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https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#1
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#2
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#3
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28410275/implementation-of-an-icu-bundle-an-interprofessional-quality-improvement-project-to-enhance-delirium-management-and-monitor-delirium-prevalence-in-a-single-picu
#4
Shari Simone, Sarah Edwards, Allison Lardieri, L Kyle Walker, Ana Lia Graciano, Omayma A Kishk, Jason W Custer
OBJECTIVES: To examine the impact of an ICU bundle on delirium screening and prevalence and describe characteristics of delirium cases. DESIGN: Quality improvement project with prospective observational analysis. SETTING: Nineteen-bed PICU in an urban academic medical center. PATIENTS: All consecutive patients admitted from December 1, 2013, to September 30, 2015. INTERVENTIONS: A multidisciplinary team implemented an ICU bundle consisting of three clinical protocols: delirium, sedation, and early mobilization using the Plan-Do-Study-Act cycles as part of a quality improvement project...
April 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28388372/protein-delivery-in-the-intensive-care-unit-optimal-or-suboptimal
#5
Daren K Heyland, Peter J M Weijs, Jorge A Coss-Bu, Beth Taylor, Arnold S Kristof, Grant E O'Keefe, Robert G Martindale
Emerging evidence suggests that exogenous protein/amino acid supplementation has the potential to improve the recovery of critically ill patients. After a careful review of the published evidence, experts have concluded that critically ill patients should receive up to 2.0-2.5 g/kg/d of protein. Despite this, however, recent review of current International Nutrition Survey data suggests that protein in critically ill patients is underprescribed and grossly underdelivered. Furthermore, the survey suggests that most of protein administration comes from enteral nutrition (EN) despite the availability of products and protocols that enhance the delivery of protein/amino acids in the intensive care unit (ICU) setting...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28355933/interprofessional-survey-of-perceived-barriers-and-facilitators-to-early-mobilization-of-critically-ill-patients-in-montreal-canada
#6
David E Anekwe, Karen Kin-Yue Koo, Michel de Marchie, Peter Goldberg, Dev Jayaraman, Jadranka Spahija
OBJECTIVE: Early mobilization is safe, feasible, and associated with better outcomes in patients with critical illness. However, barriers to mobilization in clinical practice still exist. The objective of this study was to assess the knowledge and practice patterns of intensive care unit (ICU) clinicians, as well as the barriers and facilitators to early mobilization. DESIGN: Cross-sectional survey. SETTING: Intensive care units of 3 university-affiliated hospitals in Montreal, Canada...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#7
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 23, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28289812/the-icm-research-agenda-on-intensive-care-unit-acquired-weakness
#8
Nicola Latronico, Margaret Herridge, Ramona O Hopkins, Derek Angus, Nicholas Hart, Greet Hermans, Theodore Iwashyna, Yaseen Arabi, Giuseppe Citerio, E Wesley Ely, Jesse Hall, Sangeeta Mehta, Kathleen Puntillo, Johannes Van den Hoeven, Hannah Wunsch, Deborah Cook, Claudia Dos Santos, Gordon Rubenfeld, Jean-Louis Vincent, Greet Van den Berghe, Elie Azoulay, Dale M Needham
We present areas of uncertainty concerning intensive care unit-acquired weakness (ICUAW) and identify areas for future research. Age, pre-ICU functional and cognitive state, concurrent illness, frailty, and health trajectories impact outcomes and should be assessed to stratify patients. In the ICU, early assessment of limb and diaphragm muscle strength and function using nonvolitional tests may be useful, but comparison with established methods of global and specific muscle strength and physical function and determination of their reliability and normal values would be important to advance these techniques...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28283324/early-mobilization-why-what-for-and-how
#9
A R Miranda Rocha, B P Martinez, V Z Maldaner da Silva, L A Forgiarini Junior
Early mobilization strategies in the intensive care unit may result in the prevention and reduction of polyneuromyopathy in the critical patient, improved quality of life, shortened ICU and hospital stay, and lesser mortality during hospitalization. However, it is well known that factors such as the protocol used, the population included in the studies, the timing of the strategy, the severity of the patients and different barriers directly influence the outcomes. This study examines the main protocols described in the literature and their associated results...
March 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28261491/design-of-smart-neonatal-health-monitoring-system-using-smcc
#10
Debashis De, Anwesha Mukherjee, Arkaprabha Sau, Ishita Bhakta
Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required...
February 2017: Healthcare Technology Letters
https://www.readbyqxmd.com/read/28231030/safety-of-patient-mobilization-and-rehabilitation-in-the-icu-systematic-review-with-meta-analysis
#11
Peter Nydahl, Thiti Sricharoenchai, Saurabh Chandra, Firuzan Sari Kundt, Minxuan Huang, Magdalena Fischill, Dale M Needham
BACKGROUND: Early mobilization and rehabilitation of patients in intensive care units (ICU) may improve physical function, and reduce the duration of delirium, mechanical ventilation and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. OBJECTIVE: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes (ETT), removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes and desaturation...
