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https://www.readbyqxmd.com/read/29338144/mortality-and-long-term-quality-of-life-after-percutaneous-tracheotomy-in-intensive-care-unit-a-prospective-observational-study
#1
Maria Vargas, Yuda Sutherasan, Iole Brunetti, Camilla Micalizzi, Angelo Insorsi, Lorenzo Ball, Marta Folentino, Rosanna Sileo, Arduino DE Lucia, Manuela Cerana, Alessandro Accattatis, Domenico DE Lisi, Angelo Gratarola, Francesco Mora, Giorgio Peretti, Giuseppe Servillo, Paolo Pelosi
BACKGROUND: Quality of life and mortality after percutaneous dilatational tracheotomy (PDT) has been poorly investigated. The aims of this study were to evaluate the independent risk factors for Intensive Care Unit (ICU) mortality and investigate quality of life over the first year after PDT in critically ill patients. METHODS: This was a prospective, single-center, cohort study performed in a tertiary care University Hospital, enrolling consecutive ICU patients requiring elective PDT, collecting data during the tracheotomy procedure and the ICU stay...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29335793/accuracy-of-emergency-department-triage-using-the-emergency-severity-index-and-independent-predictors-of-under-triage-and-over-triage-in-brazil-a-retrospective-cohort-analysis
#2
Jeremiah S Hinson, Diego A Martinez, Paulo S K Schmitz, Matthew Toerper, Danieli Radu, James Scheulen, Sarah A Stewart de Ramirez, Scott Levin
BACKGROUND: Emergency department (ED) triage is performed to prioritize care for patients with critical and time-sensitive illness. Triage errors create opportunity for increased morbidity and mortality. Here, we sought to measure the frequency of under- and over-triage of patients by nurses using the Emergency Severity Index (ESI) in Brazil and to identify factors independently associated with each. METHODS: This was a single-center retrospective cohort study. The accuracy of initial ESI score assignment was determined by comparison with a score entered at the close of each ED encounter by treating physicians with full knowledge of actual resource utilization, disposition, and acute outcomes...
January 15, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29329164/a-systematic-review-of-risk-factors-associated-with-cognitive-impairment-after-pediatric-critical-illness
#3
Alicia G Kachmar, Sharon Y Irving, Cynthia A Connolly, Martha A Q Curley
OBJECTIVES: To identify risk factors associated with cognitive impairment as assessed by neuropsychologic tests in neurotypical children after critical illness. DATA SOURCES: For this systematic review, we searched the Cochrane Library, Scopus, PubMed, Ovid, Embase, and CINAHL databases from January 1960 to March 2017. STUDY SELECTION: Included were studies with subjects 3-18 years old at the time of post PICU follow-up evaluation and use of an objective standardized neuropsychologic test with at least one cognitive functioning dimension...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29317845/pyomyositis-in-the-setting-of-complicated-diverticulitis-case-report
#4
James Sun, David Leor Kashan, Jolita Marie Auguste, Akella Chendrasekhar
Pyomyositis is typically thought of as a disease of the tropics. However, it is becoming more prevalent in temperate regions, and may be underdiagnosed. Here, pyomyositis is encountered as a complication of perforated diverticulitis, which has not been previously reported. A 61-year-old Caucasian man initially presented in respiratory distress and was diagnosed with respiratory failure due to COPD exacerbation. The patient was taking high-dose prednisone, 60 mg daily for the past 2 years. Initially, he was afebrile, normotensive, tachycardic to 178 beats/minute and tachypneic to 28 breaths/minute, requiring noninvasive ventilation to maintain oxygenation...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29305389/before-narrative-episodic-reading-and-representations-of-chronic-pain
#5
Sara Wasson
This article suggests that some illness experience may require a reading practice less concerned with narrative coherence or self-authorship, and more interested in the value of textual fragments, episodes and moments considered outside a narrative framework. Chronic pain can pose multiple challenges to the narrative orientations celebrated in both 'survivorship' discourse and classic medical humanities scholarship. In its recalcitrance to cure, its often mysterious aetiology and its complex blend of somatic, interpersonal and affective elements, representations of chronic pain can require a richer vocabulary of temporality...
January 5, 2018: Medical Humanities
https://www.readbyqxmd.com/read/29283868/a-review-of-the-essential-components-of-quality-palliative-care-in-the-home
#6
Hsien Seow, Daryl Bainbridge
OBJECTIVE: The home is an important and often preferable setting of palliative care. While much research has demonstrated the benefits of specialized palliative homecare on patient and system outcomes, there has been little delineation of the underlying components of these efficacious programs. We synthesized the essential elements of palliative homecare from a combined review of successful programs, perspectives of patients and caregivers, and views of healthcare providers in palliative care...
January 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29280605/physical-restraints-in-intensive-care-experiences-of-patients-families-and-nurses
#7
Dawn Perez, Kath Peters, Lesley Wilkes, Gillian Murphy
Critically ill patients admitted to an intensive care unit (ICU) often require many invasive procedures and medical devices (Martin and Mathisen 2005). While these interventions are a necessity, they can potentially cause patients a great amount of pain and discomfort, often leading to restlessness and agitation (Langley et al. 2011).
