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Surgical ICU

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https://www.readbyqxmd.com/read/28538646/defining-the-ge-junction-in-trauma-epidemiology-and-management-of-a-challenging-injury
#1
Morgan Schellenberg, Kenji Inaba, James M Bardes, Daniel OʼBrien, Lydia Lam, Elizabeth Benjamin, Daniel Grabo, Demetrios Demetriades
INTRODUCTION: Injuries to the gastroesophageal (GE) junction are infrequently encountered because of the high mortality of associated injuries. Consequently, there is a paucity of literature on the patient demographics and treatment options. The aim of this study was to examine the epidemiology, surgical management, and outcomes of these rare injuries. METHODS: Patients presenting to LAC+USC Medical Center (01/2008-08/2016) with traumatic esophageal or gastric injury (ICD-9 and -10 codes) were extracted from the trauma registry...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28537973/identifying-variability-in-mental-models-within-and-between-disciplines-caring-for-the-cardiac-surgical-patient
#2
Evans K H Brown, Kathleen A Harder, Ioanna Apostolidou, Joyce A Wahr, Douglas C Shook, R Saeid Farivar, Tjorvi E Perry, Mojca R Konia
BACKGROUND: The cardiac operating room is a complex environment requiring efficient and effective communication between multiple disciplines. The objectives of this study were to identify and rank critical time points during the perioperative care of cardiac surgical patients, and to assess variability in responses, as a correlate of a shared mental model, regarding the importance of these time points between and within disciplines. METHODS: Using Delphi technique methodology, panelists from 3 institutions were tasked with developing a list of critical time points, which were subsequently assigned to pause point (PP) categories...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#3
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28536917/comparison-of-early-outcomes-of-surgical-ablation-procedures-for-atrial-fibrillation-concomitant-to-non-mitral-cardiac-surgery-a-japan-adult-cardiovascular-surgery-database-study
#4
Hideaki Takai, Hiroaki Miyata, Noboru Motomura, Kenichi Sasaki, Takashi Kunihara, Shinichi Takamoto
OBJECTIVE: Although the benefit of surgical ablation for atrial fibrillation (AF) performed concomitant to mitral valve surgery is established, whether that performed concomitant to non-mitral cardiac surgery is beneficial remains unclear. In non-mitral, non-left-atriotomy cardiac surgery, the optimal surgical approach for AF remains to be established. Therefore, using the Japan Adult Cardiovascular Surgery Database (JACVSD), we compared 2 surgical ablation procedures [the maze procedure and pulmonary vein isolation (PVI)] performed concomitant to non-mitral cardiac surgery...
May 23, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28530779/predictive-factors-for-early-hospital-readmission-and-1-year-mortality-in-elder-patients-following-surgical-treatment-of-a-hip-fracture
#5
Hakan Sofu, Hanifi Üçpunar, Yalkın Çamurcu, Serda Duman, Mehmet Nuri Konya, Sarper Gürsu, Vedat Şahin
BACKGROUND: Early hospital readmission after surgically treated hip fracture is a common entity, often involving an adverse event and causing strains on an already overburdened healthcare system. The main purposes of the present study were to determine the 30-day readmission rate, analyze the predictive factors for early hospital readmissions, and assess 1-year mortality following surgical treatment of hip fracture in elderly patients. Retrospective case-control study. METHODS: In total, 517 patients with a mean age of 74 years were evaluated...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530772/characteristics-of-the-injuries-of-syrian-refugees-sustained-during-the-civil-war
#6
Betül Kocamer Şimşek, Mehmet Dokur, Erdal Uysal, Necdet Çalıker, Oruç Numan Gökçe, İbrahim Kürşat Deniz, Murat Uğur, Murat Geyik, Mehmet Kaya, Güner Dağlı
BACKGROUND: During a war, many civilians are severely injured by firearms, bombs, and shrapnel. The triage of war injuries involves difficult and complicated processes requiring surgical procedures and patient monitoring in the Intensive Care Unit (ICU) of hospitals. In this study, we examine the demographic, traumatic, and critical care characteristics of cases injured during the civil war in Syria and requiring emergency surgery. METHODS: Electronic data of the traumatic, surgical, and ICU monitoring features of 707 patients admitted to Kilis Public Hospital between March 2012 and January 2013 were analyzed retrospectively RESULTS: Most of the patients reported having been injured due to firearms (83...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530118/readmission-to-intensive-care-unit-incidence-risk-factors-resource-use-and-outcomes-a-retrospective-cohort-study
#7
Carolina R Ponzoni, Thiago D Corrêa, Roberto R Filho, Ary Serpa Neto, Murillo Sc Assunção, Andreia Pardini, Guilherme Pp Schettino
RATIONALE: Readmission to intensive care unit (ICU) is associated with poor clinical outcomes, increased length of ICU and hospital stay and higher costs. Nevertheless, knowledge on epidemiology of ICU readmissions, risk factors and attributable outcomes are restricted to developed countries. OBJECTIVES: Determine the effect of ICU readmissions on in-hospital mortality, incidence of ICU readmissions, identify predictors of ICU readmissions and hospital mortality and compare resource use and outcomes between readmitted and nonreadmitted patients in a developing country...
