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Surgical Intensive Care Unit

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https://www.readbyqxmd.com/read/28916848/interleukin-17-as-a-predictor-of-sepsis-in-polytrauma-patients-a-prospective-cohort-study
#1
M Ahmed Ali, E S Mikhael, A Abdelkader, L Mansour, R El Essawy, R El Sayed, A Eladawy, A Mukhtar
Sepsis is one of the most serious complications after major trauma, and may be associated with increased mortality. We sought to determine whether there is an association between serum levels of interleukin-17 (IL-17) at the time of admission to the intensive care unit (ICU) and the development of sepsis. We evaluated 100 adult patients with major trauma admitted to the surgical ICU over a 6-month period. Serum levels of IL-17, IL-6, and TNF-α were determined by enzyme-linked immunosorbent assays (ELISA). The IL-17 rs1974226 genotype was determined by real-time PCR...
September 15, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28914429/a-systematic-review-of-patient-and-caregiver-experiences-with-a-tracheostomy
#2
REVIEW
Ivana Nakarada-Kordic, Niamh Patterson, Jill Wrapson, Stephen D Reay
BACKGROUND: A tracheostomy is a surgically created opening through the anterior neck tissues and the trachea, into which a tube is inserted. Despite its influence on basic human needs such as respiration, communication and nutrition, little is known about the impact of tracheostomy on patients and their caregivers or what could be done to enable better care and quality of life (QoL) for these individuals. OBJECTIVE: The aim of this review was to better understand the current knowledge related to the experience and QoL of adults living with a tracheostomy and their caregivers so as to be able to improve these experiences...
September 15, 2017: Patient
https://www.readbyqxmd.com/read/28913495/improvement-of-recovery-parameters-using-patient-controlled-epidural-analgesia-after-oncological-surgery-a-prospective-randomized-single-center-study
#3
Armeana Olimpia Zgâia, Cosmin Ioan Lisencu, Alexandru Rogobete, Cătălin Vlad, Patriciu Achimaş-Cadariu, Gabriel Lazăr, Maximilian Muntean, Florin Ignat, Vlad Ormindean, Alexandru Irimie
PURPOSE: The aim of this study was to compare patient-controlled epidural analgesia (PCEA) versus conventional opioid intravenous (IV) infusion after gastrointestinal cancer surgery regarding several post-surgery parameters of recovery. METHODS: One hundred and one patients were prospectively randomized to receive either thoracic/lumbar PCEA (PCEA group) or the standard analgesia technique used in our hospital, conventional IV infusion of morphine (IVMO group) after gastrointestinal cancer surgery...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28912916/acute-liver-failure-in-a-patient-travelling-from-asia-the-other-face-of-the-coin-of-infectious-disease
#4
Balen Abdulrahman, Mohamed H Ahmed, John Ramage
We present a case of a 63-year-old male who had travelled from South India to United Kingdom (UK) visiting relatives. He had developed episodes of diarrhea, vomiting and fevers while travelling and on assessment in hospital, mild abdominal distension was noted with rapid deterioration to hypovolemic shock. Initial blood test showed a low platelet count with deranged liver function tests (LFTs). It was noted that during admission to intensive care unit (ICU), blood continued to ooze from a previous surgical laparoscopy wound, central and arterial line access sites...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912909/the-use-of-tranexamic-acid-for-upper-gastrointestinal-bleeding-by-medical-and-surgical-intensivists-a-single-center-experience
#5
Jason Chertoff, Grant Lowther, Hassan Alnuaimat, Ali Ataya
BACKGROUND: Tranexamic acid (TXA) may be beneficial in the management of upper gastrointestinal bleeding (UGIB). We sought to investigate how frequently intensivists at our academic institution use TXA for patients with UGIB, and to investigate whether the utilization rate of TXA differs between surgical and medical intensivists, and provide an updated literature review on the subject. METHODS: We performed a retrospective cohort study of patients admitted for UGIB to the surgical intensive care unit (SICU) and the medical intensive care unit (MICU) at our academic healthcare facility (University of Florida Health - Shands Hospital) from January 1, 2013 to December 31, 2016...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28910303/the-influence-of-analgesic-based-sedation-protocols-on-delirium-and-outcomes-in-critically-ill-patients-a-randomized-controlled-trial
#6
Dan Liu, Jie Lyu, Huiying Zhao, Youzhong An
OBJECTIVE: To investigate the influence of analgesic-based midazolam sedation on delirium and outcomes in critically ill patients and to analyze the risk factors of delirium. DESIGN: Single center, prospective randomized controlled trial. SETTING: A surgical intensive care unit (ICU) in a tertiary care hospital in China. PATIENTS: Mechanically ventilated patients requiring sedation. MEASUREMENTS AND MAIN RESULTS: Patients admitted to the surgical intensive care unit who required sedation and were undergoing mechanical ventilation for longer than 24 hours were randomly divided into three groups: 1) the remifentanil group received remifentanil and midazolam, 2) the fentanyl group received fentanyl and midazolam, and 3) the control group received only midazolam...
