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https://www.readbyqxmd.com/read/29430447/mechanisms-involved-in-brain-dysfunction-in-mechanically-ventilated-critically-ill-patients-implications-and-therapeutics
#1
REVIEW
Marc Turon, Sol Fernández-Gonzalo, Candelaria de Haro, Rudys Magrans, Josefina López-Aguilar, Lluís Blanch
Critical illness may lead to significant long-term neurological morbidity and patients frequently develop neuropsychological disturbances including acute delirium or memory impairment after intensive care unit (ICU) discharge. Mechanical ventilation (MV) is a risk factor to the development of adverse neurocognitive outcomes. Patients undergoing MV for long periods present neurologic impairment with memory and cognitive alteration. Delirium is considered an acute form of brain dysfunction and its prevalence rises in mechanically ventilated patients...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29430446/models-of-disuse-muscle-atrophy-therapeutic-implications-in-critically-ill-patients
#2
REVIEW
Esther Barreiro
Skeletal muscle weakness is common in the intensive care units (ICU). Approximately 50% of patients under mechanical ventilation for more than 7 days show signs of ICU-acquired muscle weakness. In these patients, muscle weakness may be the result of axonal polyneuropathy, myopathy or a combination of both. The commonest risk factors in patients with ICU-acquired weakness (AW) are the severity and duration of the systemic inflammatory response, duration of the stay in the ICU and of mechanical ventilation, hyperglycemia, hypoalbuminemia, parenteral nutrition, and administration of corticosteroids and of neuromuscular blocking agents...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29424400/-validity-of-scales-for-the-functional-assessment-of-critically-ill-patients
#3
Marcela H Libuy, Paola Szita C, Juan Hermosilla P, Daniel Arellano S, Iván Rodríguez-Núñez, Claudio Báez R
The decrease in mortality in critical patient units led to an increase in intensive care unit acquired weakness (ICUAW), which significantly affects the functional performance and quality of life of patients. There are several scales that measure functionality in critical patients. The aim of this systematic review is to determine the criterion validity and reliability of the scales that evaluate functionality in critically ill adult patients. We considered studies in critically ill adult subjects of both genders that determined the psychometric properties of the scales that evaluate functionality...
September 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29413508/weaning-failure-and-respiratory-muscle-function-what-has-been-done-and-what-can-be-improved
#4
REVIEW
Paulo A F Magalhães, Carlos A Camillo, Daniel Langer, Lívia B Andrade, Maria do Carmo M B Duarte, Rik Gosselink
INTRODUCTION: Respiratory muscle dysfunction, being a common cause of weaning failure, is strongly associated with prolonged mechanical ventilation (MV) and prolonged stay in intensive care units. Inspiratory muscle training (IMT) has been described as an important contributor to the treatment of respiratory muscle dysfunction in critically ill patients. Its effectiveness is however yet controversial. OBJECTIVE: To discuss evidence for assessment of readiness and the effectiveness of interventions for liberation from MV, with special attention to the role of IMT...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29407008/cardiac-intensive-care-unit-management-of-patients-after-cardiac-arrest-now-the-real-work-begins
#5
REVIEW
Varinder K Randhawa, Brian E Grunau, Derek B Debicki, Jian Zhou, Ahmed F Hegazy, Terry McPherson, A Dave Nagpal
Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)-in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post-cardiac arrest syndrome also require diligent observation and management, including post-cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29403646/barriers-and-facilitators-to-early-rehabilitation-in-mechanically-ventilated-patients-a-theory-driven-interview-study
#6
Shannon L Goddard, Fabiana Lorencatto, Ellen Koo, Louise Rose, Eddy Fan, Michelle E Kho, Dale M Needham, Gordon D Rubenfeld, Jill J Francis, Brian H Cuthbertson
Background: Despite a supportive evidence base and a push to implement, the uptake of early rehabilitation in critical care has been inconsistent. The objective of this study was to explore barriers and facilitators to early rehabilitation for critically ill patients receiving invasive mechanical ventilation. Methods: Using the Theoretical Domains Framework (TDF) of behavior change, we conducted semi-structured interviews exploring barriers and facilitators to early rehabilitation among four purposively sampled ICU clinician groups (nurses, rehabilitation professionals, respiratory therapists, and physicians)...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29394221/functional-recovery-in-critically-ill-children-the-weecover-multicenter-study
#7
Karen Choong, Douglas Fraser, Samah Al-Harbi, Asm Borham, Jill Cameron, Saoirse Cameron, Ji Cheng, Heather Clark, Tim Doherty, Nora Fayed, Jan-Willem Gorter, Margaret Herridge, Mary Khetani, Kusum Menon, Jamie Seabrook, Racquel Simpson, Lehana Thabane
OBJECTIVES: To evaluate functional outcomes and evaluate predictors of an unfavorable functional outcome in children following a critical illness. DESIGN: Prospective observational longitudinal cohort study. SETTING: Two tertiary care, Canadian PICUs: McMaster Children's Hospital and London Health Sciences. PATIENTS: Children 12 months to 17 years old, admitted to PICU for at least 48 hours with one or more organ dysfunction, were eligible...
