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https://www.readbyqxmd.com/read/27898439/limiting-sedation-for-patients-with-acute-respiratory-distress-syndrome-time-to-wake-up
#1
Faraaz Ali Shah, Timothy D Girard, Sachin Yende
PURPOSE OF REVIEW: Critically ill patients with acute respiratory distress syndrome (ARDS) may require sedation in their clinical care. The goals of sedation in ARDS patients are to improve patient comfort and tolerance of supportive and therapeutic measures without contributing to adverse outcomes. This review discusses the current evidence for sedation management in patients with ARDS. RECENT FINDINGS: Deep sedation strategies should be avoided in the care of patients with ARDS because deep sedation has been associated with increased time on mechanical ventilation, longer ICU and hospital length of stay, and higher mortality in critically ill patients...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27864615/the-effects-of-active-mobilisation-and-rehabilitation-in-icu-on-mortality-and-function-a-systematic-review
#2
REVIEW
Claire J Tipping, Meg Harrold, Anne Holland, Lorena Romero, Travis Nisbet, Carol L Hodgson
PURPOSE: Early active mobilisation and rehabilitation in the intensive care unit (ICU) is being used to prevent the long-term functional consequences of critical illness. This review aimed to determine the effect of active mobilisation and rehabilitation in the ICU on mortality, function, mobility, muscle strength, quality of life, days alive and out of hospital to 180 days, ICU and hospital lengths of stay, duration of mechanical ventilation and discharge destination, linking outcomes with the World Health Organization International Classification of Function Framework...
November 18, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27861180/improving-hospital-survival-and-reducing-brain-dysfunction-at-seven-california-community-hospitals-implementing-pad-guidelines-via-the-abcdef-bundle-in-6-064-patients
#3
Mary Ann Barnes-Daly, Gary Phillips, E Wesley Ely
OBJECTIVES: To track compliance by an interprofessional team with the Awakening and Breathing Coordination, Choice of drugs, Delirium monitoring and management, Early mobility, and Family engagement (ABCDEF) bundle in implementing the Pain, Agitation, and Delirium guidelines. The aim was to study the association between ABCDEF bundle compliance and outcomes including hospital survival and delirium-free and coma-free days in community hospitals. DESIGN: A prospective cohort quality improvement initiative involving ICU patients...
November 17, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850909/1273-implementing-an-early-mobility-program-in-a-pediatric-intensive-care-unit
#4
Kristina Betters, David Farthing, Stephanie Sparacino, Lauren Perrino, Tricia Easley, Hartley Turman, Brittany Griego, Mary DeAlmeida
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850844/1208-icu-delirium-adversely-impacts-early-mobilization-in-mechanically-ventilated-cancer-patients
#5
Steven Hsu, Louis Voigt, Amanda Weeks, Claudine Campbell, Maryann Herklotz, Natalie Kostelecky, Stephen Pastores, Neil Halpern
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850821/1185-implementing-and-early-mobility-program-in-a-multisystem-icu-a-multidisciplinary-team-approach
#6
Charles Hunley, Jamie Dyson, Matthew Burkhalter, Nicole Hawkins, Greta Rucks, Erin Jones, Katrina Michlik, Crystal Gross
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850772/1135-early-progressive-mobility-protocol-implementation-in-the-icu-medical-and-fiscal-benefits
#7
Lauren Jones, Charles Brudney, Suraj Yalamuri
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850760/1123-the-impact-of-early-mobilization-in-the-icu
#8
Hersh Shah, Jill Wing, Nirav Mistry, Fariborz Rezai, Kristin Fless, Paul Yodice, Vagram Ovnanian, Sungyub Lew
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850463/825-pediatric-intensive-care-unit-early-mobilization-and-impact-on-parent-stress
#9
Blair Colwell, Erin Olufs, Cydni Williams, Katharine Zuckerman, Serena Kelly, Laura Ibsen
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27836209/-extracorporeal-co2-removal-as-life-support-system-for-a-severe-organizing-pneumonia
#10
G Rival, O Millet, G Capellier
INTRODUCTION: Acute lung injuries are usually found in intensive care unit. The diffuse alveolar damage (DAD) is the associated histological pattern and the most severe end-stage of the disease. Organizing pneumonia (OP), for which corticosteroids are the reference therapy, can mimic DAD. While postponing the response to treatment, to limit mechanical ventilation side effects, extracorporeal membrane oxygene can be proposed. We present a case of a severe OP for which extracorporeal CO2 removal (ECCO2R) is used as a bridge to recovery under corticosteroid therapy...
