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https://www.readbyqxmd.com/read/29927877/platelet-transfusions-in-the-picu-does-disease-severity-matter
#1
Arun Saini, Alina N West, Camden Harrell, Tamekia L Jones, Marianne E Nellis, Ashwini D Joshi, Krista M Cowan, Connor W Gatewood, Alex B Ryder, Ulrike M Reiss
OBJECTIVES: Pediatric intensivists frequently prescribe platelet transfusions to critically ill children, but there are limited data on platelet transfusion practice and platelet transfusion-related outcomes in the PICU. In this study, we evaluated the current platelet transfusion practice and platelet transfusion-related outcomes in the PICU. DESIGN: Institutional review board-approved, retrospective cohort study from January 2010 to March 2016. SETTING: Tertiary-level PICU...
June 20, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29927776/critical-care-management-of-anti-n-methyl-d-asparate-receptor-encephalitis
#2
Ron R Neyens, George E Gaskill, Julio A Chalela
OBJECTIVES: Anti-N-methyl-D-asparate receptor encephalitis is considered an immune-mediated form of encephalitis with paraneoplastic and nonparaneoplastic forms. Delay in recognition is common and patients typically present to the ICU without a diagnosis or with complications following a delayed diagnosis. The aim of this review is to provide a focused overview for the ICU clinician regarding presentation, diagnosis, and critical care management. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: PubMed database search with manual review of articles involving anti-N-methyl-D-asparate receptor encephalitis...
June 20, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29926792/a-paradigm-shift-in-the-provision-of-improved-critical-care-in-the-emergency-department
#3
K M Yim, H F Ko, M Lc Yang, T Y Li, S Ip, J Tsui
With Hong Kong's ageing population, advancement of medical technologies and hospital congestion, it is not uncommon for emergency physicians to encounter complicated critically ill patients in daily practice. It becomes a fundamental role of emergency physicians to initiate timely diagnostic and therapeutic interventions to save a patient's life and improve their prognosis. It is the reason a critical care service has been developed in emergency departments worldwide over the last decade. This article shares how emergency department intensivists can contribute to this novel model of care with some illustrative cases...
June 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29916835/the-modern-cardiovascular-care-unit-the-cardiologist-managing-multiorgan-dysfunction
#4
Thomas Bochaton, Eric Bonnefoy-Cudraz, Nadia Aissaoui
PURPOSE OF REVIEW: Despite many advances in the management of critically ill patients, cardiogenic shock remains a challenge because it is associated with high mortality. Even if there is no universally accepted definition of cardiogenic shock, end-perfusion organ dysfunction is an obligatory and major criterion of its definition.Organ dysfunction is an indicator that cardiogenic shock is already at an advanced stage and is undergoing a rapid self-aggravating evolution. The aim of the review is to highlight the importance to diagnose and to manage the organ dysfunction occurring in the cardiogenic shock patients by providing the best literature published this year...
June 16, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29910579/bedside-ultrasonography-screening-for-congenital-renal-anomalies-in-children-with-congenital-heart-diseases-undergoing-cardiac-repair
#5
Hussam K Hamadah, Omar Hijazi, Mohammad A Faraji, Mohamed S Kabbani
Introduction: Ultrasound (US) assessment of renal anomalies in children requiring pediatric cardiac surgery is not a standard practice. This study is highlighting the role of bedside US performed by intensivist to detect occult renal anomalies associated with congenital heart disease (CHD). Methods: A cross sectional study for 100 consecutive children with CHD admitted to Pediatric Cardiac Intensive Care Unit (PCICU) in 2015. US of kidneys screening was performed by trained pediatric cardiac intensivists to ascertain the presence of both kidneys in renal fossae without gross anomalies and to investigate if early detection of occult kidney anomaly would have any impact on outcome...
April 2018: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/29910544/competence-of-intensivists-in-focused-transthoracic-echocardiography-in-intensive-care-unit-a-prospective-observational-study
#6
Muthapillai Senthilnathan, Pankaj Kundra, Sandeep Kumar Mishra, Savitri Velayudhan, Ajith Ananthakrishna Pillai
Objectives: Focused transthoracic echocardiography (fTTE) in critical care can be used to assess patient's volume status, ventricular contractility, right ventricle chamber size, and valvular abnormalities. The objective of the study was to assess the competency of intensivists in performing fTTE in Intensive Care Unit (ICU) patients after a brief training course by cardiologist using a specific ECHO protocol. Methods: One hundred and four patients in ICU were recruited for this prospective observational study over a period of 12 months...
