...
2017: PloS One
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