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Emergency intensive critical care

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https://www.readbyqxmd.com/read/29768359/case-report-of-gastric-distension-due-to-superior-mesenteric-artery-syndrome-mimicking-hollow-viscus-perforation-considerations-in-critical-care-ultrasound
#1
Yan-Mei Feng, Dong Wan, Rui Guo
RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766132/red-cell-distribution-width-predicts-out-of-hospital-outcomes-in-critically-ill-emergency-general-surgery-patients
#2
Joaquim Michael Havens, Anupamaa J Seshadri, Ali Salim, Kenneth B Christopher
Introduction: Red cell distribution width (RDW) is associated with mortality and bloodstream infection risk in critically ill patients. We hypothesized that an increase in RDW at hospital discharge in critically ill patients who received emergency general surgery (EGS) would be associated with increased mortality after hospital discharge. Methods: We performed a two-center observational study of patients treated in medical and surgical intensive care units. We studied 1567 patients, who received critical care between 1998 and 2012 who underwent EGS and survived hospitalization...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29764560/-discussion-of-the-implementation-of-mimic-database-in-emergency-medical-study
#3
Kaiyuan Li, Cong Feng, Lijing Jia, Li Chen, Fei Pan, Tanshi Li
To introduce Medical Information Mart for Intensive Care (MIMIC) database and elaborate the approach of critically emergent research with big data based on the feature of MIMIC and updated studies both domestic and overseas, we put forward the feasibility and necessity of introducing medical big data to research in emergency. Then we discuss the role of MIMIC database in emergency clinical study, as well as the principles and key notes of experimental design and implementation under the medical big data circumstance...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#4
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29761755/a-deadly-wait-for-u-s-health-insurance-coverage-sitting-on-the-couch-with-malaria
#5
Jonathan S Schultz, Adam J Atherly, Andrés F Henao-Martínez
Uninsured and unprepared travelers to countries with endemic tropical diseases pose great health-care burdens and financial risks on returning to the United States. We discuss the delayed presentation of an uninsured U.S. traveler returning from West Africa with severe malaria who required intensive care measures to save his life. Despite being critically ill on his return, he sat rigoring on his couch taking antipyretics for 3 days, while he applied for insurance on the Affordable Care Act website and waited for approval because he was fearful of the costs of seeking care...
May 14, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29756521/cost-analysis-of-initial-treatment-with-endovascular-revascularization-open-surgery-or-primary-major-amputation-in-patients-with-peripheral-artery-disease
#6
Linda Tang, Sharath C V Paravastu, Shannon D Thomas, Elaine Tan, Eric Farmer, Ramon L Varcoe
PURPOSE: To compare the total initial treatment costs for open surgery, endovascular revascularization, and primary major amputation within a single-payer healthcare system. METHODS: A multicenter, retrospective analysis was undertaken to evaluate 1138 patients with symptomatic peripheral artery disease (PAD) who underwent 1017 endovascular procedures, 86 open surgeries, and 35 major amputations between 2013 and 2016. A cost-mix analysis was performed on individual patient data generated for selected diagnosis-related groups...
May 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29742551/exploring-research-topics-and-trends-in-nursing-related-communication-in-intensive-care-units-using-social-network-analysis
#7
Youn-Jung Son, Soo-Kyoung Lee, SeJin Nam, Jae Lan Shim
This study used social network analysis to identify the main research topics and trends in nursing-related communication in intensive care units. Keywords from January 1967 to June 2016 were extracted from PubMed using Medical Subject Headings terms. Social network analysis was performed using Gephi software. Research publications and newly emerging topics in nursing-related communication in intensive care units were classified into five chronological phases. After the weighting was adjusted, the top five keyword searches were "conflict," "length of stay," "nursing continuing education," "family," and "nurses...