May 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29907267/critical-care-airway-management
#7
REVIEW
Etieno U Umobong, Paul H Mayo
Critical care airway management is associated with a variety of complications, including severe oxygen desaturation, life-threatening hypotension, and death. This article reviews aspects of airway management that are relevant to intensivists and emergency medicine clinicians tasked with improving the quality of urgent endotracheal intubation in the critically ill patient.
July 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29903639/focused-transthoracic-echocardiography-curriculum-for-advanced-practice-providers-assures-good-concordance-with-intensivists-at-echocardiography
#8
Jose L Diaz-Gomez, Ami A Grek, Carla P Venegas-Borsellino, Andreea C Chirila, Angela M Builes, Robert A Ratzlaff
OBJECTIVE: To describe a focused transthoracic echocardiography (FoTE) curriculum for advanced practice providers (APPs) for echocardiography-driven diagnosis of shock in critically ill patients. METHODS: Twelve APPs in 4 intensive care units at an academic medical center received didactic sessions on FoTE, including 1-on-1 proctorship with a registered cardiac sonographer. For a period of 6 months the trainees performed individual studies, then they performed FoTE examinations on critically ill patients; their diagnoses were compared with those of experienced intensivists for the same patients...
June 11, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29902555/inter-rater-agreement-of-intensivists-evaluating-the-goal-concordance-of-preference-sensitive-icu-interventions
#9
Alison E Turnbull, Sarina K Sahetya, Elizabeth Colantuoni, Josephine Kweku, Roozbeh Nikooie, J Randall Curtis
CONTEXT: Goal-concordant care has been identified as an important outcome of advance care planning and shared decision-making initiatives. However validated methods for measuring goal-concordance are needed. OBJECTIVES: To estimate the inter-rater reliability of senior critical care fellows rating the goal-concordance of preference-sensitive interventions performed in intensive care units (ICUs) while considering patient-specific circumstances as described in a previously-proposed methodology...
June 11, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29895296/thrombocytopenia-in-the-icu-disseminated-intravascular-coagulation-and-thrombotic-microangiopathies-what-intensivists-need-to-know
#10
EDITORIAL
Jean-Louis Vincent, Pedro Castro, Beverley J Hunt, Achim Jörres, Manuel Praga, Jose Rojas-Suarez, Eizo Watanabe
No abstract text is available yet for this article.
June 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29894253/on-foreign-soil-anaesthetists-at-the-surgical-multidisciplinary-team-meeting
#11
David Timbrell, Pradeep Prabhu
Decision making through multidisciplinary teams offers an opportunity to improve perioperative care for high-risk surgical patients. While multidisciplinary team decision making is commonplace in the NHS, involvement of perioperative physicians including anaesthetists and intensivists in this process is not well established. This article presents an exemplar of anaesthetic and intensivist involvement in a joint perioperative upper gastrointestinal cancer multidisciplinary team meeting at the Royal Surrey County Hospital in Guildford, UK...
June 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29890556/-management-of-clostridium-difficile-infections-at-german-intensive-care-units-results-from-a-survey-among-intensivists
#12
Jan Bruensing, Lukas Buendgens, Christoph Jochum, Ulf Herbers, Ali Canbay, Georg Braun, Christian Trautwein, Wolfgang Huber, Alexander Koch, Frank Tacke
BACKGROUND: Clostridium difficile associated colitis is a frequent cause of nosocomial diarrhea at the intensive care unit (ICU) and is associated with poor prognosis in critically ill patients. Few studies have evaluated the efficacy of treatment options or adherence to guideline recommendations of Clostridium difficile infections at the ICU. METHODS: Therefore, on behalf of the Gastroenterology Intensive Care Medicine working group of the DGVS, we have conducted an online-based survey among leading intensivists in Germany...
June 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29887705/outcome-of-pancreaticoduodenectomy-at-low-volume-centre-in-tier-ii-city-of-india
#13
Kumar Vinchurkar, Vishwanath M Pattanshetti, Manoj Togale, Santosh Hazare, Varadraj Gokak
Currently, pancreaticoduodenectomy (PD) is considered a common and feasibly performed surgery for periampullary tumours, but it is still a high-risk surgical procedure with potential morbidity and mortality rates. Previously, it was emphasised for the need of high-volume centres to perform specialised surgery such as PD. The authors have made an attempt to know the relation between low-volume centre and outcomes of PD. The study was conducted in a Tier-II city referral hospital located in Karnataka, India. A total of 37 patients with suspected periampullary neoplasms underwent surgical exploration with curative intent over a period of 4 years, i...
