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Emergency intensive critical care

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https://www.readbyqxmd.com/read/28342442/comparison-of-qsofa-and-sirs-for-predicting-adverse-outcomes-of-patients-with-suspicion-of-sepsis-outside-the-intensive-care-unit
#1
Eli J Finkelsztein, Daniel S Jones, Kevin C Ma, Maria A Pabón, Tatiana Delgado, Kiichi Nakahira, John E Arbo, David A Berlin, Edward J Schenck, Augustine M K Choi, Ilias I Siempos
BACKGROUND: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) Task Force recently introduced a new clinical score termed quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) for identification of patients at risk of sepsis outside the intensive care unit (ICU). We attempted to compare the discriminatory capacity of the qSOFA versus the Systemic Inflammatory Response Syndrome (SIRS) score for predicting mortality, ICU-free days, and organ dysfunction-free days in patients with suspicion of infection outside the ICU...
March 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28332367/value-of-serum-cystatin-c-measurement-in-the-diagnosis-of-sepsis-induced-kidney-injury-and-prediction-of-renal-function-recovery
#2
Ah Young Leem, Moo Suk Park, Byung Hoon Park, Won Jai Jung, Kyung Soo Chung, Song Yee Kim, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Se Kyu Kim, Joon Chang, Joo Han Song
PURPOSE: Acute kidney injury (AKI) is common in critically ill patients. Serum cystatin C has emerged as a reliable marker of AKI. We sought to assess the value of serum cystatin C for early detection and prediction of renal function recovery in patients with sepsis. MATERIALS AND METHODS: Sepsis patients (113 AKI patients and 49 non-AKI patients) admitted to the intensive care unit (ICU) were included. Serum creatinine and cystatin C levels and glomerular filtration rate were measured on days 0, 1, 3, and 7...
May 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28327497/the-mapping-competences-of-the-nurse-case-care-manager-in-the-context-of-intensive-care
#3
Emanuela Alfieri, Anna Chiara Ferrini, Francesca Gianfrancesco, Gianluca Lise, Giovanni Messana, Lorenzo Tirelli, Ana Lorenzo, Leopoldo Sarli
BACKGROUND AND AIMS: Since the recent introduction of the Case/Care Manager's professional figure, it is quite difficult to identify properly his/her own particular features, which could be mainly be found revising mainly in American studies. Therefore, the present study intended to identify the Case/Care Manager's skills and professional profile in an Intensive Care Unit experience, taking into consideration the staff's activities, perception and expectations towards the Case/Care Manager...
March 15, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28320461/neuroanatomy-of-sepsis-associated-encephalopathy
#4
REVIEW
Nicholas Heming, Aurelien Mazeraud, Franck Verdonk, Fernando A Bozza, Fabrice Chrétien, Tarek Sharshar
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901 .Originally published in the Annual Update in Intensive Care and Emergency Medicine 2017. The number of authors differs in the two versions due to constraints regarding the number of authors in the Annual Update in Intensive Care and Emergency Medicine...
March 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28320437/anemia-and-blood-transfusion-in-the-critically-ill-patient-with-cardiovascular-disease
#5
REVIEW
Annemarie B Docherty, Timothy S Walsh
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901 .
March 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28301034/professional-nursing-practice-in-critical-units-assessment-of-work-environment-characteristics
#6
Luiz Felipe Sales Maurício, Meiry Fernanda Pinto Okuno, Cássia Regina Vancini Campanharo, Maria Carolina Barbosa Teixeira Lopes, Angélica Gonçalves Silva Belasco, Ruth Ester Assayag Batista
Objective: assess the autonomy, control over environment, and organizational support of nurses' work process and the relationships between physicians and nurses in critical care units. Method: cross-sectional study conducted with 162 nurses working in the intensive care units and emergency service of a university hospital. The workers' satisfaction with their work environment was assessed using Brazilian Nursing Work Index - Revised, translated and adapted for the Brazilian culture...
March 2, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28288355/time-required-to-initiate-outbreak-and-pandemic-observational-research
#7
Asgar H Rishu, Nicole Marinoff, Lisa Julien, Mariana Dumitrascu, Nicole Marten, Shauna Eggertson, Su Willems, Stacy Ruddell, Dane Lane, Bruce Light, Henry T Stelfox, Philippe Jouvet, Richard Hall, Steven Reynolds, Nick Daneman, Robert A Fowler
PURPOSE: Observational research focused upon emerging infectious diseases such as Ebola virus, Middle East respiratory syndrome, and Zika virus has been challenging to quickly initiate. We aimed to determine the duration of start-up procedures and barriers encountered for an observational study focused upon such infectious outbreaks. MATERIALS AND METHODS: At 1 pediatric and 5 adult intensive care units, we measured durations from protocol receipt to a variety of outbreak research milestones, including research ethics board (REB) approval, data sharing agreement (DSA) execution, and patient study screening initiation...