2017: PloS One
https://www.readbyqxmd.com/read/28904523/music-listening-among-postoperative-patients-in-the-intensive-care-unit-a-randomized-controlled-trial-with-mixed-methods-analysis
#7
Nancy Ames, Rebecca Shuford, Li Yang, Brad Moriyama, Meredith Frey, Florencia Wilson, Thiruppavai Sundaramurthi, Danelle Gori, Andrew Mannes, Alexandra Ranucci, Deloris Koziol, Gwenyth R Wallen
BACKGROUND: Music listening may reduce the physiological, emotional, and mental effects of distress and anxiety. It is unclear whether music listening may reduce the amount of opioids used for pain management in critical care, postoperative patients or whether music may improve patient experience in the intensive care unit (ICU). METHODS: A total of 41 surgical patients were randomized to either music listening or controlled non-music listening groups on ICU admission...
2017: Integrative Medicine Insights
https://www.readbyqxmd.com/read/28904481/external-validation-of-risk-prediction-scores-for-invasive-candidiasis-in-a-medical-surgical-intensive-care-unit-an-observational-study
#8
Armin Ahmed, Arvind Kumar Baronia, Afzal Azim, Rungmei S K Marak, Reema Yadav, Preeti Sharma, Mohan Gurjar, Banani Poddar, Ratender Kumar Singh
BACKGROUND: The aim of this study was to conduct external validation of risk prediction scores for invasive candidiasis. METHODS: We conducted a prospective observational study in a 12-bedded adult medical/surgical Intensive Care Unit (ICU) to evaluate Candida score >3, colonization index (CI) >0.5, corrected CI >0.4 (CCI), and Ostrosky's clinical prediction rule (CPR). Patients' characteristics and risk factors for invasive candidiasis were noted. Patients were divided into two groups; invasive candidiasis and no-invasive candidiasis...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28903083/delirium-characteristics-and-outcomes-in-medical-and-surgical-lnpatients-a-subgroup-analysis
#9
Sungmin Kim, Jae-Jin Kim, Jooyoung Oh, Jaesub Park, Jin Young Park
PURPOSE: Persistent delirium can negatively affect patients, increase healthcare costs, and extend the length of hospital stays. This investigation was undertaken to explore associations between patient characteristics and delirium outcomes. MATERIALS AND METHODS: Intensive care unit (ICU) and medical and surgical ward inpatients for whom psychiatric consultation was requested for delirium were included in this study. Delirium screening and ongoing assessments were conducted using the Confusion Assessment Method for ICU patients...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28902700/effectiveness-of-collaboration-between-emergency-department-and-intensive-care-unit-teams-on-mortality-rates-of-patients-presenting-with-critical-illness-a-systematic-review
#10
Kerchelle McDowald, Svetlana Direktor, Elizabeth A Hynes, Anna Sahadeo, Margaret E Rogers
BACKGROUND: The increasing volume of adult patients with critical illness entering emergency departments (EDs) burdens the resources of EDs worldwide. This subpopulation faces a high risk of mortality because they require specialized care which many EDs are not yet poised to deliver. An element crucial to delivering care and decreasing the mortality of critically ill patients in the ED is expert collaborative practice across disciplines. Several ED and intensive care unit (ICU) collaborative models exist including: emergency department intensive care units (EDICU) and medical emergency teams (MET)...
