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https://www.readbyqxmd.com/read/28918202/implementation-of-a-risk-stratified-opioid-weaning-protocol-in-a-pediatric-intensive-care-unit
#1
L Nelson Sanchez-Pinto, Lara P Nelson, Phuong Lieu, Joyce Y Koh, John W Rodgers, Krichelle A Larson, Jennifer M Huson, Rambod Amirnovin
PURPOSE: Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. METHODS: A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol...
September 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28917604/the-needs-of-the-relatives-in-the-adult-intensive-care-unit-cultural-adaptation-and-psychometric-properties-of-the-chilean-spanish-version-of-the-critical-care-family-needs-inventory
#2
Noelia Rojas Silva, Cristobal Padilla Fortunatti, Yerko Molina Muñoz, Macarena Amthauer Rojas
INTRODUCTION: The admission of a patient to an intensive care unit is an extraordinary event for their family. Although the Critical Care Family Needs Inventory is the most commonly used questionnaire for understanding the needs of relatives of critically ill patients, no Spanish-language version is available. The aim of this study was to culturally adapt and validate theCritical Care Family Needs Inventory in a sample of Chilean relatives of intensive care patients. METHODS: The back-translated version of the inventory was culturally adapted following input from 12 intensive care and family experts...
September 13, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28917227/pharmacoeconomics-of-parenteral-nutrition-in-surgical-and-critically-ill-patients-receiving-structured-triglycerides-in-china
#3
Guo Hao Wu, Alexandra Ehm, Marco Bellone, Lorenzo Pradelli
BACKGROUND AND OBJECTIVES: A prior meta-analysis showed favorable metabolic effects of structured triglyceride (STG) lipid emulsions in surgical and critically ill patients compared with mixed medium-chain/long-chain triglycerides (MCT/LCT) emulsions. Limited data on clinical outcomes precluded pharmacoeconomic analysis. We performed an updated meta-analysis and developed a cost model to compare overall costs for STGs vs MCT/LCTs in Chinese hospitals. METHODS AND STUDY DESIGN: We searched Medline, Embase, Wanfang Data, the China Hospital Knowledge Database, and Google Scholar for clinical trials comparing STGs to mixed MCT/LCTs in surgical or critically ill adults published between October 10, 2013 and September 19, 2015...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28917226/energy-intake-in-the-first-week-in-an-emergency-intensive-care-unit-may-not-influence-clinical-outcomes-in-critically-ill-overweight-japanese-patients
#4
Satomi Ichimaru, Maren Sono, Ryutaro Seo, Koichi Ariyoshi, Teruyoshi Amagai
BACKGROUND AND OBJECTIVES: The American Society for Parenteral and Enteral Nutrition recommends hypocaloric feeding for critically ill patients with a BMI of >=30.0 kg/m2. However, the cut-off value of obesity in Japan is BMI >25.0 kg/m2, due to the higher prevalence of type 2 diabetes mellitus, and cardiovascular risk factors, even at a lower BMI than in Western populations. Thus, the optimal energy intake for critically ill, overweight Asian patients is unknown. METHODS AND STUDY DESIGN: A retrospective chart review was conducted in patients with BMI of >=25...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28917221/determining-the-predictive-equation-for-height-from-ulnar-length-in-the-vietnamese-population
#5
Ana Bonell, Nguyen Nguyen Huyen, Vu Dinh Phu, Heiman Wertheim, Behzad Nadjm
BACKGROUND AND OBJECTIVES: Height is an essential measurement in clinical medicine. It allows the calculation of body mass index, ideal body weight, basic energy requirements and tidal volumes. In many patient groups, such as the critically ill, height cannot be measured easily and surrogate anthropometric measures are used. Regression equations estimating height are specific to ethnicity. We aimed to develop the regression equation for Vietnamese men and women to predict height from ulna length and so improve prescription of life-saving treatment in the intensive care units...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28917160/is-magnet%C3%A2-recognition-associated-with-improved-outcomes-among-critically-ill-children-treated-at-freestanding-children-s-hospitals
#6
Mallikarjuna Rettiganti, Kavisha M Shah, Jeffrey M Gossett, Joshua A Daily, Paul M Seib, Punkaj Gupta
PURPOSE: With increasing emphasis on high-quality care, we designed this study to evaluate the relationship between Magnet® recognition and patient outcomes in pediatric critical care. MATERIALS AND METHODS: Post hoc analysis of data from an existing administrative national database. We used inverse probability of treatment weighting and multivariate models to compare outcomes between two study groups after adjusting for confounding variables. RESULTS: A total of 823,634 pediatric patients from 41 centers were included...