May 2017: Australian Nursing & Midwifery Journal
https://www.readbyqxmd.com/read/29261818/update-in-hospital-palliative-care-symptom-management-communication-caregiver-outcomes-and-moral-distress
#8
Rachel D Havyer, Daniel H Pomerantz, Robert L Jayes, Patricia F Harris, Stephanie M Harman, Aziz A Ansari
BACKGROUND: Updated knowledge of the palliative care (PC) literature is needed to maintain competency and best address the PC needs of hospitalized patients. We critiqued the recent PC literature with the highest potential to impact hospital practice. METHODS: We reviewed articles published between January 2016 and December 2016, which were identified through a handsearch of leading journals and a MEDLINE search. The final 9 articles selected were determined by consensus based on scientific rigor, relevance to hospital medicine, and impact on practice...
December 20, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29247307/attitudes-towards-end-of-life-issues-in-intensive-care-unit-among-italian-anesthesiologists-a-nation-wide-survey
#9
Andrea Cortegiani, Vincenzo Russotto, Santi Maurizio Raineri, Cesare Gregoretti, Antonino Giarratano, Sebastiano Mercadante
BACKGROUND: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). METHODS: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. RESULTS: Eight hundred and five persons responded to the full list of questions...
December 15, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29227709/a-review-study-on-the-beneficial-effects-of-baduanjin
#10
Liye Zou, Zhujun Pan, Albert Yeung, Saira Talwar, Chaoyi Wang, Yang Liu, Yankai Shu, Xiaoan Chen, Garrett Anthony Thomas
AIM: Baduanjin, a Chinese traditional Qigong exercise that focuses on a mind-body integration, is considered to be an effective exercise in promoting health. Thus, we systematically and critically evaluated the emerging literature relating to the effects of Baduanjin on health outcomes. METHODS: We used seven English-language electronic databases for the literature search. At least one health-related parameter was reported in retrievable full-text Baduanjin intervention studies...
December 11, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29223743/early-vs-late-tracheostomy-in-intensive-care-settings-impact-on-icu-and-hospital-costs
#11
Brent Herritt, Dipayan Chaudhuri, Kednapa Thavorn, Dalibor Kubelik, Kwadwo Kyeremanteng
INTRODUCTION: Up to 12% of the 800,000 patients who undergo mechanical ventilation in the United States every year require tracheostomies. A recent systematic review showed that early tracheostomy was associated with better outcomes: more ventilator-free days, shorter ICU stays, less sedation and reduced long-term mortality. However, the financial impact of early tracheostomies remain unknown. OBJECTIVES: To conduct a cost-analysis on the timing of tracheostomy in mechanically ventilated patients...
December 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29202259/bedside-lung-ultrasound-in-the-care-of-the-critically-ill
#12
Máté Rudas, Sam Orde, Marek Nalos
OBJECTIVE: To describe the technique and review the utility of bedside lung ultrasound in acute care. SUMMARY: Lung ultrasound is a useful point-of-care investigation in acute care, especially in patients with dyspnoea or haemodynamic instability. Although normal lung parenchyma is not accessible to ultrasound, distinctive artefacts arising from parietal and visceral pleura indirectly imply the presence of normal lung. As aeration of lung tissue reduces with disease process, visual assessment of several pathologic entities by ultrasound becomes possible...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29196586/implementing-a-multicomponent-intervention-to-prevent-delirium-among-critically-ill-patients
#13
Felipe Martínez, Ana María Donoso, Carla Marquez, Eduardo Labarca
BACKGROUND: Delirium is common among the critically ill. Nonpharmacologic interventions are reportedly effective in reducing incident delirium, but limited data specific to this population exist. OBJECTIVES: To assess the efficacy and describe the implementation strategy of a multicomponent intervention to prevent delirium in an intensive care unit. METHODS: A before-and-after study was conducted in an intensive care unit between May 2014 through August 2015...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29194174/the-effects-of-endotracheal-suctioning-in-the-pediatric-population-an-integrative-review
#14
Anna C Fisk
BACKGROUND: Critically ill pediatric patients with endotracheal tubes routinely receive endotracheal tube suctioning to clear secretions and ensure tube patency. This common practice can result in adverse effects. OBJECTIVES: The aim of this study was to evaluate the research literature on the stressors of endotracheal suctioning and consequent effect on the pediatric patient. METHODS: An integrative review was conducted using the Whittemore and Knafl modified framework for integrative reviews, and article selection was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram...