May 4, 2018: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29739621/the-incidence-and-outcome-of-hyperlactatemia-in-patients-admitted-to-the-intensive-care-unit-after-elective-surgery
#8
Tatsuhiko Abe, Shigehiko Uchino, Yusuke Sasabuchi, Masanori Takinami
BACKGROUND: Although hyperlactatemia is often developed in critically ill patients, it is unclear whether hyperlactatemia is associated with poor prognosis for surgical ICU (SICU) patients. METHODS: We performed a retrospective analysis in an academic hospital in Tokyo. The maximum lactate was defined as the highest value within the SICU stay. The primary outcome was the composite outcome of in-hospital mortality, re-admission to the SICU or admission to the general ICU and emergency reoperation...
April 23, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29732880/design-of-a-vertical-composite-thin-film-system-with-ultralow-leakage-to-yield-large-converse-magnetoelectric-effect
#9
Rui Wu, Ahmed Kursumovic, Xingyao Gao, Chao Yun, Mary E Vickers, Haiyan Wang, Seungho Cho, Judith L MacManus-Driscoll
Electric field control of magnetism is a critical future technology for low-power, ultrahigh density memory. However, despite intensive research efforts, no practical material systems have emerged. Interface-coupled, composite systems containing ferroelectric and ferri-/ferromagnetic elements have been widely explored, but they have a range of problems, for example, substrate clamping, large leakage, and inability to miniaturize. In this work, through careful material selection, design, and nanoengineering, a high-performance room-temperature magnetoelectric system is demonstrated...
May 18, 2018: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/29731386/characteristics-and-outcomes-of-do-not-resuscitate-patients-admitted-to-the-emergency-department-intensive-care-unit
#10
An-Yi Wang, Hon-Ping Ma, Wei-Fong Kao, Shin-Han Tsai, Cheng-Kuei Chang
BACKGROUND: Appropriate utilization of intensive care unit (ICU) beds are essential. Patients with critical illness who have do not resuscitate (DNR) have a reduced priority of intensive care. However, the possibility of recovery/survival is ambiguous and multifactorial. OBJECTIVE: To deliberate the characteristics and outcomes of critical illness in patients with prior DNR who were admitted to the emergency department (ED)-ICU. METHOD: This was a retrospective cohort study conducted between April 2015 and November 2015 in a university-based hospital...
May 3, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29720475/comparison-of-qsofa-with-current-emergency-department-tools-for-screening-of-patients-with-sepsis-for-critical-illness
#11
Robert M Rodriguez, John C Greenwood, Thomas J Nuckton, Bryan Darger, Frances S Shofer, Dawn Troeger, Soo Y Jung, Kelly G Speich, Joel Valencia, J Hope Kilgannon, Danny Fernandez, Brigitte M Baumann
OBJECTIVE: We sought to compare the quick sequential organ failure assessment (qSOFA) to systemic inflammatory response syndrome (SIRS), severe sepsis criteria and lactate levels for their ability to identify ED patients with sepsis with critical illness. METHODS: We conducted this multicenter retrospective cohort study at five US hospitals, enrolling all adult patients admitted to these hospitals from their EDs with infectious disease-related illnesses from 1 January 2016 to 30 April 2016...
May 2, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29719745/acute-acalculous-cholecystitis-in-the-setting-of-negative-ultrasound-and-computed-tomography-scan-of-the-abdomen
#12
Muhammad Shafiq, Yousaf Zafar
Acute acalculous cholecystitis (AAC) is most commonly seen after surgery in critically ill patients. Early diagnosis and treatment is the key in the management of AAC. Ultrasound is the commonly used first modality for right upper quadrant (RUQ) pain with sensitivity equal to or greater than 80% for AAC. Computed tomography (CT) scan is reported to have a sensitivity close to 90% and if both the ultrasound and CT scan are combined, it further increases the sensitivity for the diagnosis of AAC. It is unlikely for AAC to be present in the setting of both negative ultrasound and CT scan of the abdomen...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29716908/critical-care-nurses-experiences-with-spiritual-care-the-spirit-study
#13
Nigel Bone, Marilyn Swinton, Neala Hoad, Feli Toledo, Deborah Cook
BACKGROUND: Little is known about the effect of chaplains on critical care nurses who are caring for critically ill patients and their families. OBJECTIVE: To understand nurses' experiences when they make a referral to the Spiritual Care Department for a patient or the family of a patient who is dying or deceased. Specific aims were to explore spiritual care's effect on nurses and how nurses understand the role of spiritual care in practice. METHODS: A qualitative descriptive study using in-person, semistructured interviews in a 21-bed medical-surgical intensive care unit in a teaching hospital...