September 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28902086/operative-stabilization-of-flail-chest-injuries-reduces-mortality-to-that-of-stable-chest-wall-injuries
#11
Niloofar Dehghan, Jeffrey M Mah, Emil H Schemitsch, Aaron Nauth, Milena Vicente, Michael D McKee
OBJECTIVE: To determine the prevalence, management and outcomes of patients with flail chest injuries, compared to patients without flail chest injuries (single rib fractures and multiple rib fractures without a flail segment). DESIGN: Retrospective cohort study SETTING:: Ontario, Canada PARTICIPANTS:: Ontario residents over the age of 16 who had been admitted to hospital with a chest wall injury from 2004 to 2015 were identified using administrative health care databases...
August 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28901717/preliminary-result-with-incisional-negative-pressure-wound-therapy-and-pectoralis-major-muscle-flap-for-median-sternotomy-wound-infection-in-a-high-risk-patient-population
#12
Federico Lo Torto, Ambra Monfrecola, Juste Kaciulyte, Pedro Ciudad, Donato Casella, Diego Ribuffo, Bruno Carlesimo
Deep sternal wound infection (DSWI) represents a dangerous complication that can follow open-heart surgery with median sternotomy access. Muscle flaps, such as monolateral pectoralis major muscle flap (MPMF), represent the main choices for sternal wound coverage and infection control. Negative pressure incision management system has proven to be able to reduce the incidence of these wounds' complications. Prevena(TM) represents one of these incision management systems and we aimed to evaluate its benefits. A total of 78 patients with major risk factors that presented post-sternotomy DSWI following cardiac surgery was selected...
September 13, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28900890/high-level-of-venous-thromboembolism-in-critically-ill-trauma-patients-despite-early-and-well-driven-thromboprophylaxis-protocol
#13
S R Hamada, C Espina, T Guedj, R Buaron, A Harrois, S Figueiredo, J Duranteau
BACKGROUND: Venous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of a mature and early mechanical and pharmacological thromboprophylaxis protocol. METHODS: This was a prospective observational study on a cohort of patients from a surgical intensive care unit of a university level 1 trauma centre...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28900356/humidifiers-for-oxygen-therapy-what-risk-for-reusable-and-disposable-devices
#14
REVIEW
V La Fauci, G B Costa, A Facciolà, A Conti, R Riso, R Squeri
INTRODUCTION: Nosocomial pneumonia accounts for the vast majority of healthcare-associated infections (HAI). Although numerous medical devices have been discussed as potential vehicles for microorganisms, very little is known about the role played by oxygen humidifiers as potential sources of nosocomial pathogens. The purpose of this research was to evaluate the safety of the reuse of humidifiers by analysing the rate of microbial contamination in reusable and disposable oxygen humidifiers used during therapy, and then discuss their potential role in the transmission of respiratory pathogens...
