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https://www.readbyqxmd.com/read/28102521/clinical-assessment-and-train-of-four-measurements-in-critically-ill-patients-treated-with-recommended-doses-of-cisatracurium-or-atracurium-for-neuromuscular-blockade-a-prospective-descriptive-study
#1
Pierre Bouju, Jean-Marc Tadié, Nicolas Barbarot, Julien Letheulle, Fabrice Uhel, Pierre Fillatre, Guillaume Grillet, Angélique Goepp, Yves Le Tulzo, Arnaud Gacouin
BACKGROUND: Despite few studies, a monitoring of a neuromuscular blockade with a train of four (TOF) is recommended in intensive care unit (ICU). Our objective was to compare the results of ulnar and facial TOF measurements with an overall clinical assessment for neuromuscular blockade in ICU patients treated with recommended doses of atracurium or cisatracurium, including patients with acute respiratory disease syndrome (ARDS). METHODS: We prospectively included in two ICUs 119 patients, 94 with ARDS, who required a neuromuscular blockade for more than 24 h...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#2
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28101669/outcomes-and-trends-of-peripartum-maternal-admission-to-the-intensive-care-unit
#3
Alex Farr, Agnes Lenz-Gebhart, Sabrina Einig, Clemens Ortner, Iris Holzer, Marie Elhenicky, Peter W Husslein, Rainer Lehner
BACKGROUND: The number of pregnant women with severe comorbidities is increasing. The aim of the present study was to analyze outcomes and determine trends in women who required peripartum admission to the intensive care unit (ICU). METHODS: In this retrospective study, we identified all women who were admitted to the ICU between the second trimester of pregnancy and 6 weeks postpartum. Women with ICU admission between 2011 and 2014 were assigned to the study group, whereas those admitted between 1996 and 2003 were assigned to the historical group...
January 18, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28101565/use-of-neuromuscular-electrical-stimulation-to-preserve-the-thickness-of-abdominal-and-chest-muscles-of-critically-ill-patients-a-randomized-clinical-trial
#4
Ana M Dall' Acqua, Amanda Sachetti, Laura J Santos, Fernando A Lemos, Tanara Bianchi, Wagner S Naue, Alexandre S Dias, Graciele Sbruzzi, Silvia R R Vieira
OBJECTIVE: To evaluate and compare the effects of neuromuscular electrical stimulation combined with conventional physical therapy on muscle thickness in critically ill patients. DESIGN: Double-blind, randomized controlled trial. PATIENTS: Twenty-five patients participated in the study. METHODS: Patients on mechanical ventilation for 24-48 h were randomized to an intervention group (neuromuscular electrical stimulation + conventional physical therapy) or a conventional group (sham neuromuscular electrical stimulation + conventional physical therapy)...
January 19, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28101364/hemodynamic-effects-of-electrical-muscle-stimulation-in-the-prophylaxis-of-deep-vein-thrombosis-for-intensive-care-unit-patients-a-randomized-trial
#5
Masahiro Ojima, Ryosuke Takegawa, Tomoya Hirose, Mitsuo Ohnishi, Tadahiko Shiozaki, Takeshi Shimazu
BACKGROUND: Deep vein thrombosis (DVT) is a major complication in critical care. There are various methods of prophylaxis, but none of them fully prevent DVT, and each method has adverse effects. Electrical muscle stimulation (EMS) could be a new effective approach to prevent DVT in intensive care unit (ICU) patients. We hypothesized that EMS increases the venous flow of the lower limbs and has a prophylactic effect against the formation of DVT. METHODS: This study included 26 patients admitted to a single ICU...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#6
Aleksejs Kaminskis, Aina Kratovska, Sanita Ponomarjova, Anna Tolstova, Maksims Mukans, Solvita Stabiņa, Raivis Gailums, Andrejs Bernšteins, Patricija Ivanova, Viesturs Boka, Guntars Pupelis
BACKGROUND: Transarterial embolization (TAE) is a therapeutic option for patients with a high risk of recurrent bleeding after endoscopic haemostasis. The aim of our prospective study was a preliminary assessment of the safety, efficacy, and clinical outcomes following preventive TAE in patients with non-variceal acute upper gastrointestinal bleeding (NVUGIB) with a high risk of recurrent bleeding after endoscopic haemostasis. METHODS: Preventive visceral angiography and TAE were performed after endoscopic haemostasis on patients with NVUGIB who were at a high risk of recurrent bleeding (PE+ group)...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28100942/potential-benefits-of-rib-fracture-fixation-in-patients-with-flail-chest-and-multiple-non-flail-rib-fractures