May 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29704018/consensus-statement-for-cancer-patients-requiring-intensive-care-support
#14
M G Kiehl, G Beutel, B Böll, D Buchheidt, R Forkert, V Fuhrmann, P Knöbl, M Kochanek, F Kroschinsky, P La Rosée, T Liebregts, C Lück, U Olgemoeller, E Schalk, A Shimabukuro-Vornhagen, W R Sperr, T Staudinger, M von Bergwelt Baildon, P Wohlfarth, V Zeremski, P Schellongowski
This consensus statement is directed to intensivists, hematologists, and oncologists caring for critically ill cancer patients and focuses on the management of these patients.
April 27, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29682365/bedside-endoscopic-retrograde-cholangiopancreatography-using-portable-x-ray-in-acute-severe-cholangitis
#15
Rushikesh Shah, Emad Qayed
Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#16
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29657606/early-biliary-drainage-is-associated-with-favourable-outcomes-in-critically-ill-patients-with-acute-cholangitis
#17
Mohammed Aboelsoud, Osama Siddique, Alexander Morales, Young Seol, Mazen Al-Qadi
Introduction: Acute cholangitis (AC) is a clinical condition that requires prompt medical management with IV fluids, antibiotics, and biliary drainage (BD). The optimal timing for BD remains unclear. Aim: To investigate the effect of biliary drainage timing on clinical outcomes in AC. Material and methods: We conducted a retrospective study of patients with AC admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database...
2018: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29656607/expert-agreement-in-the-interpretation-of-lung-ultrasound-studies-performed-on-mechanically-ventilated-patients
#18
Scott J Millington, Robert T Arntfield, Robert Jie Guo, Seth Koenig, Pierre Kory, Vicki Noble, Haney Mallemat, Jordan R Schoenherr
OBJECTIVES: Although lung ultrasound (US) has been shown to have high diagnostic accuracy in patients presenting with acute dyspnea, its precision in critically ill patients is unknown. We investigated common areas of agreement and disagreement by studying 6 experts as they interpreted lung US studies in a cohort of intensive care unit (ICU) patients. METHODS: A previous study by our group asked experts to rate the quality of 150 lung US studies performed by 10 novices in a population of mechanically ventilated patients...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#19
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29650397/assessment-of-five-different-probes-for-lung-ultrasound-in-critically-ill-patients-a-pilot-study
#20
Xavier Bobbia, Margaux Chabannon, Thierry Chevallier, Jean Emmanuel de La Coussaye, Jean Yves Lefrant, Sarah Pujol, Pierre-Géraud Claret, Laurent Zieleskiewicz, Claire Roger, Laurent Muller
INTRODUCTION: The present study was aimed at comparing the diagnosis concordance of five echo probes of lung ultrasound (LUS) with CT scans in intensive care and emergency patients with acute respiratory failure. MATERIALS: This prospective, observational, pilot study involved 10 acute patients in whom a thoracic CT scan was performed. An expert performed an LUS reference exam using five different probes: three probes with a high-quality conventional echo machine (cardiac phased-array probe, abdominal convex probe, linear probe) and two probes (cardiac and linear) with a pocket ultrasound device (PUD)...
April 3, 2018: American Journal of Emergency Medicine
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