January 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29194144/thoracic-epidural-analgesia-and-mortality-in-acute-pancreatitis-a-multicenter-propensity-analysis
#15
Matthieu Jabaudon, Nouria Belhadj-Tahar, Thomas Rimmelé, Olivier Joannes-Boyau, Stéphanie Bulyez, Jean-Yves Lefrant, Yannick Malledant, Marc Leone, Paer-Selim Abback, Fabienne Tamion, Hervé Dupont, Brice Lortat-Jacob, Philippe Guerci, Thomas Kerforne, Raphael Cinotti, Laurent Jacob, Philippe Verdier, Thierry Dugernier, Bruno Pereira, Jean-Michel Constantin
OBJECTIVE: Recent preclinical and clinical data suggest that thoracic epidural analgesia, a technique primarily aimed at decreasing pain, might exert anti-inflammatory effects, enhance splanchnic and pancreatic blood flow during acute pancreatitis; however, the influence of epidural analgesia on mortality remains under investigated in this setting. This study was therefore designed to assess the impact of epidural analgesia on mortality in ICU patients with acute pancreatitis. DESIGN: Multicenter retrospective, observational, cohort study...
November 30, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29189705/validation-of-the-italian-version-of-the-critical-pain-observation-tool-in-brain-injured-critically-ill-adults
#16
Francesco Sulla, Nilson De Souza Ramos, Noemi Terzi, Tania Trenta, Mariella Uneddu, Melanny Alessandra Zaldivar Cruces, Leopoldo Sarli
BACKGROUND AND AIM: Pain in intensive care units (ICUs) is a frequent and often undermanaged problem. Brain-injured patients are often unable to reliably self-report their pain, calling forth the need to use behavioural scales such as the Critical-Care Pain Observation Tool (CPOT). This study aimed to test the reliability and validity of the Italian CPOT use with brain-injured ICU adults. METHOD: A sample of 50 adults critical care patients was included. Each patient was assessed by two independent observers at three predefined times - at rest; during mobilization for hygiene; 20 minutes later - using the CPOT, PAINAD, and NRS...
November 30, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29167033/nursing-perceptions-of-the-emergency-severity-index-as-a-triage-tool-in-the-united-arab-emirates-a-qualitative-analysis
#17
Binoy Mistry, Kamna S Balhara, Jeremiah S Hinson, Xavier Anton, Iman Yassin Othman, Maysoon Abdel Latif E'nouz, Norman Agustin Avila, Sophia Henry, Scott Levin, Sarah Stewart De Ramirez
INTRODUCTION: With emergency department crowding becoming an increasing problem across the globe, nursing triage to prioritize patients receiving care is ever more important. ESI is the most common triage system used in the United States and is increasingly used worldwide. This qualitative study that explores emergency nursing perceptions of the ESI identifies strengths, weaknesses, and barriers to implementation of the ESI internationally. METHODS: We conducted a cross-sectional qualitative analysis using semistructured interviews of 27 emergency triage nurses...
November 19, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29162949/neuromuscular-electrical-stimulation-for-treatment-of-muscle-impairment-critical-review-and-recommendations-for-clinical-practice
#18
Ethne L Nussbaum, Pamela Houghton, Joseph Anthony, Sandy Rennie, Barbara L Shay, Alison M Hoens
Purpose: In response to requests from physiotherapists for guidance on optimal stimulation of muscle using neuromuscular electrical stimulation (NMES), a review, synthesis, and extraction of key data from the literature was undertaken by six Canadian physical therapy (PT) educators, clinicians, and researchers in the field of electrophysical agents. The objective was to identify commonly treated conditions for which there was a substantial body of literature from which to draw conclusions regarding the effectiveness of NMES...
2017: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/29152207/endotracheal-intubation-in-patients-with-difficult-airway-using-laryngeal-mask-airway-with-bougie-versus-video-laryngoscopy
#19
Hesameddin Modir, Esmail Moshiri, Bita Malekianzadeh, Gholamreza Noori, Abolfazl Mohammadbeigi
Airway management is essential for safe anesthesia and endotracheal intubation is the most important procedure by which critically ill patients can be better managed, especially if done quickly and successfully. This study aimed to compare the techniques of intubation through laryngeal mask airway (LMA) using a bougie versus video laryngoscopy (VL) regarding to intubation success and the quality of intubation indices in patients with difficult airways. This randomized clinical trial was performed on 96 patients aged 16-76 years with Mallampati class 3 or 4 who underwent elective surgery...
July 2017: Medical Gas Research
https://www.readbyqxmd.com/read/29146105/content-validation-of-behaviours-and-autonomic-responses-for-the-assessment-of-pain-in-critically-ill-adults-with-a-brain-injury
#20
Céline Gélinas, Kathleen A Puntillo, Madalina Boitor, Mélanie Bérubé, Jane Topolovec-Vranic, Anne-Sylvie Ramelet, Aaron M Joffe, Melissa Richard-Lalonde, Francis Bernard, David L Streiner
BACKGROUND: The evidence shows that brain-injured patients express behaviours that are related to their level of consciousness (LOC), and different from other patients in the intensive care unit (ICU). Therefore, existing behavioural scales should be revised to enhance their content and validity for use in these patients. OBJECTIVES: The aim was to evaluate the content relevance of behaviours and autonomic responses for pain assessment of brain-injured ICU patients from the perspective of critical care clinicians...
November 13, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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