June 2017: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/28895709/recombinant-tissue-plasminogen-activator-treatment-for-intracardiac-vegetation-in-a-very-low-birth-weight-infant
#15
Abdurrahman A Ozdemir
Developing treatment options have resulted in prolonged admission and increased bacterial and fungal nosocomial infections as well as improved survival in neonatal intensive care unit. Invasive fungal infections in newborns are associated with significant morbidity and mortality and can cause endorgan dissemination such as endocarditis, endophthalmitis, septic arthritis, obstructive nephropathy and meningitis. Endocarditis requires aggressive systemic antifungal therapy and sometimes surgical intervention in neonates...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28894384/technology-that-achieves-the-triple-aim-an-economic-analysis-of-the-brainpath%C3%A2-approach-in-neurosurgery
#16
Sidney P Norton, Evan M Dickerson, Charles G Kulwin, Mitesh V Shah
BACKGROUND: The Triple Aim is defined as: improving the patient experience of care, improving the health of populations, and reducing the per capita cost of health care. The purpose of this analysis was to evaluate the economic value of a new neurosurgical technique, the BrainPath™ approach, for use in patients with subcortical tumors and intracerebral hemorrhage (ICH). METHODS: Inpatient length of stay (LOS) data were collected for ICH and brain tumor surgical patient cases between August 2013 and November 2015...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28892951/outcomes-of-mechanically-ventilated-critically-ill-geriatric-patients-in-intensive-care-unit
#17
Vivek Aggarwal, Rajeshwar Singh, Jung Bahadur Singh, Jps Bawa, Nimish Gaur, Sandeep Kumar, I V Nagesh
INTRODUCTION: Increase in life expectancy across the globe has led to rise in geriatric population. Geriatric population is now living longer and healthier. This rise in geriatric population has also led to increase in the geriatric ailments leading to increased number of geriatric patients requiring intensive care including mechanical ventilation. Data on outcomes of geriatric patients requiring mechanical ventilation from India is scarce. AIM: To study the profile and outcome of geriatric patients more than equal to 60 years requiring mechanical ventilation in Intensive Care Unit (ICU)...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28892669/development-of-a-prediction-model-for-long-term-quality-of-life-in-critically-ill-patients
#18
Sandra Oeyen, Karel Vermeulen, Dominique Benoit, Lieven Annemans, Johan Decruyenaere
PURPOSE: We developed a prediction model for quality of life (QOL) 1 year after intensive care unit (ICU) discharge based upon data available at the first ICU day to improve decision-making. METHODS: The database of a 1-year prospective study concerning long-term outcome and QOL (assessed by EuroQol-5D) in critically ill adult patients consecutively admitted to the ICU of a university hospital was used. Cases with missing data were excluded. Utility indices at baseline (UIb) and at 1 year (UI1y) were surrogates for QOL...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28890524/diagnosis-and-management-of-patients-with-paroxysmal-sympathetic-hyperactivity-following-acute-brain-injuries-using-a-consensus-based-diagnostic-tool-a-single-institutional-case-series
#19
Shigeo Godo, Shigemi Irino, Atsuhiro Nakagawa, Yu Kawazoe, Motoo Fujita, Daisuke Kudo, Ryosuke Nomura, Hiroaki Shimokawa, Shigeki Kushimoto
Paroxysmal sympathetic hyperactivity (PSH) is a distinct syndrome of episodic sympathetic hyperactivities following severe acquired brain injury, characterized by paroxysmal transient fever, tachycardia, hypertension, tachypnea, excessive diaphoresis and specific posturing. PSH remains to be an under-recognized condition with a diagnostic pitfall especially in the intensive care unit (ICU) settings due to the high prevalence of concomitant diseases that mimic PSH. A consensus set of diagnostic criteria named PSH-Assessment Measure (PSH-AM) has been developed recently, which is consisted of two components: a diagnosis likelihood tool derived from clinical characteristics of PSH, and a clinical feature scale assigned to the severity of each sympathetic hyperactivity...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28890286/processes-of-care-in-surgical-patients-who-died-with-hospital-acquired-infections-in-australian-hospitals
#20
Jennifer Allen, Therese Rey-Conde, John B North, Peter Kruger, Wendy J Babidge, Arkadiusz P Wysocki, Robert S Ware, J Lennert Veerman, Guy J Maddern
BACKGROUND: Infection may complicate surgical patients' hospital admission. The effect of hospital-acquired infections (HAIs) on processes of care among surgical patients who died is unknown. AIM: We investigated the effect of HAIs on processes of care in surgical patients who died in-hospital. METHODS: Surgeon-recorded infection data extracted from a national Australian surgical mortality audit (2012-2016) were grouped into HAIs and no infection...
September 7, 2017: Journal of Hospital Infection
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