keyword
MENU ▼
Read by QxMD icon Read
search

Burn critical care

keyword
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#1
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716047/protocol-adherence-for-continuously-titrated-interventions-in-randomized-trials-an-overview-of-the-current-methodology-and-case-study
#2
F Lauzier, N K Adhikari, A Seely, K K Y Koo, E P Belley-Côté, K E A Burns, D J Cook, F D'Aragon, B Rochwerg, M E Kho, S J W Oczkowksi, E H Duan, M O Meade, A G Day, F Lamontagne
BACKGROUND: The standard definition for protocol adherence is the proportion of all scheduled doses that are delivered. In clinical research, this definition has several limitations when evaluating protocol adherence in trials that study interventions requiring continuous titration. DISCUSSION: Building upon a specific case study, we analyzed a recent trial of a continuously titrated intervention to assess the impact of different definitions of protocol deviations on the interpretation of protocol adherence...
July 17, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28712106/sensitivity-and-specificity-of-urinalysis-samples-in-critically-ill-patients
#3
Sean P Lee, Terrie Vasilopoulos, Thomas James Gallagher
BACKGROUND: Preemptive screening of urine for patients admitted to an intensive care unit can result in misinterpretation of data and over- or under-treatment of urinary tract infection. METHODS: Data were studied from 169 consecutive patients admitted to the neurologic or burn intensive care unit at Shands Hospital at the University of Florida. All patients had a urinary catheter in place at the time of admission. Urinalysis and urine culture were sent for analysis...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28705450/clinical-outcome-and-antimicrobial-therapeutic-drug-monitoring-for-the-treatment-of-infections-in-acute-burn-patients
#4
Anna Silva Machado, Maura S Oliveira, Cristina Sanches, Carlindo Vieira da Silva Junior, David S Gomez, Rolf Gemperli, Silvia Regina Cavani Jorge Santos, Anna S Levin
PURPOSE: In critical burn patients, the pharmacokinetic parameters (absorption, distribution, metabolism, and excretion) of many classes of drugs, including antibiotics, are altered. The aim of this study was to compare 2 groups of burn patients undergoing treatment for health care-associated infections with and without therapeutic drug monitoring. METHODS: A retrospective analysis of a clinical intervention (ie, a before/after study) was conducted with patients with health care-associated pneumonia, burn infection, bloodstream infection, and urinary tract infection in the burn intensive care unit of a tertiary care hospital...
July 10, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28697015/the-p50-research-center-in-perioperative-sciences-how-the-investment-by-the-national-institute-of-general-medical-sciences-in-team-science-has-reduced-post-burn-mortality
#5
Celeste C Finnerty, Karel Capek, Charles Voigt, Gabriel Hundeshagen, Janos Cambiaso-Daniel, Craig Porter, Linda E Sousse, Amina El Ayadi, Ramon Zapata-Sirvent, Ashley Guillory, Oscar E Suman, David N Herndon
Since the inception of the P50 Research Center in Peri-Operative Sciences (RCIPS) funding mechanism, the National Institute for General Medical Sciences has supported a team approach to science. Many advances in critical care, particularly burns, have been driven by RCIPS teams. In fact, burns that were fatal in the early 1970s, prior to the inception of the P50 RCIPS program, are now routinely survived as a result of the P50-funded research. The advances in clinical care that led to the reduction in post-burn death were made by optimizing resuscitation, incorporating early excision and grafting, bolstering acute care including support for inhalation injury, modulating the hypermetabolic response, augmenting the immune response, incorporating aerobic exercise, and developing anti-scarring strategies...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28694703/secondary-sclerosing-cholangitis-in-critically-ill-patients-current-perspectives
#6
REVIEW
Hafsteinn O Gudnason, Einar S Björnsson
Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28693491/hypoxia-and-hypotension-in-patients-intubated-by-physician-staffed-helicopter-emergency-medical-services-a-prospective-observational-multi-centre-study
#7
Geir Arne Sunde, Mårten Sandberg, Richard Lyon, Knut Fredriksen, Brian Burns, Karl Ove Hufthammer, Jo Røislien, Akos Soti, Helena Jäntti, David Lockey, Jon-Kenneth Heltne, Stephen J M Sollid
BACKGROUND: The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators of care provided by emergency medical services. Excluding cardiac arrests, critical trauma and non-trauma patients remain the two major groups to which helicopter emergency medical services (HEMS) are dispatched. Several studies describe the impact of pre-hospital hypoxia or hypotension on trauma patients, but few studies compare this in trauma and non-trauma patients...