March 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28282377/before-the-bombing-high-burden-of-traumatic-injuries-in-kunduz-trauma-center-kunduz-afghanistan
#8
Hamayoun Hemat, Safieh Shah, Petros Isaakidis, Mrinalini Das, Nang Thu Thu Kyaw, Sattar Zaheer, Abdul Qayeum Qasemy, Mutallib Zakir, Gbane Mahama, Catherine Van Overloop, Lynette Dominguez
BACKGROUND: Médecins Sans Frontières (MSF) has been providing healthcare in Afghanistan since 1981 including specialized health services for trauma patients in Kunduz Trauma Center (KTC) from 2011. On October 3rd, 2015, a US airstrike hit the KTC, killing 42 people including 14 MSF staff. This study aims to demonstrate the impact on healthcare provision, after hospital destruction, by assessing the extent of care provided for trauma and injuries by the MSF KTC and to report on treatment outcomes from January 2014 to June 2015, three months prior to the bombing...
2017: PloS One
https://www.readbyqxmd.com/read/28275223/evaluation-of-eight-biomarkers-to-predict-short-term-mortality-in-patients-with-acute-severe-dyspnea
#9
Claire Ara-Somohano, Agnès Bonadona, Francoise Carpentier, Patricia Pavese, Aurélien Vesin, Rebecca Hamidfar-Roy, Clémence Minet, Gerald Vanzetto, Carole Schwebel, Jean F Timsit
BACKGROUND: Being able to better predict risk and optimal care for patients presenting with acute dyspnea is critical. Prognostic biomarkers are well known: amino-terminal pro-Btype Natriuretic Peptide, troponin, C-reactive protein, procalcitonin. Some were more recently developed: mid-regional pro-A-type natriuretic peptide (Mid Pro-ANP), mid-regional-proadrenomedullin (MR-proADM), pro-endothelin, copeptin. The aim of the paper was to evaluate prognostic value of clinical findings and 8 biomarkers in patients with severe acute dyspnea...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28257538/multidisciplinary-approach-to-complicated-pregnancy
#10
Josip Andelo Borovac, Josko Bozic, Tina Ticinovic Kurir, Nikola Zaja, Kresimir Kolic, Vedran Hrboka
A nulliparous pregnant woman in her mid-20s and in the 32nd week of gestation presented to the emergency department with severe headache and vomiting. She had an uneventful medical history; however, the physical examination upon hospital admission revealed a hypertensive emergency, papilledema, and 2+ dipstick proteinuria. Upon establishing the diagnosis of preeclampsia, aggressive therapy with corticosteroids, antihypertensive medication, and seizure prophylaxis was initiated. Hemodynamic stability was achieved within 24 hours and the patient remained in the observation unit located within the gynecology clinic...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28255613/intensive-care-medicine-research-agenda-on-invasive-fungal-infection-in-critically-ill-patients
#11
REVIEW
Matteo Bassetti, Jose Garnacho-Montero, Thierry Calandra, Bartjan Kullberg, George Dimopoulos, Elie Azoulay, Arunaloke Chakrabarti, Daniel Kett, Cristobal Leon, Luis Ostrosky-Zeichner, Maurizio Sanguinetti, Jean-Francois Timsit, Malcom D Richardson, Andrew Shorr, Oliver A Cornely
PURPOSE: To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. METHODS: A systematic review of the medical literature taking account of national and international guidelines and expert opinion...