#7
Meiguang Qiu, Zhanjun Shi, Jun Xiao, Xuming Zhang, Shishui Ling, Hao Ling
The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest (n = 38) and multiple non-flail rib fracture groups (n = 124)...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100714/the-dynamics-of-the-pulmonary-microbiome-during-mechanical-ventilation-in-the-intensive-care-unit-and-the-association-with-occurrence-of-pneumonia
#8
Tetyana Zakharkina, Ignacio Martin-Loeches, Sébastien Matamoros, Pedro Povoa, Antoni Torres, Janine B Kastelijn, Jorrit J Hofstra, B de Wever, Menno de Jong, Marcus J Schultz, Peter J Sterk, Antonio Artigas, Lieuwe D J Bos
RATIONALE: Ventilator-associated pneumonia (VAP) is the most common nosocomial infections in patients admitted to the ICU. The adapted island model predicts several changes in the respiratory microbiome during intubation and mechanical ventilation. OBJECTIVES: We hypothesised that mechanical ventilation and antibiotic administration decrease the diversity of the respiratory microbiome and that these changes are more profound in patients who develop VAP. METHODS: Intubated and mechanically ventilated ICU-patients were included...
January 18, 2017: Thorax
https://www.readbyqxmd.com/read/28100110/mortality-in-patients-with-septic-shock-by-multidrug-resistant-bacteria
#9
Stefano Busani, Giulia Serafini, Elena Mantovani, Claudia Venturelli, Maddalena Giannella, Pierluigi Viale, Cristina Mussini, Andrea Cossarizza, Massimo Girardis
BACKGROUND: Patients with septic shock by multidrug resistant (MDR) microorganism maybe considered a specific population of critical patients at very high risk of death in whom the effects of standard sepsis treatment has never been assessed. The objective of this retrospective analysis was to evaluate the risk factors for 30-day mortality and the impact of sepsis management in patients with septic shock caused by MDR bacteria. METHODS: Patients with septic shock by MDR bacteria admitted to the mixed intensive care unit (ICU) of Modena University Hospital during a 6-year period were studied...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28099693/factors-associated-with-maternal-mortality-among-patients-meeting-criteria-of-severe-maternal-morbidity-and-near-miss
#10
Hesly M P Lima, Francisco Herlânio C Carvalho, Francisco Edson L Feitosa, George C Nunes
OBJECTIVE: To evaluate factors associated with maternal death among women experiencing life-threatening conditions during pregnancy, childbirth, or within 42 days of termination of pregnancy. METHODS: A secondary analysis of data prospectively collected in a Brazilian multicenter cross-sectional study between July 2009 and June 2010 was conducted. Women were identified who delivered at a hospital in Ceará and who had potentially life-threatening conditions. Stepwise logistic regression was used to identify factors associated with maternal death...
December 7, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099689/effectiveness-and-safety-of-procalcitonin-evaluation-for-reducing-mortality-in-adults-with-sepsis-severe-sepsis-or-septic-shock
#11
REVIEW
Brenda Ng Andriolo, Regis B Andriolo, Reinaldo Salomão, Álvaro N Atallah
BACKGROUND: Serum procalcitonin (PCT) evaluation has been proposed for early diagnosis and accurate staging and to guide decisions regarding patients with sepsis, severe sepsis and septic shock, with possible reduction in mortality. OBJECTIVES: To assess the effectiveness and safety of serum PCT evaluation for reducing mortality and duration of antimicrobial therapy in adults with sepsis, severe sepsis or septic shock. SEARCH METHODS: We searched the Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE (1950 to July 2015); Embase (Ovid SP, 1980 to July 2015); Latin American Caribbean Health Sciences Literature (LILACS via BIREME, 1982 to July 2015); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO host, 1982 to July 2015), and trial registers (ISRCTN registry, ClinicalTrials...