September 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28917005/outcome-of-pediatric-acute-kidney-injury-a-multicenter-prospective-cohort-study
#7
Jameela A Kari, Khalid A Alhasan, Mohamed A Shalaby, Norah Khathlan, Osama Y Safdar, Suleman A Al Rezgan, Sherif El Desoky, Amr S Albanna
BACKGROUND: Acute kidney injury (AKI) is a common problem encountered in critically ill children with an increasing incidence and evolving epidemiology. AKI carries a serious morbidity and mortality in patients requiring admission to a pediatric intensive care unit (PICU). METHODS: We undertook a prospective cohort study of PICU admissions at three tertiary care hospitals in the Kingdom of Saudi Arabia over 2 years. The Kidney Disease Improving Global Outcomes (KDIGO) definition was used to diagnose AKI...
September 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28917004/critical-illness-associated-diaphragm-weakness
#8
REVIEW
Martin Dres, Ewan C Goligher, Leo M A Heunks, Laurent J Brochard
Diaphragm weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilation but it also frequently develops during the ICU stay. Several risk factors for diaphragm weakness have been identified; among them sepsis and mechanical ventilation play central roles. We employ the term critical illness-associated diaphragm weakness to refer to the collective effects of all mechanisms of diaphragm injury and weakness occurring in critically ill patients...
September 15, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28915811/strategies-for-the-quality-assessment-of-the-health-care-service-providers-in-the-treatment-of-gastric-cancer-in-colombia
#9
María Del Pilar Villamil, David Barrera, Nubia Velasco, Oscar Bernal, Esteban Fajardo, Carlos Urango, Sebastian Buitrago
BACKGROUND: While, at its inception in 1993, the health care system in Colombia was publicized as a paradigm to be copied across the developing world, numerous problems in its implementation have led to, what is now, an inefficient and crisis-ridden health system. Furthermore, as a result of inappropriate tools to measure the quality of the health service providers, several corruption scandals have arisen in the country. This study attempts to tackle this situation by proposing a strategy for the quality assessment of the health service providers (Entidades Promotoras de Salud, EPS) in the Colombian health system...
September 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28915392/impact-of-antibiotic-therapy-in-severe-community-acquired-pneumonia-data-from-the-infauci-study
#10
J M Pereira, J Gonçalves-Pereira, O Ribeiro, J P Baptista, F Froes, J A Paiva
Antibiotic therapy (AT) is the cornerstone of the management of severe community-acquired pneumonia (CAP). However, the best treatment strategy is far from being established. To evaluate the impact of different aspects of AT on the outcome of critically ill patients with CAP, we performed a post hoc analysis of all CAP patients enrolled in a prospective, observational, multicentre study. Of the 502 patients included, 76% received combination therapy, mainly a β-lactam with a macrolide (80%). AT was inappropriate in 16% of all microbiologically documented CAP (n=177)...
September 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28915184/wide-disagreement-between-alternative-assessments-of-premorbid-physical-activity-subjective-patient-and-surrogate-reports-and-objective-smartphone-data
#11
Samuel Gluck, Matthew J Summers, Thomas P Goddard, Alice Andrawos, Natalie C Smith, Kylie Lange, Theodore J Iwashyna, Adam M Deane
OBJECTIVES: Surrogate-decision maker and patient self-reported estimates of the distances walked prior to acute illness are subjective and may be imprecise. It may be possible to extract objective data from a patient's smartphone, specifically, step and global position system data, to quantify physical activity. The objectives were to 1) assess the agreement between surrogate-decision maker and patient self-reported estimates of distance and time walked prior to resting and daily step-count and 2) determine the feasibility of extracting premorbid physical activity (step and global position system) data from critically ill patients...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28915176/prognostication-of-critically-ill-patients-with-cancer-a-long-road-ahead
#12
Pedro Caruso
No abstract text is available yet for this article.
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28914864/-hyponatremia-a-clinical-approach
#13
D Yu Shchekochikhin, N L Kozlovskaya, F Yu Kopylov, A L Syrkin, E M Shilov
Hyponatremia is the most common electrolyte metabolic abnormality in clinical practice. The unfavorable course of many diseases is associated with hyponatremia. Acute severe hyponatremia is life-threatening because cerebral edema may develop. Less obvious chronic hyponatremia increases the risk of balance problems, falls and fractures, especially in elderly patients. In any occasion, hyponatremia should not be now regarded only as a laboratory phenomenon in critically ill patients, but it necessitates a thorough clinical analysis of each individual case and appropriate therapy...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28914626/secondary-traumatic-stress-in-nicu-nurses-a-mixed-methods-study
#14
Cheryl Tatano Beck, Regina M Cusson, Robert K Gable
BACKGROUND: Secondary traumatic stress is an occupational hazard for healthcare providers who care for patients who have been traumatized. This type of stress has been reported in various specialties of nursing, but no study to date had specifically focused on neonatal intensive care unit (NICU) nurses. PURPOSE: (1) To determine the prevalence and severity of secondary traumatic stress in NICU nurses and (2) to explore those quantitative findings in more depth through nurses' qualitative descriptions of their traumatic experiences caring for critically ill infants in the NICU...