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29393040/perioperative-treatment-of-patients-undergoing-acute-high-risk-abdominal-surgery%C3%A2
#8
Line Toft Tengberg
Critically ill acute high-risk abdominal surgery patients represent a major challenge to health care providers, with the typical patient being elderly and frail, and with severe and multiple comorbidities. The mortality rate in this population is high, and the postoperative course is characterized by complications, prolonged hospitalisation and considerable risk of permanent disability. With an ageing population, the number of elderly patients, as well as challenges concerning treatment will arise, calling for a coordinated effort both nationally and internationally to enhance treatment in this vulnerable patient group...
February 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29358002/the-effect-of-a-natural-food-based-tube-feeding-in-minimizing-diarrhea-in-critically-ill-neurological-patients
#9
Simone B Schmidt, Willibald Kulig, Ralph Winter, Antje S Vasold, Anette E Knoll, Jens D Rollnik
BACKGROUND & AIMS: Diarrhea has negative consequences for patients, health care staff and health care costs when neurological patients are fed enterally over long periods. We examined the effect of tube feeding with natural foods in reducing the number of fluid stool evacuations and diarrhea in critically ill neurological patients. METHODS: A multicenter, prospective, open-label and randomized controlled trial (RCT) was conducted at facilities in Germany specializing in early rehabilitation after neurological damage...
January 9, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29357778/normal-baseline-function-is-associated-with-delayed-rehabilitation-in-critically-ill-children
#10
Shinya Miura, Beth Wieczorek, Hallie Lenker, Sapna R Kudchadkar
BACKGROUND: Early mobilization of patients in the adult intensive care unit (ICU) is associated with improved functional outcomes and shorter ICU stay. Although emerging evidence suggests that early mobilization in pediatric ICUs (PICUs) is safe and feasible, physical therapist (PT) consultation may be delayed because of perceptions that patient acuity precludes mobilization activities. Factors that influence timely involvement of PTs to facilitate acute rehabilitation in critically ill children have not been characterized...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29357716/the-design-briefing-process-matters-a-case-study-on-telehealthcare-device-providers-in-the-uk
#11
Fan Yang, Gianni Renda
PURPOSE: The telehealthcare sector has been expanding steadily in the UK. However, confusing, complex and unwieldy designs of telehealthcare devices are at best, less effective than they could be, at worst, they are potentially dangerous to the users. METHOD: This study investigated the factors within the new product development process that hindered satisfactory product design outcomes, through working collaboratively with a leading provider based in the UK. RESULTS: This study identified that there are too many costly late-stage design changes; a critical and persistent problem area ripe for improvement...
January 23, 2018: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#12
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29319723/characteristics-and-outcomes-of-intensive-care-unit-survivors-experience-of-a-multidisciplinary-outpatient-clinic-in-a-teaching-hospital
#13
Péricles A D Duarte, Jaquilene Barreto Costa, Silvana Trilo Duarte, Sheila Taba, Claudia Regina Felicetti Lordani, Erica Fernanda Osaku, Claudia Rejane Lima Macedo Costa, Dalas Cristina Miglioranza, Daniela Prochnow Gund, Amaury Cesar Jorge
OBJECTIVES: To describe the experience of an outpatient clinic with the multidisciplinary evaluation of intensive care unit survivors and to analyze their social, psychological, and physical characteristics in a low-income population and a developing country. METHODS: Retrospective cohort study. Adult survivors from a general intensive care unit were evaluated three months after discharge in a post-intensive care unit outpatient multidisciplinary clinic over a period of 6 years (2008-2014) in a University Hospital in southern Brazil...
December 2017: Clinics
https://www.readbyqxmd.com/read/29276219/indirect-calorimetry-measurement-of-energy-expenditure-related-to-body-position-changes-in-healthy-adults
#14
Kengo Obata, Tetsuya Yumoto, Soichiro Fuke, Kohei Tsukahara, Hiromichi Naito, Atsuyoshi Iida, Tetsuya Takahashi, Yoshihito Ujike, Atsunori Nakao
Early mobilization is advocated to prevent intensive care unit-acquired physical weakness, but the patient's workload and its changes in response to body position changes have not been established. We used indirect calorimetry to determine the energy expenditure (EE) in response to body position changes, and we assessed EE's correlation with respiratory parameters in healthy volunteers: 8 males and 8 females, mean age 23.4±1.3 years. The subjects started in the resting supine position followed by a 30° head-up position, a 60° head-up position, an upright sitting position, a standing position, and the resting supine position...