July 11, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28687380/patient-and-family-engagement-in-designing-and-implementing-a-weaning-trial-a-novel-research-paradigm-in-critical-care
#8
Karen E A Burns, John W Devlin, Nicholas S Hill
The call for meaningful patient and family engagement in research has recently gained considerable momentum. This article defines patient and family engagement broadly and specifically in clinical research. Using a multicenter, North American weaning trial as an exemplar, we describe our early experiences as clinical researchers with patient and family engagement. The role of our Patient and Family Advisory Committee in trial design and implementation is illustrated. Through our experiences, we share our insights regarding the perceived opportunities and also highlight some challenges associated with engaging patients and family engagement in critical care research...
July 4, 2017: Chest
https://www.readbyqxmd.com/read/28678920/pain-and-distress-outcomes-in-infants-and-children-a-systematic-review
#9
N C A C Oliveira, C M Gaspardo, M B M Linhares
The aim of the present study was to systematically review the recent literature about pain and distress outcomes in children and critically analyze the methodological quality of the reports. The systematic review was based on the PRISMA statement and performed by selecting articles that are indexed in scientific databases. The methodological quality of reports was examined using STROBE statement, for observational studies, and CONSORT statement, for randomized controlled trials. The PedIMMPACT consensus was used to evaluate the psychometric quality of pain instruments...
July 3, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28676296/contributing-factors-of-frequent-use-of-the-emergency-department-a-synthesis
#10
REVIEW
Timothy R Burns
INTRODUCTION: Overcrowding in emergency departments is an issue that has a negative impact worldwide. As attendance in emergency departments has increased, the ability to provide critical services to patients suffering from actual medical emergencies in a timely manner has decreased as these departments are many times at or over capacity. One patient population whose negative influence has been researched with regard to their impact on the overcrowding issue is that of the frequent user...
July 1, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28661988/bowel-necrosis-and-3-limb-amputation-from-high-voltage-electrical-injury
#11
Elie P Ramly, Rebekah MacFie, Niknam Eshraghi, Frederick Cole, Delphine Engel
The objective of this study was to report the case and multidisciplinary management of a 44-year-old man with 40% TBSA third- and fourth-degree burns sustained during high-voltage electrical injury including 3 limb amputation and bowel necrosis requiring small bowel resection. This study is a case report and review of the literature. A 44-year-old man was brought to the Emergency Department with 40% TBSA third- and fourth-degree burns sustained during accidental contact with high-voltage electric current. He had multisystem injury including injuries to 3 of his extremities ultimately requiring a forequarter amputation of the left upper extremity and guillotine amputations of his bilateral lower extremities...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28661976/enteral-nutrition-delivery-is-overestimated-in-provider-documentation
#12
Jenna Kesey, Yana Puckett, Sharmila Dissanaike
Burn-injured patients have the highest metabolic demand of all critically ill patients and are vulnerable to complications of malnutrition. Many burn centers have challenges in achieving prescribed rates of nutrition, despite aggressive algorithms. One possible reason for the discrepancy is inaccurate documentation of volumes. This is a retrospective review of patients requiring tube feeding admitted to a regional burn center between June and August 2015. Demographics were abstracted including gender, type of injury, TBSA, and age...
June 21, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28649389/cases-of-acute-mercury-poisoning-by-mercury-vapor-exposure-during-the-demolition-of-a-fluorescent-lamp-factory
#13
Sang Yoon Do, Chul Gab Lee, Jae Yoon Kim, Young Hoon Moon, Min Sung Kim, In Ho Bae, Han Soo Song
BACKGROUND: In 2015, workers dismantling a fluorescent lamp factory in Korea were affected by mercury poisoning from exposure to mercury vapor. CASE PRESENTATION: Eighteen out of the 21 workers who participated in the demolition project presented with symptoms of poisoning and, of these, 10 had persistent symptoms even at 18 months after the initial exposure to mercury vapor. Early symptoms of 18 workers included a general skin rash, pruritus, myalgia, sleep disturbance, and cough and sputum production...