March 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28241903/adult-epiglottitis-a-case-series
#12
Benjamin Lindquist, Sybil Zachariah, Anita Kulkarni
INTRODUCTION: Emergency Departments are inundated by patients with respiratory illness during the winter months. Emergency physicians are required to quickly identify critically ill patients among the large volume of patients with mild upper respiratory illness. Among these life-threatening conditions is acute epiglottitis. CASE PRESENTATION: We report a rare series of four adult patients who presented to our Emergency Department during a period of only one week in April 2015 and were ultimately diagnosed with acute epiglottitis...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28238004/effects-of-therapeutic-hypothermia-for-neuroprotection-from-the-viewpoint-of-redox-regulation
#13
REVIEW
Nobuyuki Nosaka, Ayumi Okada, Hirokazu Tsukahara
Redox regulation has recently been recognized as an important factor in acute illnesses as well as in chronic diseases. It has also become a target for neuroprotection in acute intensive care. Despite its well-known therapeutic effects, therapeutic hypothermia has recently been re-evaluated for its potential use in emergency and critical care medicine. Hypothermia is an undesirable physiological condition that can increase oxidative stress and decrease anti-oxidative potency. However, many studies have shown that under ischemia/reperfusion conditions, therapeutic hypothermia actually suppresses enhanced oxidative stress and maintains or increases anti-oxidative potency...
February 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#14
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#15
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28191345/holistic-care-for-patients-during-weaning-from-mechanical-ventilation-a-qualitative-study
#16
Ali Khalafi, Nasrin Elahi, Fazlollah Ahmadi
BACKGROUND: Weaning patients from mechanical ventilation is a complex and highly challenging process. It requires continuity of care, the overall assessment of patients, and a focus on all aspects of patients' needs by critical care nurses. OBJECTIVES: The aim of the present study was to explore holistic care while patients are being weaned from mechanical ventilation from the perspective of the critical care nurses. METHODS: The study was carried out in the intensive care units (ICUs) of six hospitals in Ahvaz, Iran, from 2014 to 2015...
November 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28187802/critical-care-management-of-traumatic-brain-injury
#17
REVIEW
D K Menon, A Ercole
Traumatic brain injury (TBI) is a growing global problem, which is responsible for a substantial burden of disability and death, and which generates substantial healthcare costs. High-quality intensive care can save lives and improve the quality of outcome. TBI is extremely heterogeneous in terms of clinical presentation, pathophysiology, and outcome. Current approaches to the critical care management of TBI are not underpinned by high-quality evidence, and many of the current therapies in use have not shown benefit in randomized control trials...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28167543/carbapenem-minimal-inhibitory-concentrations-in-escherichia-coli-and-klebsiella-species-producing-extended-spectrum-beta-lactamases-esbls-in-critical-care-patients-from-2001-2009
#18
J Kristie Johnson, Gwen L Robinson, Lisa L Pineles, Adebola O Ajao, LiCheng Zhao, Jennifer S Albrecht, Anthony D Harris, Kerri A Thom, Jon P Furuno
Extended spectrum β-lactamase (ESBL) -producing Enterobacteriaceae are increasing in prevalence worldwide. Carbapenem antibiotics are used as a first line of therapy against ESBL-producing Enterobacteriaceae. We examined gastrointestinal colonization of carbapenem-resistant-ESBLs (CR-ESBL) among a cohort of critical care patients. In this cohort of patients, we cultured for ESBL-producing Klebsiella spp. and Escherichia coli and then performed MIC susceptibility testing for imipenem, doripenem, meropenem, and ertapenem on the patient's first isolate...
February 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28160953/interpreting-laboratory-tests-in-infection-making-sense-of-biomarkers-in-sepsis-and-systemic-inflammatory-response-syndrome-for-intensive-care-unit-patients
#19
REVIEW
Jennifer B Martin, Jennifer E Badeaux
Sepsis and severe sepsis are leading causes of death in the United States and the most common causes of death among critically ill patients in noncoronary intensive care units. Diagnosis of infection and sepsis is a subjective clinical judgment based on the criteria for systemic inflammatory reaction, which is highly sensitive, not specific, and often misleading in intensively treated patients. Biomarkers are emerging as adjuncts to traditional diagnostic measures. No biomarkers have sufficient specificity or sensitivity to be routinely used in clinical practice, but they can aid in the diagnosis and treatment of infection versus inflammation...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160952/antibiotic-trends-amid-multidrug-resistant-gram-negative-infections-in-intensive-care-units
#20
REVIEW
Leanne H Fowler, Susan Lee
Isolates from ICUs most commonly find multidrug-resistant (MDR) gram-negative bacteria. The purpose of this article is to discuss the significant impact MDR gram-negative infections are having on ICUs, the threat on health and mortality, and effective and new approaches aimed to combat MDR gram-negative infections in critically ill populations. Inappropriate antibiotic therapies for suspected or documented infections are the leading cause of the emergence of bacterial resistance. A variety of strategies are aimed at combatting this international burden via antibiotic stewardship programs...
March 2017: Critical Care Nursing Clinics of North America
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