September 13, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28914279/blood-products-provided-to-patients-receiving-futile-critical-care
#15
Thanh H Neville, Alyssa Ziman, Neil S Wenger
The number of hospitalized patients receiving treatment perceived to be futile is not insignificant. Blood products are valuable resources that are donated to help others in need. We aimed to quantify the amount of blood transfused into patients who were receiving treatment that the critical care physician treating them perceived to be futile. During a 3-month period, critical care physicians in 5 adult intensive care units completed a daily questionnaire to identify patients perceived as receiving futile treatment...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913918/clopidogrel-in-critically-ill-patients
#16
Christian Schoergenhofer, Eva-Luise Hobl, Peter Schellongowski, Gottfried Heinz, Walter Speidl, Jolanta Siller-Matula, Monika Schmid, Raute Sunder-Plaßmann, Thomas Stimpfl, Matthias Hackl, Bernd Jilma
Only limited data are available regarding the treatment of critically ill patients with clopidogrel. This trial investigated the effects and the drug concentrations of the CYP450 activated pro-drug clopidogrel (n=43) and the half-life of the similarly metabolized pantoprazole (n=16) in critically ill patients. ADP-induced aggregometry in whole blood classified 74% (95% confidence intervals 59-87%) of critically ill patients as poor responders (n=43), and 65% (49-79%) responded poorly according to the VASP-P assay...
September 15, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28913813/pharmacotherapy-pearls-for-emergency-neurological-life-support
#17
Gretchen M Brophy, Theresa Human
The appropriate use of medications during Emergency Neurological Life Support (ENLS) is essential to optimize patient care. Important considerations when choosing the appropriate agent include the patient's organ function and medication allergies, potential adverse drug effects, drug interactions and critical illness and aging pathophysiologic changes. Critical medications used during ENLS include hyperosmolar therapy, anticonvulsants, antithrombotics, anticoagulant reversal and hemostatic agents, anti-shivering agents, neuromuscular blockers, antihypertensive agents, sedatives, vasopressors and inotropes, and antimicrobials...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28912884/towards-translational-immunopet-mr-imaging-of-invasive-pulmonary-aspergillosis-the-humanised-monoclonal-antibody-jf5-detects-aspergillus-lung-infections-in-vivo
#18
Genna Davies, Anna-Maria Rolle, Andreas Maurer, Philipp R Spycher, Claudia Schillinger, Djamschid Solouk-Saran, Mike Hasenberg, Juliane Weski, Jesper Fonslet, Adrien Dubois, Frederic Boschetti, Franck Denat, Matthias Gunzer, Martin Eichner, Lauren S Ryder, Mikael Jensen, Roger Schibli, Bernd J Pichler, Stefan Wiehr, Christopher R Thornton
Invasive pulmonary aspergillosis (IPA) is a life-threatening lung disease of hematological malignancy or bone marrow transplant patients caused by the ubiquitous environmental fungus Aspergillus fumigatus. Current diagnostic tests for the disease lack sensitivity as well as specificity, and culture of the fungus from invasive lung biopsy, considered the gold standard for IPA detection, is slow and often not possible in critically ill patients. In a previous study, we reported the development of a novel non-invasive procedure for IPA diagnosis based on antibody-guided positron emission tomography and magnetic resonance imaging (immunoPET/MRI) using a [(64)Cu]DOTA-labeled mouse monoclonal antibody (mAb), mJF5, specific to Aspergillus...
2017: Theranostics
https://www.readbyqxmd.com/read/28912829/mental-health-leadership-and-patient-access-to-care-a-public-private-initiative-in-south-africa
#19
Christopher Paul Szabo, Jennifer Fine, Pat Mayers, Shan Naidoo, Tuviah Zabow
BACKGROUND: Mental health leadership is a critical component of patient access to care. More specifically, the ability of mental health professionals to articulate the needs of patients, formulate strategies and engage meaningfully at the appropriate level in pursuit of resources. This is not a skill set routinely taught to mental health professionals. METHODS: A public-private mental health leadership initiative, emanating from a patient access to care programme, was developed with the aim of building leadership capacity within the South African public mental health sector...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28912058/translation-and-cultural-adaptation-of-the-quality-of-communication-questionnaire-for-icu-family-members-in-korea
#20
Minjeong Jo, Mi-Kyung Song, Marcia Van Riper, Yang-Sook Yoo, George J Knafl, Linda Beeber
BACKGROUND: There are no Korean instruments to assess the concepts associated with end-of-life communication quality. OBJECTIVES: To translate and culturally adapt the Quality of Communication (QOC) questionnaire into Korean and evaluate its acceptability and internal consistency. METHODS: We first translated the QOC from English into Korean, then back-translated from Korean to English, and evaluated the cultural appropriateness of the items...
September 11, 2017: Heart & Lung: the Journal of Critical Care
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