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https://www.readbyqxmd.com/read/28441677/building-a-global-online-community-of-practice-the-openpediatrics-world-shared-practices-video-series
#1
Traci A Wolbrink, Niranjan Kissoon, Nabila Mirza, Jeffrey P Burns
PROBLEM: Health care professionals are familiar with engaging in local communities of practice (CoPs) within their hospital, region, and/or country, but despite the availability of online technologies that facilitate online global collaboration, the health care sector has yet to fully embrace these tools. APPROACH: In 2013, OPENPediatrics (an online social learning platform) launched the World Shared Practices video (WSP) series to engage and coalesce the global community of critical care clinicians...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28439852/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-a-concise-review-with-a-comprehensive-summary-of-therapeutic-interventions-emphasizing-supportive-measures
#2
REVIEW
Jeremy A Schneider, Philip R Cohen
INTRODUCTION: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two of the most severe dermatologic conditions occurring in the inpatient setting. There is a lack of consensus regarding appropriate management of SJS and TEN. PURPOSE: The scientific literature pertaining to SJS and TEN (subsequently referred to as SJS/TEN) is summarized and assessed. In addition, an interventional approach for the clinician is provided. METHODS: PubMed was searched with the key words: corticosteroids, cyclosporine, etanercept, intravenous immunoglobulin, Stevens-Johnson syndrome, and toxic epidermal necrolysis...
April 24, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28430755/differentiating-delirium-from-sedative-hypnotic-related-iatrogenic-withdrawal-syndrome-lack-of-specificity-in-pediatric-critical-care-assessment-tools
#3
Kate Madden, Michele M Burns, Robert C Tasker
OBJECTIVES: To identify available assessment tools for sedative/hypnotic iatrogenic withdrawal syndrome and delirium in PICU patients, the evidence supporting their use, and describe areas of overlap between the components of these tools and the symptoms of anticholinergic burden in children. DATA SOURCES: Studies were identified using PubMed and EMBASE from the earliest available date until July 3, 2016, using a combination of MeSH terms "delirium," "substance withdrawal syndrome," and key words "opioids," "benzodiazepines," "critical illness," "ICU," and "intensive care...
April 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28416582/relationship-between-oxygen-concentration-and-temperature-in-an-exothermic-warming-device
#4
Ben Brooks, Charles D Deakin
INTRODUCTION: Actively warming hypothermic patients or preventing hypothermia is critical in optimising outcomes in patients with traumatic injuries. Our aim was to investigate the effect of ambient oxygen concentration on the rate and change in temperature of the TechTrade Ready-Heat II exothermic (oxygen-activated) warming blanket, to evaluate safety and ascertain the risk of thermal injury. METHODS: A mannequin covered with an exothermic blanket was placed in a sealed oxygen tent...
April 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28416497/prognostication-in-critically-ill-patients-with-severe-traumatic-brain-injury-the-tbi-prognosis-multicentre-feasibility-study
#5
Alexis F Turgeon, François Lauzier, Ryan Zarychanski, Dean A Fergusson, Caroline Léger, Lauralyn A McIntyre, Francis Bernard, Andrea Rigamonti, Karen Burns, Donald E Griesdale, Robert Green, Damon C Scales, Maureen O Meade, Martin Savard, Michèle Shemilt, Jérôme Paquet, Jean-Luc Gariépy, André Lavoie, Kesh Reddy, Draga Jichici, Giuseppe Pagliarello, David Zygun, Lynne Moore
OBJECTIVE: Severe traumatic brain injury is a significant cause of morbidity and mortality in young adults. Assessing long-term neurological outcome after such injury is difficult and often characterised by uncertainty. The objective of this feasibility study was to establish the feasibility of conducting a large, multicentre prospective study to develop a prognostic model of long-term neurological outcome in critically ill patients with severe traumatic brain injury. DESIGN: A prospective cohort study...
April 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28396935/state-of-the-art-in-fluid-and-volume-therapy-a%C3%A2-user-friendly-staged-concept-english-version
#6
M Rehm, N Hulde, T Kammerer, A S Meidert, K Hofmann-Kiefer
Adequate intraoperative infusion therapy is essential for the perioperative outcome of a patient. Both hypo- and hypervolemia can lead to an increased rate of perioperative complications and to a worse outcome. Perioperative infusion therapy should therefore be needs-based. The primary objective is the maintenance of preoperative normovolemia using a rational infusion strategy. Perioperative fluid losses should be differentiated from volume losses due to surgical bleeding or protein losses into the interstitial space...