November 8, 2016: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/27802955/effect-of-abcde-bundle-implementation-on-prevalence-of-delirium-in-intensive-care-unit-patients
#11
Mandy Bounds, Stacey Kram, Karen Gabel Speroni, Kim Brice, Mary Anne Luschinski, Stephanie Harte, Marlon G Daniel
BACKGROUND: The ABCDE bundle incorporates multidisciplinary measures to improve and/or preserve patients' physical, functional, and neurocognitive status through awakening and breathing coordination, delirium prevention and management, and early physical mobility. OBJECTIVES: To quantify the prevalence and duration of delirium in patients in the intensive care unit (ICU) before and after implementation of the ABCDE bundle. METHODS: Delirium prevalence was defined as the percentage of patients who had at least 1 positive delirium score on the Intensive Care Delirium Screening Checklist (ICDSC) during the ICU stay; delirium duration was the number of days during the ICU stay that a positive ICDSC score was noted...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27771274/continuous-positive-airway-pressure-versus-oxygen-therapy-in-the-cardiac-surgical-ward-a-randomized-trial
#12
Luigi Olper, Elena Bignami, Ambra L Di Prima, Santina Albini, Simona Nascimbene, Luca Cabrini, Giovanni Landoni, Ottavio Alfieri
BACKGROUND: Noninvasive ventilation (NIV) is a common technique to manage patients with acute respiratory failure in the intensive care unit. However, use of NIV in general wards is less well described. The authors' aim was to demonstrate efficacy of NIV, applied in a cardiac surgery ward, in improving oxygenation in patients who developed hypoxemic acute respiratory failure after being discharged from the intensive care unit. DESIGN: Randomized, open-label trial...
August 10, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27749438/interprofessional-perspectives-on-abcde-bundle-implementation-a-focus-group-study
#13
Leanne M Boehm, Eduard E Vasilevskis, Lorraine C Mion
BACKGROUND: The ABCDE bundle is a multifaceted, interprofessional intervention that is associated with reduced ventilator and delirium days as well as increased likelihood of mobility in intensive care. OBJECTIVES: The aim of this study is to describe organizational domains that contribute to variation in ABCDE bundle implementation as reported by intensive care unit providers and to examine the capability of a conceptual framework for identifying variation in ABCDE bundle implementation...
November 2016: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27749432/the-abcde-bundle-a-survey-of-nurses-knowledge-and-attitudes-in-the-intensive-care-units-of-a-national-teaching-hospital-in-italy
#14
Floriana Pinto, Gianni Biancofiore
BACKGROUND: The ABCDE (Awakening and Breathing coordination of daily sedation and ventilator removal trials; Choice of sedative or analgesic exposure; Delirium monitoring and management; and Early mobility and exercise) bundle is a multidisciplinary set of evidence-based practices for improving patient outcomes in the intensive care unit. Nurses are critical to all the bundle's requirements. Therefore, understanding their knowledge, attitudes, and perception of the different bundle's components might help for an easier implementation into everyday clinical practice...
November 2016: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27745753/the-sara-combilizer-%C3%A2-as-an-early-mobilisation-aid-for-critically-ill-patients-a-prospective-before-and-after-study
#15
David McWilliams, Gemma Atkins, James Hodson, Catherine Snelson
BACKGROUND: Early mobility within the ICU is associated with a number of positive outcomes including reductions in ICU and hospital length of stay and better functional recovery. The exact definition of 'early' mobility is still not defined, with the actual ability to mobilise limited by a number of perceived factors. The Sara Combilizer is a combined tilt table and stretcher chair, which allows passive transfer of patients out of bed. This study aimed to assess whether the introduction of the Sara Combilizer reduced time taken to first mobilise for patients mechanically ventilated for at least five days and at risk of ICU acquired weakness...