June 2018: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29878608/analysis-of-the-level-of-clinical-skills-of-physician-assistants-tested-with-simulated-intensive-care-patients
#14
Anneke J A H van Vught, Geert T W J van den Brink, Murielle G E C Hilkens, Jos A H van Oers
RATIONALE, AIMS, AND OBJECTIVES: Since adequate staffing in intensive care units (ICUs) is an increasing problem worldwide, we investigated whether physician assistants (PAs) are able to substitute medical residents (MR) in ICUs with at least the same quality of clinical skills. In this study, we analysed the level of clinical skills of PAs in direct comparison with those who traditionally performed these tasks, ie, MR with 6 to 24 months of work experience in the ICU. METHOD: Physician assistants and MRs in the ICUs were observed on their clinical skills by means of a simulated ICU comprising 2 scenarios on a human patient simulator with typical ICU cases...
June 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29877876/critical-care-echocardiography-and-outcomes-in-the-critically-ill
#15
Karan Singh, Paul Mayo
PURPOSE OF REVIEW: Critical care echocardiography offers a comprehensive assessment of cardiac anatomy and function performed by the intensivist at point of care. This has resulted in widespread use of critical care echocardiography in ICUs leading to the question if this increased usage has resulted in improved patient outcomes. RECENT FINDINGS: Recent studies have evaluated the role of critical care echocardiography in the ICU with an emphasis on establishing accurate diagnosis and measurement of haemodynamic variables...
June 4, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29877873/terrorist-attacks-in-paris-managing-mass-casualties-in-a-remote-trauma-center
#16
Florent Femy, Arnaud Follin, Philippe Juvin, Anne-Laure Feral-Pierssens
OBJECTIVE: On 13 November 2015, Paris was the target of multiple terrorist attacks responsible for a massive influx of casualties in emergency departments (EDs). Because of the activation of a local crisis plan and the arrival of extra staff, our capacities increased markedly. Our aim was to analyze whether our center, in this challenging context, efficiently managed this massive influx of patients. PATIENTS AND METHODS: We carried out a monocentric retrospective study...
June 5, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29875062/-glass-ceiling-for-women-in-academic-medicine-in-france
#17
C Rosso, A Leger, O Steichen
OBJECTIVE: To determine whether career development in academic medicine is more difficult for women than for men, and, if any, the nature and level of barriers to this progression. METHODS: Extraction of full-time medical staff in a Parisian hospital group, through the SIGAPS platform; an online questionnaire survey of career choices and barriers experienced by full-time male and female physicians. The study population comprises 181 hospital practitioners and 141 academic physicians (49 associate professors and 92 full professors)...
June 3, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29868526/commentary-echocardiographic-evaluation-of-pulmonary-pressures-and-right-ventricular-function-after-pediatric-cardiac-surgery-a-simple-approach-for-the-intensivist
#18
COMMENT
Stefan Kurath-Koller, Sabrina Schweintzger, Martin Köestenberger
No abstract text is available yet for this article.
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29845940/an-alternative-icu-staffing-model-implementation-of-the-non-physician-provider
#19
H G Kreeftenberg, J T Aarts, A de Bie, A J G H Bindels, A N Roos, P H J van der Voort
INTRODUCTION: Literature in Europe regarding implementation of nurse practitioners or physician assistants in the intensive care unit (ICU) is lacking, while some available studies indicate that this concept can improve the quality of care and overcome physician shortages on ICUs. The aim of this study is to provide insight on how a Dutch ICU implemented non-physician providers (NPP), besides residents, and what this staffing model adds to the care on the ICU. METHODS: This paper defines the training course and job description of NPPs on a Dutch ICU...
May 2018: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29808412/point-of-care-ultrasonography-in-brazilian-intensive-care-units-a-national-survey
#20
José Augusto Santos Pellegrini, Ricardo Luiz Cordioli, Ana Cristina Burigo Grumann, Patrícia Klarmann Ziegelmann, Leandro Utino Taniguchi
BACKGROUND: Point-of-care ultrasonography (POCUS) has recently become a useful tool that intensivists are incorporating into clinical practice. However, the incorporation of ultrasonography in critical care in developing countries is not straightforward. METHODS: Our objective was to investigate current practice and education regarding POCUS among Brazilian intensivists. A national survey was administered to Brazilian intensivists using an electronic questionnaire...
April 20, 2018: Annals of Intensive Care
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