April 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28392713/a-case-report-on-the-treatment-of-complex-chronic-pain-and-opioid-dependence-by-a-multidisciplinary-transitional-pain-service-using-the-act-matrix-and-buprenorphine-naloxone
#7
Aliza Z Weinrib, Lindsay C Burns, Alex Mu, Muhammad Abid Azam, Salima Sj Ladak, Karen McRae, Rita Katznelson, Saam Azargive, Cieran Tran, Joel Katz, Hance Clarke
In an era of growing concern about opioid prescribing, the postsurgical period remains a critical window with the risk of significant opioid dose escalation, particularly in patients with a history of chronic pain and presurgical opioid use. The purpose of this case report is to describe the multidisciplinary care of a complex, postsurgical pain patient by an innovative transitional pain service (TPS). A 59-year-old male with complex chronic pain, as well as escalating long-term opioid use, presented with a bleeding duodenal ulcer requiring emergency surgery...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28363300/microsurgical-reconstruction-of-the-burned-hand-and-upper-extremity
#8
REVIEW
Mauricio De la Garza, Michael Sauerbier, Germann Günter, Curtis L Cetrulo, Reuben A Bueno, Robert C Russell, Michael W Neumeister
Improvements in critical care and burn victim resuscitation have led to increased survival of burned patients. Initial resuscitation, early excision of burned tissues, prevention of burn wound sepsis, and wound coverage remain mainstays of care. Many burn wounds require complex reconstruction. This is particularly important in the hand. Coverage of tendons, ligaments, joints, vessels, nerves, and bones of the hand requires healthy vascularized tissue to maintain viability and function. Local flaps or regional flaps may be within the burn zone of injury...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28341258/treatment-costs-of-burn-victims-in-a-university-hospital
#9
Elza H T Anami, Elisangela F Zampar, Marcos T Tanita, Lucienne T Q Cardoso, Tiemi Matsuo, Cintia Magalhães C Grion
OBJECTIVES: To analyze the direct costs of treating critically ill patients in the intensive care unit of a center specializing in treating burns. METHODS: This is a prospective cohort study of 180 patients from May 2011 to May 2013. Clinical and demographic data were collected in addition to data for the calculation of severity scores. The costs related to daily clinical and surgical treatment were evaluated until hospital outcome. The costs were grouped into five blocks: Clinical support, Drugs and blood products, Medical procedures, Specific burn procedures and Hospital fees...
March 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28338594/the-association-of-non-accidental-trauma-with-historical-factors-exam-findings-and-diagnostic-testing-during-the-initial-trauma-evaluation
#10
Mauricio A Escobar, Marc Auerbach, Katherine Flynn-O'Brien, Gunjan Tiyyagura, Matthew A Borgman, Susan J Duffy, Kelly Falcone, Rita Burke, John M Cox, Sabine Maguire
Early identification of non-accidental trauma (NAT) is a critical component of pediatric trauma care. Literature searches were conducted related to the association of NAT with seven key areas: history, exam findings (burns, oral trauma, bruising) and imaging (fractures, abdominal and brain injuries). When available, odds ratios (OR) with 95% confidence intervals (CI) for associations with NAT are presented. Systematic reviews have been published in six of the seven key areas and are described. The operational definition of NAT was widely variable across studies, prohibiting meta-analysis...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28329734/elevated-mif-2-levels-predict-mortality-in-critically-ill-patients
#11
Julia Pohl, Ulrike B Hendgen-Cotta, Pia Stock, Peter Luedike, Tienush Rassaf
PURPOSE: D-dopachrome tautomerase (MIF-2 or DDT) is a member of the macrophage migration inhibitory factor (MIF) superfamily and a close structural homolog to MIF. Circulating MIF-2 has been described to be elevated in patients suffering from sepsis, severe burn injury and after surgery. We sought to evaluate the prognostic value of MIF-2 in critically ill patients. METHODS: A total of 72 patients were studied upon admission to the medical intensive care unit (ICU)...
March 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28296811/new-onset-atrial-fibrillation-in-the-critically-ill
#12
Travis J Moss, James Forrest Calland, Kyle B Enfield, Diana C Gomez-Manjarres, Caroline Ruminski, John P DiMarco, Douglas E Lake, J Randall Moorman
OBJECTIVE: To determine the association of new-onset atrial fibrillation with outcomes, including ICU length of stay and survival. DESIGN: Retrospective cohort of ICU admissions. We found atrial fibrillation using automated detection (≥ 90 s in 30 min) and classed as new-onset if there was no prior diagnosis of atrial fibrillation. We identified determinants of new-onset atrial fibrillation and, using propensity matching, characterized its impact on outcomes...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28296670/intraoperative-feeding-improves-calorie-and-protein-delivery-in-acute-burn-patients
#13
David E Varon, Gil Freitas, Neha Goel, Jennifer Wall, Deepak Bharadia, Erin Sisk, Joshua C Vacanti, Bohdan Pomahac, Indranil Sinha, Vihas M Patel
Enteral nutrition support is a critical component of modern burn care for severely burned patients. However, tube feeds are frequently withheld during the perioperative period because of aspiration concerns. As a result, patients requiring multiple operative procedures risk accumulating significant protein-calorie deficits. The objective of this study was to describe our American Burn Association-certified burn center's experience implementing an intraoperative feeding protocol in severely burned patients defined as a cutaneous burn ≥20% TBSA...
