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https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#1
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27902388/the-exploration-of-risk-factors-of-concurrent-bacteremia-among-critically-ill-patients-with-severe-dengue
#2
Chin-Ming Chen, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Hui-Chun Chao, Chiu-Yin Yeh, Wen-Liang Yu
We investigated the clinical features of intensive care unit (ICU) patients with a concomitant severe dengue infection and bacteremia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during a July 31-November 31, 2015 were reviewed. Patients with "concurrent bacteremia" (positive bacterial blood culture within 72 hours of ICU admission) were identified. ICU admission was required for 142 patients; 22 (15.5%) had concurrent bacteremia. Streptococcus spp. was the most common pathogen, then Escherichia coli, and then Staphylococcus spp...
November 7, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27867308/effect-of-n-methyl-d-aspartate-receptor-antagonist-dextromethorphan-on-opioid-analgesia-in-pediatric-intensive-care-unit
#3
Mohammed Naeem, Hala Al Alem, Ali Al Shehri, Majed Al-Jeraisy
Objective. Pain control is an essential goal in the management of critical children. Narcotics are the mainstay for pain control. Patients frequently need escalating doses of narcotics. In such cases an adjunctive therapy may be beneficial. Dextromethorphan (DM) is NMDA receptor antagonist and may prevent tolerance to narcotics; however, its definitive role is still unclear. We sought whether dextromethorphan addition could decrease the requirements of fentanyl to control pain in critical children. Design. Double-blind, randomized control trial (RCT)...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27867133/fiberoptic-bronchoscopy-and-remifentanil-target-controlled-infusion-in-critically-ill-patients-with-acute-hypoxaemic-respiratory-failure-a-descriptive-study
#4
Saïda Rezaiguia-Delclaux, Florent Laverdure, Talna Kortchinsky, Léa Lemasle, Audrey Imbert, François Stéphan
INTRODUCTION: Sedation optimizes patient comfort and ease of execution during fiberoptic bronchoscopy (FOB). Our objective was to describe the safety and efficacy of remifentanil-TCI during FOB in non-intubated, hypoxaemic, thoracic-surgery ICU patients. METHODS: Consecutive spontaneously breathing adults requiring FOB after thoracic surgery were included if they had hypoxaemia (PaO2/FiO2 < 300mmHg or need for non-invasive ventilation [NIV]) and prior FOB failure under topical anaesthesia...
November 17, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#5
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27848889/contemporary-pediatric-palliative-care-myths-and-barriers-to-integration-into-clinical-care
#6
Stefan J Friedrichsdorf
At least 20 million children would benefit from Pediatric Palliative Care (PPC) annually, and 8 million children would need specialized PPC services. In the USA alone, more than 42,000 children 0-19 years died in 2013, fifty-five percent of them infants younger than 1 year. This article aims to critically review eight common assumptions, myths and barriers, which may hinder the implementation of PPC into the care of a child with advanced serious illnesses. Interdisciplinary PPC is about matching treatment to patient goals and is considered specialized medical care for children with serious illness...
November 15, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27833752/accuracy-of-critical-care-pain-observation-tool-and-behavioral-pain-scale-to-assess-pain-in-critically-ill-conscious-and-unconscious-patients-prospective-observational-study
#7
Paolo Severgnini, Paolo Pelosi, Elena Contino, Elisa Serafinelli, Raffaele Novario, Maurizio Chiaranda
BACKGROUND: Critically ill patients admitted to intensive care unit (ICU) may suffer from different painful stimuli, but the assessment of pain is difficult because most of them are almost sedated and unable to self-report. Thus, it is important to optimize evaluation of pain in these patients. The main aim of this study was to compare two commonly used scales for pain evaluation: Critical Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS), in both conscious and unconscious patients...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27821384/the-effectiveness-of-hand-massage-on-pain-in-critically-ill-patients-after-cardiac-surgery-a-randomized-controlled-trial-protocol
#8
Madalina Boitor, Géraldine Martorella, Andréa Maria Laizner, Christine Maheu, Céline Gélinas
BACKGROUND: Postoperative pain is common in the intensive care unit despite the administration of analgesia. Some trials suggest that massage can be effective at reducing postoperative pain in acute care units; however, its effects on pain relief in the intensive care unit and when pain severity is highest remain unknown. OBJECTIVE: The objective is to evaluate the effectiveness of hand massage on the pain intensity (primary outcome), unpleasantness and interference, muscle tension, anxiety, and vital signs of critically ill patients after cardiac surgery...