May 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28529913/critical-care-management-and-intensive-care-unit-outcomes-following-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#8
Sumit Kapoor, Adel Bassily-Marcus, Rafael Alba Yunen, Parissa Tabrizian, Sabrine Semoin, Joseph Blankush, Daniel Labow, John Oropello, Anthony Manasia, Roopa Kohli-Seth
AIM: To study the early postoperative intensive care unit (ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Our study is a retrospective, observational study performed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28526657/risk-adjusted-adverse-outcomes-in-complex-abdominal-wall-hernia-repair-with-biologic-mesh-a-case-series-of-140-patients
#9
Rifat Latifi, David Samson, Ansab Haider, Asad Azim, Hajira Iftikhar, Bellal Joseph, Elizabeth Tilley, Jorge Con, Saranda Gashi, Ayman El-Menyar
INTRODUCTION: Biologic mesh is preferred for repair of complex abdominal wall hernias (CAWHs) in patients at high risk of wound infection. We aimed to identify predictors of adverse outcomes after complex abdominal wall hernia repair (CAWR) using biologic mesh with different placement techniques and under different surgical settings. METHODS: A retrospective case series study was conducted on all patients who underwent CAWR with biologic mesh between 2010 and 2015 at a tertiary medical center...
May 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28523268/the-sedative-effect-of-propranolol-on-critically-ill-patients-a-case-series
#10
Junji Shiotsuka, Andrew Steel, James Downar
INTRODUCTION: Recent studies have examined the effectiveness of alpha-2 adrenergic agonists for controlling delirium and agitation. Propranolol, a non-selective beta-adrenergic antagonist with good penetration of the blood-brain barrier, has not been investigated for this purpose. MATERIALS AND METHODS: We retrospectively reviewed the medical records of all patients who were prescribed propranolol in our Medical Surgical ICU from January 1, 2010, to December 31, 2013...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28523130/the-development-of-uniportal-video-assisted-thoracoscopic-surgery-in-s%C3%A3-o-paulo-from-diagnosis-to-lobectomy
#11
Alexandre de Oliveira, Thais Amarante P P Couto
BACKGROUND: The use of uniportal video-assisted thoracoscopic surgery (VATS) has been increasing worldwide. Our main goal was to describe the evolution of uniportal surgery in the biggest private hospital in Latin America that is located in São Paulo, Brazil. METHODS: This descriptive and retrospective study included patients who underwent uniportal VATS in the thoracic surgical department of Beneficencia Portuguesa Hospital, after being referred to our team to undergo the aforementioned procedure within the period from February 2012 to March 2016...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28521598/malnutrition-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#12
Kris M Mogensen, Clare M Horkan, Steven W Purtle, Takuhiro Moromizato, James D Rawn, Malcolm K Robinson, Kenneth B Christopher
BACKGROUND: We hypothesized that preexisting malnutrition in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed an observational cohort study in 1 academic medical center in Boston. We studied 23,575 patients, aged ≥18 years, who received critical care between 2004 and 2011 and survived hospitalization. RESULTS: The exposure of interest was malnutrition determined at intensive care unit (ICU) admission by a registered dietitian using clinical judgment and on data related to unintentional weight loss, inadequate nutrient intake, and wasting of muscle mass and/or subcutaneous fat...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28515741/respiratory-functional-status-after-conventional-and-minimally-invasive-aortic-valve-replacement-surgery-a-propensity-score-analysis
#13
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Kamil Fijorek, Michał Mędrzycki, Janusz Andres, Bogusław Kapelak
INTRODUCTION: Reports describing respiratory function of patients after conventional or minimally invasive cardiac surgery are infrequent. AIM: To compare pulmonary functional status after conventional (AVR) and after minimally invasive, through right anterior minithoracotomy, aortic valve replacement (RT-AVR). MATERIAL AND METHODS: This was an observational analysis of 212 patients scheduled for RT-AVR and 212 for AVR between January 2011 and December 2014 selected using propensity score matching...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28511483/a-study-of-morbidity-and-cost-of-peripheral-venous-cannulation-in-neonates-admitted-to-paediatric-surgical-intensive-care-unit
#14
Sushama Raghunath Tandale, Nandini Dave, Madhu Garasia, Shalil Patil, Sandesh Parelkar
INTRODUCTION: Peripheral venous access in sick neonates is indicated for administration of fluids, drugs or nutrients. AIM: We conducted an audit of peripheral venous access in neonates admitted to paediatric surgical intensive care unit to study the morbidity, time spent on cannulation and cost with its use. MATERIALS AND METHODS: One hundred consecutive neonates requiring hospital admission to paediatric surgical intensive care unit in a period of one year were included in the study...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28511450/emergency-peripartum-hysterectomy-indications-and-outcome-in-a-tertiary-care-setting