February 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#12
Megan Moyer, Bethany Young, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
February 23, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28222805/use-of-activity-tracking-in-major-visceral-surgery-the-enhanced-perioperative-mobilization-epm-trial-study-protocol-for-a-randomized-controlled-trial
#13
Steffen Wolk, Theresa Meißner, Sebastian Linke, Benjamin Müssle, Ann Wierick, Andreas Bogner, Dorothée Sturm, Nuh N Rahbari, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: Enhanced recovery after surgery (ERAS) programs are aimed at minimizing postoperative stress and accelerating postoperative recovery by implementing multiple perioperative principles. "Early mobilization" is one such principle, but the quality of assessment and monitoring is poor, and evidence of improved outcome is lacking. Activity trackers allow precise monitoring and automatic feedback to the patients to enhance their motivation for early mobilization. The aim of the study is to monitor and increase the postoperative mobilization of patients by giving them continuous automatic feedback in the form of a step count using activity-tracking wristbands...
February 21, 2017: Trials
https://www.readbyqxmd.com/read/28197216/introducing-the-comprehensive-unit-based-safety-program-for-mechanically-ventilated-patients-in-saudi-arabian-intensive-care-units
#14
Raymond M Khan, Maha Aljuaid, Hanan Aqeel, Mohammed M Aboudeif, Shaimaa Elatwey, Rajeh Shehab, Yasser Mandourah, Khalid Maghrabi, Hassan Hawa, Imran Khalid, Ismael Qushmaq, Asad Latif, Bickey Chang, Sean M Berenholtz, Sultan Tayar, Khloud Al-Harbi, Amin Yousef, Anas A Amr, Yaseen M Arabi
Over the past decade, there have been major improvements to the care of mechanically ventilated patients (MVPs). Earlier initiatives used the concept of ventilator care bundles (sets of interventions), with a primary focus on reducing ventilator-associated pneumonia. However, recent evidence has led to a more comprehensive approach: The ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization). The approach of the Comprehensive Unit-based Safety Program (CUSP) was developed by patient safety researchers at the Johns Hopkins Hospital and is supported by the Agency for Healthcare Research and Quality to improve local safety cultures and to learn from defects by utilizing a validated structured framework...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28190550/overcoming-nursing-barriers-to-intensive-care-unit-early-mobilisation-a-quality-improvement-project
#15
Oluwatobi O Hunter, Elisabeth L George, Dianxu Ren, Douglas Morgan, Margaret Rosenzweig, Patricia Klinefelter Tuite
OBJECTIVES: To increase adherence with intensive care unit mobility by developing and implementing a mobility training program that addresses nursing barriers to early mobilisation. DESIGN: An intensive care unit mobility training program was developed, implemented and evaluated with a pre-test, immediate post-test and eight-week post-test. Patient mobility was tracked before and after training. SETTING: A ten bed cardiac intensive care unit...
February 9, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28190430/delirium-in-critically-ill-patients
#16
REVIEW
A J C Slooter, R R Van De Leur, I J Zaal
Delirium is common in critically ill patients and associated with increased length of stay in the intensive care unit (ICU) and long-term cognitive impairment. The pathophysiology of delirium has been explained by neuroinflammation, an aberrant stress response, neurotransmitter imbalances, and neuronal network alterations. Delirium develops mostly in vulnerable patients (e.g., elderly and cognitively impaired) in the throes of a critical illness. Delirium is by definition due to an underlying condition and can be identified at ICU admission using prediction models...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28179250/impact-of-pharmacist-management-of-pain-agitation-and-delirium-in-the-intensive-care-unit-through-participation-in-multidisciplinary-bundle-rounds
#17
Patricia Louzon, Heath Jennings, Mahmood Ali, Marijo Kraisinger
PURPOSE: A two-phase program to increase pharmacist involvement in management of pain, agitation and delirium (PAD) at a large community teaching hospital is described. SUMMARY: Florida Orlando Hospital implemented a two-phase initiative to decrease intensive care unit (ICU) length of stay (LOS), ventilator use, sedative use, and hospital expenditures while advancing pharmacists' scope of practice. Phase 1 of the initiative involved a pilot project to evaluate pharmacist management of sedative therapy for mechanically ventilated patients...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28035878/are-no-or-late-mobility-practices-taken-in-intensive-care-units-without-an-early-mobility-protocol
#18
Shunsuke Taito, Hideto Yasuda
No abstract text is available yet for this article.
January 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28035874/reply-are-no-or-late-mobility-practices-taken-in-intensive-care-units-without-an-early-mobility-protocol
#19
Rita N Bakhru, William D Schweickert
No abstract text is available yet for this article.
January 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28018320/single-molecule-sequencing-pacbio-of-the-staphylococcus-capitis-nrcs-a-clone-reveals-the-basis-of-multidrug-resistance-and-adaptation-to-the-neonatal-intensive-care-unit-environment
#20
Patrícia Martins Simões, Hajar Lemriss, Yann Dumont, Sanâa Lemriss, Jean-Philippe Rasigade, Sophie Assant-Trouillet, Azeddine Ibrahimi, Saâd El Kabbaj, Marine Butin, Frédéric Laurent
The multi-resistant Staphylococcus capitis clone NRCS-A has recently been described as a major pathogen causing nosocomial, late-onset sepsis (LOS) in preterm neonates worldwide. NRCS-A representatives exhibit an atypical antibiotic resistance profile. Here, the complete closed genome (chromosomal and plasmid sequences) of NRCS-A prototype strain CR01 and the draft genomes of three other clinical NRCS-A strains from Australia, Belgium and the United Kingdom are annotated and compared to available non-NRCS-A S...
2016: Frontiers in Microbiology
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