November 7, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27807447/endoscopic-management-of-foreign-bodies-in-the-gastrointestinal-tract-a-review-of-the-literature
#9
REVIEW
Mikhael Bekkerman, Amit H Sachdev, Javier Andrade, Yitzhak Twersky, Shahzad Iqbal
Foreign body ingestion is a common diagnosis that presents in emergency departments throughout the world. Distinct foreign bodies predispose to particular locations of impaction in the gastrointestinal tract, commonly meat boluses in the esophagus above a preexisting esophageal stricture or ring in adults and coins in children. Several other groups are at high risk of foreign body impaction, mentally handicapped individuals or those with psychiatric illness, abusers of drugs or alcohol, and the geriatric population...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27793165/surviving-critical-illness-what-is-next-an-expert-consensus-statement-on-physical-rehabilitation-after-hospital-discharge
#10
M E Major, R Kwakman, M E Kho, B Connolly, D McWilliams, L Denehy, S Hanekom, S Patman, R Gosselink, C Jones, F Nollet, D M Needham, R H H Engelbert, M van der Schaaf
BACKGROUND: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness? METHODS: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record...
October 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27782344/the-role-of-social-support-in-the-experience-of-fibromyalgia-narratives-from-south-africa
#11
Silvie Cooper, Leah Gilbert
This paper focuses on the role of 'social support' in the experience of fibromyalgia (a musculoskeletal pain disorder) in South Africa. In-depth semi-structured interviews were used to collect narratives from 15 participants. Sources of social support constitute important mechanisms for coping with the illness experience of fibromyalgia. In providing a space for consultation and validation of the diagnosis of fibromyalgia, and the person living with the condition, people giving support fulfil a critical role in shaping the experience...
October 26, 2016: Health & Social Care in the Community
https://www.readbyqxmd.com/read/27777355/analgesia-in-the-surgical-intensive-care-unit
#12
REVIEW
Eric Ehieli, Suraj Yalamuri, Charles S Brudney, Srinivas Pyati
Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critically ill patients in the ICU presents numerous challenges to intensivists. Inconsistencies in pain assessment, analgesic prescription and variation in monitoring sedation and analgesia result in suboptimal pain management. Inadequate pain control can have deleterious effects on several organ systems in critically ill patients...
October 24, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27756590/the-challenges-of-providing-effective-pain-management-for-children-in-the-pediatric-intensive-care-unit
#13
Ahmad Ismail
Providing effective pain management is necessary for all patients in the intensive care unit (ICU). Because of developmental considerations, caring for children may provide additional challenges. The purpose of this literature review is to describe key challenges in providing effective pain management in pediatric intensive care units (PICUs), with the aim of bringing about a better understanding by health care providers caring for children. Challenges of providing effective pain management in the PICU can be categorized into four levels...
October 15, 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/27721728/spontaneous-bacterial-peritonitis-and-anasarca-in-a-female-patient-with-ovarian-hyperstimulation-syndrome-complicated-by-respiratory-and-kidney-failure
#14
Muhammad Abdul Mabood Khalil, Muhammad Salman Ghazni, Jackson Tan, Nazish Naseer, Muhammad Ashhad Ullah Khalil
Ovarian hyperstimulation syndrome (OHSS) was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH) along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output...
May 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27717509/patterns-of-palliative-care-service-consultation-in-a-sample-of-critically-ill-icu-patients-at-high-risk-of-dying
#15
Jennifer B Seaman, Amber E Barnato, Susan M Sereika, Mary Beth Happ, Judith A Erlen
OBJECTIVE: Describe patterns of palliative care service consultation among a sample of ICU patients at high risk of dying. BACKGROUND: Patients receiving mechanical ventilation (MV) face threats to comfort, social connectedness and dignity due to pain, heavy sedation and physical restraint. Palliative care consultation services may mitigate poor outcomes. METHODS: From a dataset of 1440 ICU patients with ≥2 days of MV and ≥12 h of sustained wakefulness, we identified those at high risk of dying and/or who died and assessed patterns of sub-specialty palliative care consultation...