#15
Anshuja Singla, Rajlaxmi Mundhra, Latika Phogat, Sumita Mehta, Shalini Rajaram
INTRODUCTION: Emergency Peripartum Hysterectomy (EPH) is an important lifesaving procedure, mostly reserved for conditions deemed to be serious and life threatening, and not amenable to conservative methods. In the present scenario, the advent of newer medical and conservative surgical methods for controlling obstetric haemorrhage has influenced the incidence, trend and the outcomes of the procedure. AIM: To evaluate the demographic profile, indications, operative details, maternal morbidity and mortality and neonatal outcomes of women undergoing EPH...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28509706/length-of-stay-mortality-cost-and-perceptions-of-care-associated-with-transition-from-an-open-to-closed-staffing-model-in-the-cardiac-intensive-care-unit
#16
Jason N Katz, Anton Lishmanov, Sean van Diepen, Dongqing Yu, Haipeng Shen, Eric Pauley, Jatin Bhatia, Adam Buntaine, Arun Das, Cristie Dangerfield, Brooke McLaughlin, George A Stouffer, Prashant Kaul
BACKGROUND: Organizational models in the intensive care unit (ICU) have classically been described as either closed or open, depending on the presence or absence of a dedicated ICU team. Although a closed model has been shown to improve patient outcomes in medical and surgical ICUs, the merits of various care models have not been previously explored in the cardiac ICU (CICU) setting. METHODS: From November 2012 to March 2014, data were prospectively collected on all admissions before and after transition from an open to closed CICU at our institution...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28503258/feasibility-of-pancreatectomy-following-high-dose-proton-therapy-for-unresectable-pancreatic-cancer
#17
Kathryn E Hitchcock, R Charles Nichols, Christopher G Morris, Debashish Bose, Steven J Hughes, John A Stauffer, Scott A Celinski, Elizabeth A Johnson, Robert A Zaiden, Nancy P Mendenhall, Michael S Rutenberg
AIM: To review surgical outcomes for patients undergoing pancreatectomy after proton therapy with concomitant capecitabine for initially unresectable pancreatic adenocarcinoma. METHODS: From April 2010 to September 2013, 15 patients with initially unresectable pancreatic cancer were treated with proton therapy with concomitant capecitabine at 1000 mg orally twice daily. All patients received 59.40 Gy (RBE) to the gross disease and 1 patient received 50.40 Gy (RBE) to high-risk nodal targets...
April 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28502236/family-presence-in-the-adult-icu-during-bedside-procedures
#18
Marnie Jakab, Alex Z Day, Alan Kraguljac, Maedean Brown, Sangeeta Mehta
PURPOSE: To understand perspectives of family members of adult patients admitted to the medical-surgical intensive care unit (ICU) regarding their presence during procedures. METHODS: Respondents completed a questionnaire about procedures the patient had undergone, their desire to be present, and their experience. Procedures of interest were endotracheal intubation; chest compressions; vascular catheter insertion; and gastric, chest, and rectal tubes. Impact of Events Scale-Revised (IES-R) was completed at the time of questionnaire completion and again 1 month later to evaluate the psychological impact of witnessing a procedure...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28500920/the-impact-of-delayed-rapid-response-call-activation-on-patient-outcomes
#19
Sachin Gupta, Cameron Green, Ashwin Subramaniam, Lim Dee Zhen, Elizabeth Low, Ravindranath Tiruvoipati
PURPOSE: To investigate the impact of delay in rapid response call (RRC) activation on Hospital mortality. MATERIALS AND METHODS: This study was conducted in a university affiliated hospital providing medical, surgical, mental health, maternity, and pediatric services. RRCs were considered delayed if RRC activation was delayed by ≥15min. The primary outcome measure was in-hospital mortality. Secondary outcomes included hospital length of stay (LOS), requirement of ICU admission, as well as requirement of mechanical ventilation and ICU LOS for patients requiring ICU admission...
May 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28495690/intensive-care-in-thoracic-oncology
#20
Anne-Pascale Meert, Bogdan Grigoriu, Marc Licker, Paul E Van Schil, Thierry Berghmans
The admission of lung cancer patients to intensive care is related to postprocedural/postoperative care and medical complications due to cancer or its treatment, but is also related to acute organ failure not directly related to cancer.Despite careful preoperative risk management and the use of modern surgical and anaesthetic techniques, thoracic surgery remains associated with high morbidity, related to the extent of resection and specific comorbidities. Fast-tracking processes with timely recognition and treatment of complications favourably influence patient outcome...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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