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Surgical Intensive Care Unit

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https://www.readbyqxmd.com/read/29161170/examining-the-implementation-of-collaborative-competencies-in-a-critical-care-setting-key-challenges-for-enacting-competency-based-education
#1
Joanne Goldman, Simon Kitto, Scott Reeves
Interprofessional collaboration is recognised as an important factor in improving patient care in intensive care units (ICUs). Competency frameworks, and more specifically interprofessional competency frameworks, are a key strategy being used to support the development of attitudes, knowledge, skills, and behaviours needed for an interprofessional approach to care. However, evidence for the application of competencies is limited. This study aimed to extend our empirically based understanding of the significance of interprofessional competencies to actual clinical practice in an ICU...
November 21, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29160481/stimulus-response-time-to-alarms-of-the-intra-aortic-balloon-pump-safe-care-practices
#2
Andrezza Serpa Franco, Adriana Carla Bridi, Monica de Almeida Karam, Ana Paula Amorim Moreira, Karla Biancha Silva de Andrade, Roberto Carlos Lyra da Silva
OBJECTIVE: To characterize the sound alarms of the Intra-Aortic Balloon Pump (IABP) during aortic counterpulsation therapy; to measure the stimulus-response time of the team to these; and to discuss the implications of increasing this time for patient safety from the alarm fatigue perspective. METHOD: This is an observational and descriptive study with quantitative and qualitative approach, case study type, carried out in a Cardiac Surgical Intensive Care Unit. RESULTS: The most audible IABP alarm was the one of high priority increased-reduced diastolic blood pressure...
November 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29159605/outcomes-of-emergency-laparotomy-el-care-protocol-at-tertiary-care-center-from-low-middle-income-country-lmic
#3
Nitin Vashistha, Dinesh Singhal, Sandeep Budhiraja, Bharat Aggarwal, Raj Tobin, Kamal Fotedar
BACKGROUND: Emergency laparotomy mortality ranges between 10 and 20% in best of Western healthcare systems and is currently a major focus for quality improvement programs. In contrast, emergency surgery scenario in LMIC is largely undefined, often neglected and complex (large burden of diseases but only limited capacity for adequate treatment). We evaluated the efficacy of 'EL care protocol' aimed at cost-effective optimal utilization of best available local expertise and infrastructure...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29154953/correlation-between-cefepime-utilization-and-pseudomonas-aeruginosa-resistance-rate-to-beta-lactams-and-carbapenems-in-patients-with-healthcare-associated-infections
#4
Zorana M Djordjevic, Marko M Folic, Slobodan M Jankovic
OBJECTIVES: There is direct link between overutilization or abuse of antibiotics and P.aeruginosa resistance rate, but other factors could influence the resistance rate, too. The study aim was to observe changes of P.aeruginosa resistance rate in patients with hospital acquired infections (HAIs) after a period of cefepime unavailability in an intensive care unit (ICU). METHODS: The study was designed as retrospective observational analysis of trends in utilization of antibiotics and density of resistance to antibiotics...
November 14, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29153960/barriers-and-facilitators-to-the-implementation-of-an-evidence-based-electronic-minimum-dataset-for-nursing-team-leader-handover-a-descriptive-survey
#5
Amy J Spooner, Leanne M Aitken, Wendy Chaboyer
INTRODUCTION: There is widespread use of clinical information systems in intensive care units however, the evidence to support electronic handover is limited. OBJECTIVES: The study aim was to assess the barriers and facilitators to use of an electronic minimum dataset for nursing team leader shift-to-shift handover in the intensive care unit prior to its implementation. METHODS: The study was conducted in a 21-bed medical/surgical intensive care unit, specialising in cardiothoracic surgery at a tertiary referral hospital, in Queensland, Australia...
November 15, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29153826/performance-evaluation-of-phase-angle-and-handgrip-strength-in-patients-undergoing-cardiac-surgery-prospective-cohort-study
#6
Taís Kereski da Silva, Ingrid Dalira Schweigert Perry, Janete Salles Brauner, Orlando Carlos Belmonte Weber, Gabriela Corrêa Souza, Sílvia Regina Rios Vieira
BACKGROUND AND AIMS: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), has been interpreted as a cell membrane integrity indicator, while handgrip strength (HGS) has been used as a prognostic indicator in certain clinical situations, such as in cardiac, oncologic patients with renal disease, hemodialysis patients, HIV-positive patients, and liver disease patients. In addition to prognostic scores, body changes due to surgical procedures indicate the importance of measuring muscle function and cell integrity...