December 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29251709/benchmarking-clinical-outcomes-and-the-immunocatabolic-phenotype-of-chronic-critical-illness-after-sepsis-in-surgical-intensive-care-unit-patients
#15
Julie A Stortz, Juan C Mira, Steven L Raymond, Tyler J Loftus, Tezcan Ozrazgat-Baslanti, Zhongkai Wang, Gabriela L Ghita, Christiaan Leeuwenburgh, Mark S Segal, Azra Bihorac, Babette A Brumback, Alicia M Mohr, Philip A Efron, Lyle L Moldawer, Frederick A Moore, Scott C Brakenridge
BACKGROUND: A growing number of patients survive sepsis but remain chronically critically ill. We sought to define clinical outcomes and incidence of chronic critical illness (CCI) after sepsis and to determine whether selected biomarkers of inflammation, immunosuppression, and catabolism differ between these patients and those that rapidly recover (RAP). METHODS: This 3-year prospective observational cohort study (NCT02276417) evaluated 145 surgical intensive care unit patients with sepsis for the development of CCI (≥14 days of intensive care unit resource utilization with persistent organ dysfunction)...
February 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29249784/-surgical-embolectomy-for-acute-massive-pulmonary-thromboembolism-requiring-percutaneous-cardiopulmonary-support-after-thoracoabdominal-aorta-replacement
#16
Takahiko Masuda, Masaki Hata, Kazuhiro Yamaya, Tomoyuki Suzuki, Yukihiro Hayatsu, Kyohei Ueno, Masaaki Naganuma, Naoya Terao
A 48-year-old man was admitted to our hospital and underwent thoracoabdominal aorta replacement. Eight days postoperatively, he developed severe dyspnea and transient drop in blood pressure suddenly following walk rehabilitation. Contrast-enhanced computed tomography showed thrombi in the bilateral main pulmonary artery. Respiratory failure and unstable hemodynamics developed, which required percutaneous cardiopulmonary support (PCPS). Because catheter embolectomy and thrombolytic therapy via pulmonary artery catheter were not effective, surgical thrombectomy was performed...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29232263/can-the-critically-ill-patient-generate-sufficient-energy-to-facilitate-exercise-in-the-icu
#17
Danielle E Bear, Selina M Parry, Zudin A Puthucheary
PURPOSE OF REVIEW: Trials of physical rehabilitation post critical illness have yet to deliver improved health-related quality of life in critical illness survivors. Muscle mass and strength are lost rapidly in critical illness and a proportion of patients continue to do so resulting in increased mortality and functional disability. Addressing this issue is therefore fundamental for recovery from critical illness. RECENT FINDINGS: Altered mitochondrial function occurs in the critically ill and is likely to result in decreased adenosine tri-phosphate (ATP) production...
March 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29227709/a-review-study-on-the-beneficial-effects-of-baduanjin
#18
Liye Zou, Zhujun Pan, Albert Yeung, Saira Talwar, Chaoyi Wang, Yang Liu, Yankai Shu, Xiaoan Chen, Garrett Anthony Thomas
AIM: Baduanjin, a Chinese traditional Qigong exercise that focuses on a mind-body integration, is considered to be an effective exercise in promoting health. Thus, we systematically and critically evaluated the emerging literature relating to the effects of Baduanjin on health outcomes. METHODS: We used seven English-language electronic databases for the literature search. At least one health-related parameter was reported in retrievable full-text Baduanjin intervention studies...
December 11, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29128195/-what-support-of-young-presenting-a-first-psychotic-episode-when-schooling-is-being-challenged
#19
M-N Vacheron, H Veyrat-Masson, E Wehbe
Psychiatric disorders (more specifically mood disorders and psychosis) represent the 1st cause of disability among young people. Unemployment rate between 75 to 95% for the person with schizophrenia. It is correlated to poor social integration and bad economic status, worse symptomatology loss of autonomy as well as global bad functioning. It is responsible of more than half of the overall cost of psychosis. The onset of most of psychiatric disorders occur between the age of 25 and 35 years old, a critical time in young adult life when they should build their professional as well as social future...
November 8, 2017: L'Encéphale
https://www.readbyqxmd.com/read/29099454/early-rehabilitation-a-path-toward-optimizing-function-while-treating-critical-illness-in-children
#20
Amy Houtrow
No abstract text is available yet for this article.
November 2017: Pediatric Critical Care Medicine
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