January 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28099387/use-of-an-evidence-based-algorithm-for-patients-with-traumatic-hemothorax-reduces-need-for-additional-interventions
#12
Bradley M Dennis, Stephen P Gondek, Richard A Guyer, Susan E Hamblin, Oliver L Gunter, Oscar D Guillamondegui
BACKGROUND: Concerted management of the traumatic hemothorax is ill-defined. Surgical management of specific hemothoraces may be beneficial. A comprehensive strategy to delineate appropriate patients for additional procedures does not exist. We developed an evidence-based algorithm for hemothorax management. We hypothesize the use of this algorithm will decrease additional interventions. METHODS: A pre/post study was performed on all patients admitted to our trauma service with traumatic hemothorax from August 2010 to September 2013...
January 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099379/systemic-intraoperative-anticoagulation-during-arterial-injury-repair-implications-for-patency-and-bleeding
#13
Zoё Maher, Brian Frank, Noelle Saillant, Anna Goldenberg, Elizabeth Dauer, Joshua P Hazelton, Andrea Lubitz, Huaqing Zhao, Jeremy W Cannon, Mark J Seamon
BACKGROUND: The role of systemic intraoperative anticoagulation (SIAC) during surgical repair of major arterial injuries is controversial. Any potential improvement in arterial patency must be weighed against the risk of hemorrhage in these critically injured patients. We hypothesized that SIAC would increase arterial patency without increasing bleeding complications. METHODS: We conducted a multi-institution, retrospective cohort study of trauma patients with major vascular injury from 2005-2013 in 3 level I centers...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099062/rectal-carriage-of-extended-spectrum-beta-lactamase-and-carbapenemase-producing-gram-negative-bacilli-in-intensive-care-units-in-tunisia
#14
Samia Hammami, Chaima Dahdeh, Kelthoum Mamlouk, Sana Ferjeni, Elaa Maamar, Zeineb Hamzaoui, Mabrouka Saidani, Salma Ghedira, Mohamed Houissa, Amin Slim, Ilhem Boutiba-Ben Boubaker
This study was conducted to evaluate the rate of fecal carriage of Gram-negative bacilli (GNB) resistant to third-generation cephalosporins (third GC) in patients hospitalized in the intensive care unit (ICU) of Charles Nicolle Hospital of Tunis and to identify the enzymatic mechanisms involved. From February to April 2014, rectal swabs were collected from all patients (n = 38) at admission and once weekly thereafter to identify acquisition. They were cultured on desoxycholate-lactose-agar plates supplemented with cefotaxime (2 mg/L)...
January 18, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/28099053/palliative-care-involvement-is-associated-with-less-intensive-end-of-life-care-in-adolescent-and-young-adult-oncology-patients
#15
Jennifer M Snaman, Erica C Kaye, Jessie J Lu, April Sykes, Justin N Baker
BACKGROUND: Adolescent and young adult oncology (AYAO) patients often receive intensive medical care and experience significant symptoms at the end of life (EOL). OBJECTIVE: This study aimed to describe the characteristics of AYAO patients aged 15-26 years who died as inpatients in a hospital and to compare the illness and EOL experiences of AYAO patients who did and did not receive palliative care (PC). DESIGN AND SETTING: A standardized data extraction tool was used to collect information about demographics, treatment, terminal characteristics, and symptoms during the last month of life (LMOL) for 69 AYAO patients who died while hospitalized between 2008 and 2014...
January 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28098643/are-icu-length-of-stay-predictions-worthwhile
#16
Andrew A Kramer
No abstract text is available yet for this article.
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098636/icu-rounds-what-we-ve-got-here-is-failure-to-communicate
#17
Noa Segall, Elliott Bennett-Guerrero
No abstract text is available yet for this article.
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098632/palliative-care-in-the-icu-and-the-role-for-physician-assisted-dying-or-lack-thereof
#18
J Randall Curtis, Mark R Tonelli
No abstract text is available yet for this article.
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098631/after-the-fall-the-tapestry-of-disturbance-and-recovery
#19
Nalini M Nadkarni
On July 3, 2015, Nalini Nadkarni, a world-renowned ecologist who had been studying the biologic processes of ecosystem disturbance and recovery, sustained a catastrophic 50-foot free-fall from the top of the rainforest canopy to the forest floor at her remote field research site. She lost consciousness in shock and sustained life-threatening injuries. Her accompanying students hiked out, radio-called 911, and the Harborview Medical Center (Seattle) Medivac team arrived 4 hours later to rescue her. Her prognosis was extremely grim; her family gathered in anticipation of her death as she underwent four operations during her 10 days in the ICU...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#20
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
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