October 10, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27730109/early-mobilization-of-critically-ill-adults-a-survey-of-knowledge-perceptions-and-practices-of-canadian-physicians-and-physiotherapists
#16
Karen K Y Koo, Karen Choong, Deborah J Cook, Margaret Herridge, Anastasia Newman, Vincent Lo, Gordon Guyatt, Fran Priestap, Eileen Campbell, Karen E A Burns, FranÇois Lamontagne, Maureen O Meade
BACKGROUND: The promotion of early mobilization following critical illness is tempered by national reports of patient and institutional barriers to this approach. We carried out a survey to assess current knowledge, perceptions and practices of Canadian physicians and physiotherapists with respect to acquired weakness and early mobilization in adults in the intensive care unit (ICU). METHODS: We conducted a cross-sectional, self-administered postal survey among critical care physicians and physiotherapists in all 46 academic ICUs in Canada in 2011-2012...
July 2016: CMAJ Open
https://www.readbyqxmd.com/read/27707496/early-goal-directed-mobilisation-in-the-surgical-intensive-care-unit-a-randomised-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Stefan J Schaller, Matthew Anstey, Manfred Blobner, Thomas Edrich, Stephanie D Grabitz, Ilse Gradwohl-Matis, Markus Heim, Timothy Houle, Tobias Kurth, Nicola Latronico, Jarone Lee, Matthew J Meyer, Thomas Peponis, Daniel Talmor, George C Velmahos, Karen Waak, J Matthias Walz, Ross Zafonte, Matthias Eikermann
BACKGROUND: Immobilisation predicts adverse outcomes in patients in the surgical intensive care unit (SICU). Attempts to mobilise critically ill patients early after surgery are frequently restricted, but we tested whether early mobilisation leads to improved mobility, decreased SICU length of stay, and increased functional independence of patients at hospital discharge. METHODS: We did a multicentre, international, parallel-group, assessor-blinded, randomised controlled trial in SICUs of five university hospitals in Austria (n=1), Germany (n=1), and the USA (n=3)...
October 1, 2016: Lancet
https://www.readbyqxmd.com/read/27661864/point-prevalence-study-of-mobilization-practices-for-acute-respiratory-failure-patients-in-the-united-states
#18
Sarah Elizabeth Jolley, Marc Moss, Dale M Needham, Ellen Caldwell, Peter E Morris, Russell R Miller, Nancy Ringwood, Megan Anders, Karen K Koo, Stephanie E Gundel, Selina M Parry, Catherine L Hough
OBJECTIVE: Early mobility in mechanically ventilated patients is safe, feasible, and may improve functional outcomes. We sought to determine the prevalence and character of mobility for ICU patients with acute respiratory failure in U.S. ICUs. DESIGN: Two-day cross-sectional point prevalence study. SETTING: Forty-two ICUs across 17 Acute Respiratory Distress Syndrome Network hospitals. PATIENTS: Adult patients (≥ 18 yr old) with acute respiratory failure requiring mechanical ventilation...
September 22, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27620874/early-goal-directed-mobility-in-the-icu-something-in-the-way-you-move
#19
COMMENT
Claudia C Dos Santos, Margaret Herridge, Jane Batt
No abstract text is available yet for this article.
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27600938/-algorithms-for-early-mobilization-in-intensive-care-units
#20
P Nydahl, R Dubb, S Filipovic, C Hermes, F Jüttner, A Kaltwasser, S Klarmann, H Mende, S Nessizius, C Rottensteiner
Immobility of patients in intensive care units (ICU) can lead to long-lasting physical and cognitive decline. During the last few years, bundles for rehabilitation were developed, including early mobilization. The German guideline for positioning therapy and mobilization, in general, recommends the development of ICU-specific protocols. The aim of this narrative review is to provide guidance when developing a best practice protocol in one's own field of work. It is recommended to a) implement early mobilization as part of a bundle, including screening and management of patient's awareness, pain, anxiety, stress, delirium and family's presence, b) develop a traffic-light system of specific in- and exclusion criteria in an interprofessional process, c) use checklists to assess risks and preparation of mobilization, d) use the ICU Mobility Scale for targeting and documentation of mobilization, e) use relative safety criteria for hemodynamic and respiratory changes, and Borg Scale for subjective evaluation, f) document and evaluate systematically mobilization levels, barriers, unwanted safety events and other parameters...
September 6, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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