March 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28267682/a-retrospective-descriptive-comparative-study-to-identify-patient-variables-that-contribute-to-the-development-of-deep-tissue-injury-among-patients-in-intensive-care-units
#14
Holly Kirkland-Kyhn, Oleg Teleten, Machelle Wilson
Deep tissue injury (DTI) may develop in critically ill patients despite implementation of preventive interventions. A retrospective, descriptive study was conducted in a 620-bed, level 1 trauma, academic medical center with 7 adult intensive care units ([ICUs] cardiac surgery, trauma surgery, burn surgery, med-surgery, neurosurgery, medical, and transfer) among patients treated from January 1, 2010 to January 1, 2015. All patients 18 years of age or older that developed a sacral DTI that evolved into a Stage 3, Stage 4, or unstageable hospital-acquired pressure ulcers (HAPU) in the ICU were included...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28256051/histopathological-assessment-of-oasis-ultra-on-critical-sized-wound-healing-a-pilot-study
#15
Daniel Dante Yeh, Rosalynn M Nazarian, Leah Demetri, Tomaz Mesar, Suzan Dijkink, Andreas Larentzakis, George Velmahos, Karim Walid Sadik
BACKGROUND: Dermatopathologists assess wounds secondary to trauma, infection, or oncologic resection that can be challenging to reconstruct. OASIS® Ultra, an extracellular matrix, has been described for use in chronic and burn wounds. The aim of this pilot study is to assess wound healing in post-traumatic and infective wounds treated with OASIS using histological markers of repair. METHODS: Adults with traumatic, infective or iatrogenic wound defects with size precluding primary closure were eligible...
March 2, 2017: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/28253213/systematic-reviews-in-burns-care-poor-quality-and-getting-worse
#16
Jared M Campbell, Sheila Kavanagh, Rochelle Kurmis, Zachary Munn
The objective of this article is to investigate adherence to reporting standards and methodological quality in systematic reviews on burns care published in peer-reviewed journals to determine their utility for guiding evidence-based burns care. PubMed, Embase, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews, and the Joanna Briggs Institute (JBI) Database of Systematic Reviews and Implementation Reports were searched from 2009. Any systematic review on any question on therapeutic interventions in burns care was eligible for inclusion...
March 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28240961/gender-parity-in-critical-care-medicine
#17
Sangeeta Mehta, Karen E A Burns, Flavia R Machado, Alison E Fox-Robichaud, Deborah J Cook, Carolyn S Calfee, Lorraine B Ware, Ellen L Burnham, Niranjan Kissoon, John C Marshall, Jordi Mancebo, Simon Finfer, Christiane Hartog, Konrad Reinhart, Kathryn Maitland, Renee D Stapleton, Arthur Kwizera, Pravin Amin, Fekri Abroug, Orla Smith, Jon H Laake, Gentle S Shrestha, Margaret S Herridge
Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. These documents inform and shape patient care around the world. In this perspective we discuss the importance of diversity on guideline panels, the disproportionately low representation of women on critical care guideline panels, and existing initiatives to increase the representation of women in corporations, universities and government...
February 27, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28221300/patient-experience-of-wearing-compression-garments-post-burn-injury-a-review-of-the-literature
#18
Nicole Coghlan, Jodie Copley, Tammy Aplin, Jenny Strong
This review was conducted to critically appraise the literature regarding the patient's lived experience of, and adherence to, wearing compression garments post burn injury. Scholarly articles were identified from searches of the following databases: Pubmed, Cochrane Central, CINAHL, PsycINFO, and OT Seeker. Combinations of key words including compression therapy/garment, pressure therapy/garment, burn(s), adherence, and patient experience were utilized. Retrieved studies were included in the review if they were written in English, reported on adult burn populations, and the patient's lived experience of wearing compression garments...
February 16, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28220508/quantitative-long-term-measurements-of-burns-in-a-rat-model-using-spatial-frequency-domain-imaging-sfdi-and-laser-speckle-imaging-lsi
#19
Adrien Ponticorvo, David M Burmeister, Rebecca Rowland, Melissa Baldado, Gordon T Kennedy, Rolf Saager, Nicole Bernal, Bernard Choi, Anthony J Durkin
BACKGROUND AND OJECTIVES: The current standard for diagnosis of burn severity and subsequent wound healing is through clinical examination, which is highly subjective. Several new technologies are shifting focus to burn care in an attempt to help quantify not only burn depth but also the progress of healing. While accurate early assessment of partial thickness burns is critical for dictating the course of treatment, the ability to quantitatively monitor wound status over time is critical for understanding treatment efficacy...
March 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28203387/an-overview-of-available-drugs-for-management-of-opioid-abuse-during-pregnancy
#20
REVIEW
Jillian Laslo, Jon-Michael Brunner, Daniel Burns, Emily Butler, Autumn Cunningham, Ryan Killpack, Courtney Pyeritz, Kimberly Rinard, Jennifer Childers, Joseph Horzempa
The prevalence of opioid abuse in the United States has been steadily increasing over the last several years among many major demographics, including pregnant women. Rise in prenatal opioid abuse has resulted in subsequent escalation of neonatal abstinence syndrome incidence, prompting the US Congress to pass the Protecting Our Infants Act of 2015. This act specifically calls for a critical review of current treatment options for prenatal opioid abuse which may ultimately lead to the development of better therapies and a decreased incidence of neonatal abstinence syndrome...
2017: Maternal Health, Neonatology and Perinatology
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