November 16, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29153772/effectiveness-and-safety-of-transcatheter-aortic-valve-implantation-for-aortic-stenosis-in-patients-with-porcelain-aorta
#7
Fernando Ramirez-Del Val, Sameer A Hirji, Maroun Yammine, Julius I Ejiofor, Siobhan McGurk, Anthony Norman, Prem Shekar, Sary Aranki, Deepak L Bhatt, Pinak Shah, Lawrence H Cohn, Tsuyoshi Kaneko
Surgical aortic valve replacement (SAVR) in patients with porcelain aorta is considered a high-risk procedure. Hence, transcatheter aortic valve implantation (TAVI) is emerging as the intervention of choice. However, there is a paucity of data directly comparing TAVI with SAVR in patients with porcelain aorta. We compared outcomes of TAVI versus SAVR in high-risk patients with porcelain between March 2012 and June 2015. The TAVI group included 54 patients, whereas 130 SAVR patients with porcelain aorta were identified (operated on between 2004 and 2015)...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29152230/rare-fungal-infectious-agents-a-lurking-enemy
#8
REVIEW
Anna Skiada, Ioannis Pavleas, Maria Drogari-Apiranthitou
In the expanding population of immunocompromised patients and those treated in intensive care units, rare fungal infectious agents have emerged as important pathogens, causing invasive infections associated with high morbidity and mortality. These infections may present either as de novo or as breakthrough invasive infections in high-risk patients with hematologic malignancies receiving prophylactic or empirical antifungal therapy or in patients with central venous catheters. Diagnosis and treatment are challenging...
2017: F1000Research
https://www.readbyqxmd.com/read/29149961/practice-variation-in-the-immediate-postoperative-care-of-pediatric-kidney-transplantation-a-national-survey
#9
S Abu-Sultaneh, M J Hobson, A C Wilson, W C Goggins, M E Nitu, R Lutfi
INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149690/a-modified-montpellier-protocol-for-intubating-intensive-care-unit-patients-is-associated-with-an-increase-in-first-pass-intubation-success-and-fewer-complications
#10
Keith A Corl, Christopher Dado, Ankita Agarwal, Nader Azab, Tim Amass, Sarah J Marks, Mitchell M Levy, Roland C Merchant, Jason Aliotta
BACKGROUND: The Montpellier protocol for intubating patients in the intensive care unit (ICU) is associated with a decrease in intubation-related complications. We sought to determine if implementation of a simplified version of the Montpellier protocol that removed selected components and allowed for a variety of pre-oxygenation modalities increased first-pass intubation success and reduced intubation-related complications. METHODS: A prospective pre/post-comparison of a modified Montpellier protocol in two medical and one medical/surgical/cardiac ICU within a hospital system...
November 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#11
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29147897/vacuum-assisted-wound-closure-with-mesh-mediated-fascial-traction-achieves-better-outcomes-than-vacuum-assisted-wound-closure-alone-a-comparative-study
#12
Giuseppe Salamone, Leo Licari, Giovanni Guercio, Albert Comelli, Mirko Mangiapane, Nicolò Falco, Roberta Tutino, Noemi Bagarella, Sofia Campanella, Calogero Porrello, Roberto Gullo, Gianfranco Cocorullo, Gaspare Gulotta
BACKGROUND: Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur. METHODS: Non-traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients' records were collected from charts and the surgical and intensive care unit (ICU) registries...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142747/clinical-characteristics-of-critically-ill-cancer-patients-who-are-undergoing-isolated-limb-perfusion
#13
Silvio A Ñamendys-Silva, Arturo M Ruiz-Beltran, Mireya Barragán-Dessavre, Andoreni R Bautista-Ocampo, Abelardo Meneses-García, Octavio González-Chon, Angel Herrera-Gómez
The aim of the present study was to investigate the incidence of organ dysfunction, and to describe the clinical characteristics and intensive care unit (ICU) outcomes of critically ill cancer patients who were admitted to an oncological ICU during the isolated limb perfusion post-operative period. The present study was an observational investigation of 42 critically ill cancer patients who were admitted to the ICU of the Instituto Nacional de Cancerología, during the isolated limb perfusion post-operative period, between July 2010 and February 2016...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#14
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137024/effect-of-different-surgical-type-of-coronary-artery-bypass-grafting-on-kidney-injury-a-propensity-score-analysis
#15