2017: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28637738/the-reanimation-low-immune-status-markers-realism-project-a-protocol-for-broad-characterisation-and-follow-up-of-injury-induced-immunosuppression-in-intensive-care-unit-icu-critically-ill-patients
#14
Mary-Luz Rol, Fabienne Venet, Thomas Rimmele, Virginie Moucadel, Pierre Cortez, Laurence Quemeneur, David Gardiner, Andrew Griffiths, Alexandre Pachot, Julien Textoris, Guillaume Monneret
INTRODUCTION: The host response to septic shock is dynamic and complex. A sepsis-induced immunosuppression phase has recently been acknowledged and linked to bad outcomes and increased healthcare costs. Moreover, a marked suppression of the immune response has also been partially described in patients hospitalized in intensive care unit (ICU) for severe trauma or burns. It has been hypothesized that immune monitoring could enable identification of patients who might most benefit from novel, adjunctive immune-stimulating therapies...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28625600/where-to-do-water-testing-for-pseudomonas-aeruginosa-in-a-healthcare-setting
#15
Mark I Garvey, Craig W Bradley, Elisabeth Holden, Mike Weibren
Pseudomonas aeruginosa is an important nosocomial pathogen commonly colonising hospital water supplies. HTM 04-01 addresses the risk posed by recommending water testing in augmented care areas which includes outpatient haemodialysis. We discuss how two teaching hospitals independently reviewed the risk to outpatient haemodialysis patients drawing the same conclusion. The highest number of infection episodes with P. aeruginosa was seen in critical care followed by burns and haematology with the lowest in haemodialysis...
June 15, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28602586/fungal-periapical-abscess-and-the-burn-patient-a-report-of-two-cases-of-an-unreported-source-for-systemic-infection
#16
Stephen Serio, Brian Burgess, David Voigt
Fungal infections in the intensive care unit are becoming a more common occurrence, especially in the care of the burn patient. Fungal infections in the critically burned patient, who by nature have a heightened inflammatory state and impaired immune response, have been found to carry a profound degree of morbidity and mortality. We present our experience in the care of severe thermal injuries; a series of patients with endodontic fungal infection which, as we found, pose a significant risk for the development of systemic infection and sepsis...
June 9, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28600109/the-cardio-respiratory-effects-of-intra-abdominal-hypertension-considerations-for-critical-care-nursing-practice
#17
REVIEW
Martin Christensen, Judy Craft
Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondaryintra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
June 6, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28590164/care-of-the-critically-ill-burn-patient-an-overview-from-the-perspective-of-optimizing-palliative-care
#18
Daniel E Ray, Mohana B Karlekar, Donnelle L Crouse, Margaret Campbell, J Randall Curtis, Jeffrey Edwards, Dana R Lustbader, Anne C Mosenthal, Colleen Mulkerin, Kathleen A Puntillo, David E Weissman, Renee D Boss, Karen J Brasel, Judith E Nelson
Burn specialists have long recognized the need for and have role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many U.S. hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context...
July 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28576233/disaster-preparedness-and-response-for-the-burn-mass-casualty-incident-in-the-twenty-first-century
#19
REVIEW
Randy D Kearns, David E Marcozzi, Noran Barry, Lewis Rubinson, Charles Scott Hultman, Preston B Rich
The effective and efficient coordination of emergent patient care at the point of injury followed by the systematic resource-based triage of casualties are the most critical factors that influence patient outcomes after mass casualty incidents (MCIs). The effectiveness and appropriateness of implemented actions are largely determined by the extent and efficacy of the planning and preparation that occur before the MCI. The goal of this work was to define the essential efforts related to planning, preparation, and execution of acute and subacute medical care for disaster burn casualties...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28557867/rapid-communication-solution-for-the-meek-glue-transfer-problem
#20
Derek M Culnan, Beretta Craft-Coffman, Genevieve Bitz, Robert F Mullins
Meek micrografting permits wide expansion of skin grafts in true ratios from 3:1 to 9:1, as well as the utilization of poor donor sites. The proprietary glue critical to successful skin transference is unavailable in the United States. While the technique is widely employed worldwide, alternative glues resulted in poor skin transfer and frustrated use in American burn centers. The authors present their protocol resulting in effective MEEK skin transfer using Mastisol® adhesive: "The Rule of Sevens." 1) Soak the corks in normal saline for 7 minutes...
May 23, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
keyword
keyword
24477
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"