October 4, 2016: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27704695/weight-loss-after-head-and-neck-cancer-a-dynamic-relationship-with-depressive-symptoms
#16
Julia R Van Liew, Rebecca L Brock, Alan J Christensen, Lucy Hynds Karnell, Nitin A Pagedar, Gerry F Funk
BACKGROUND: Weight loss and depressive symptoms are critical head and neck cancer outcomes, yet their relation over the illness course is unclear. METHODS: Associations between self-reported depressive symptoms and objective weight loss across the year after head and neck cancer diagnosis were examined using growth curve modeling techniques (n = 564). RESULTS: A reciprocal covariation pattern emerged-changes in depressive symptoms over time were associated with same-month changes in weight loss (t [1148] = 2...
October 5, 2016: Head & Neck
https://www.readbyqxmd.com/read/27704172/improvement-of-postoperative-pain-control-processes-and-outcomes-in-veterans-of-a-surgical-intensive-care-unit
#17
Melissa S D'Andrea, P Marco Fisichella
BACKGROUND: Postoperative pain remains undertreated in critically ill patients. We hypothesized that the adequacy of pain control in our Surgical Intensive Care Unit (SICU) was above the reported average of 71 % in the literature and that the introduction of the critical care pain observation tool (CPOT) could improve it. We used a Lean Six Sigma methodology to improve our processes and quantify our improvement. PATIENTS AND METHODS: We retrospectively review 713 consecutive veterans admitted to our SICU...
October 4, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27697569/performance-of-consultative-palliative-care-model-in-achieving-quality-metrics-in-the-icu
#18
Nicholas G Wysham, Michael J Hochman, Steven P Wolf, Christopher E Cox, Arif H Kamal
CONTEXT: Quality metrics for intensive care unit (ICU)-based palliative care have been proposed but it is unknown how consultative palliative care can contribute to performance on these measures. OBJECTIVES: Assess adherence to proposed quality metrics of intensive care unit (ICU)-based palliative care by palliative care specialists. METHODS: Surrogates for 9/14 patient-level quality metrics were assessed in all patients who received an initial palliative care specialist consult while in an ICU from 10/26/2012 to 1/16/2015 in the Global Palliative Care Quality Alliance, a nationwide palliative care quality registry...
September 30, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27688917/compartment-syndrome-as-a-result-of-systemic-capillary-leak-syndrome
#19
Kwadwo Kyeremanteng, Gianni D'Egidio, Cynthia Wan, Alan Baxter, Hans Rosenberg
Objective. To describe a single case of Systemic Capillary Leak Syndrome (SCLS) with a rare complication of compartment syndrome. Patient. Our patient is a 57-year-old male, referred to our hospital due to polycythemia (hemoglobin (Hgb) of 220 g/L), hypotension, acute renal failure, and bilateral calf pain. Measurements and Main Results. The patient required bilateral forearm, thigh, and calf fasciotomies during his ICU stay and continuous renal replacement therapy was instituted following onset of acute renal failure and oliguria...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27685422/a-systematic-review-of-observational-pain-assessment-instruments-for-use-with-nonverbal-intubated-critically-ill-adult-patients-in-the-emergency-department-an-assessment-of-their-suitability-and-psychometric-properties
#20
Wayne Varndell, Margaret Fry, Doug Elliott
AIM: This systematic review examined the psychometric properties and suitability of the available observational pain instruments for potential use with nonverbal critically ill adult patients in the emergency department. BACKGROUND: In the emergency department assessing pain in critically ill patients is challenging, especially those unable to communicate the presence of pain. Critically ill patients are commonly unable to verbally communicate pain due to altered oral communication (e...
September 29, 2016: Journal of Clinical Nursing
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