Ming-Jen Chan, Cheng-Chia Lee, Shao-Wei Chen, Feng-Chun Tsai, Pyng-Jing Lin, Pei-Chun Fan, Hsiang-Hao Hsu, Ming-Yang Chang, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with a less favorable outcome. Off-pump surgery results in lower kidney dysfunction than conventional on-pump arrest surgery. On-pump arrest surgery results in a lower revascularization rate compared with off-pump surgery. On-pump beating heart (OPBH) CABG combines the advantages of beating heart surgery and cardiopulmonary bypass. This study compared the renal outcomes of 3 cardiac surgical methods. From January 2010 to December 2012, 373 patients who underwent on-pump CABG were enrolled...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136712/-long-term-outcome-and-prognostic-factors-in-pregnant-women-with-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#16
Q T Ou, J K Lu, J Zhang, Y Chen, Q Li, J L Zhang
Objective: To investigate the perinatal outcome, risk factors and long-term outcome of pregnancy complicated with pulmonary arterial hypertension(PAH) and congenital heart diseases (CHD). Methods: Clinical data of 110 pregnant women who were diagnosed as PAH-CHD were retrospectively analyzed in the Department of Obstetrics and Gynecology and Surgical Intensive Care Unit at Beijing Anzhen Hospital from 2004 to 2013. The survival and treatment status were followed up. Results: 110 subjects consisted of 11 mild PAH, 33 moderate and 66 severe ones...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29135100/safety-and-efficacy-of-liver-resections-in-elderly-patients
#17
Georgios C Sotiropoulos, Ioannis D Kostakis, Nikolaos Machairas, Stylianos Kykalos, Gregory Kouraklis
PURPOSE: Elderly patients constitute a special group of surgical candidates due to the frequent coexistence of major comorbidities. We report our experience in performing liver resections in patients aged 75 years or older. METHODS: During a period of 62 months, 154 patients underwent liver resections, out of which 20 were 75 years old or older. Our prospectively maintained database was reviewed regarding patient and tumor characteristics, intraoperative and postoperative data...
September 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29133567/risk-factors-and-outcomes-associated-with-multidrug-resistant-acinetobacter-baumannii-upon-icu-admission
#18
Natalia Blanco, Anthony D Harris, Clare Rock, J Kristie Johnson, Lisa Pineles, Robert A Bonomo, Arjun Srinivasan, Melinda M Pettigrew, Kerri A Thom
Introduction: Multi-drug resistant (MDR) Acinetobacter baumannii, associated with broad-spectrum antibiotic use, is an important nosocomial pathogen associated with morbidity and mortality. This study aimed to investigate the prevalence of MDR A. baumannii perirectal colonization among adult patients at ICU admission over a 5-year period, and to identify risk factors and outcomes associated with colonization.Methods: A retrospective cohort analysis of patients admitted to the medical (MICU) and surgical intensive care units (SICU) at the University of Maryland Medical Center from May 2005 to September 2009 was performed using perirectal surveillance cultures on admission...
November 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29132842/-a-comparison-of-post-surgical-plasma-glucose-levels-in-patients-on-fluids-with-different-glucose-concentrations
#19
Isabel Martínez Carapeto, José Domingo López Castilla, Reyes Fresneda Gutiérrez
OBJECTIVE: To compare plasma glucose levels and incidence of hyperglycaemia in the post-operative period after general surgery using fluids with different glucose. METHODOLOGY: A randomised, open-label, non-blind, clinical trial was conducted on patients admitted to Paediatric Intensive Care Unit after elective surgery. The inclusion criteria were from 6 months to 14 years of age, with a weight greater than 6kg, onset glucose level >60mg/dL, and a signed informed consent, with no oral intake and maintenance intravenous fluid therapy using fluids with 3...
November 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29132626/early-hospital-mortality-prediction-of-intensive-care-unit-patients-using-an-ensemble-learning-approach
#20
Aya Awad, Mohamed Bader-El-Den, James McNicholas, Jim Briggs
BACKGROUND: Mortality prediction of hospitalized patients is an important problem. Over the past few decades, several severity scoring systems and machine learning mortality prediction models have been developed for predicting hospital mortality. By contrast, early mortality prediction for intensive care unit patients remains an open challenge. Most research has focused on severity of illness scoring systems or data mining (DM) models designed for risk estimation at least 24 or 48h after ICU admission...
December 2017: International Journal of Medical Informatics
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