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https://www.readbyqxmd.com/read/28441856/-clinical-value-of-the-early-use-of-ulinastatin-in-patients-with-moderately-severe-or-severe-acute-pancreatitis
#1
J Wang, J Jin, J Huang, D R Li, Y Hao, J D Kong, Z Y Chu, J H Fu, F Huang
Objective: To observe the clinical efficacy and the effects on serum inflammatory factors of early use of ulinastatin in patients with moderately severe or severe acute pancreatitis (MSAP/SAP). Methods: This prospective, randomized, controlled trial was conducted in the First Affiliated Hospital of Soochow University from September 2013 to May 2016. A total of 42 cases were enrolled and assigned into either observation group or conventional treatment group (n=21 each). The conventional treatment group received somatostatin, while the observation group received somatostatin combined with ulinastatin...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28441684/development-of-consensus-based-best-practice-guidelines-for-postoperative-care-following-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#2
Nicholas D Fletcher, Michael P Glotzbecker, Michelle Marks, Peter O Newton
STUDY DESIGN: Delphi process with multiple iterative rounds using a nominal group technique. OBJECTIVE: The aim of this study was to use expert opinion to achieve consensus on various aspects of postoperative care following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Significant variability exists in postoperative care following PSF for AIS, despite a relatively healthy patient population and continuously improving operative techniques...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28441237/noninvasive-ventilation-in-acute-hypoxemic-nonhypercapnic-respiratory-failure-a-systematic-review-and-meta-analysis
#3
Xiu-Ping Xu, Xin-Chang Zhang, Shu-Ling Hu, Jing-Yuan Xu, Jian-Feng Xie, Song-Qiao Liu, Ling Liu, Ying-Zi Huang, Feng-Mei Guo, Yi Yang, Hai-Bo Qiu
OBJECTIVE: To evaluate the effectiveness of noninvasive ventilation in patients with acute hypoxemic nonhypercapnic respiratory failure unrelated to exacerbation of chronic obstructive pulmonary disease and cardiogenic pulmonary edema. DATA SOURCES: PubMed, EMBASE, Cochrane library, Web of Science, and bibliographies of articles were retrieved inception until June 2016. STUDY SELECTION: Randomized controlled trials comparing application of noninvasive ventilation with standard oxygen therapy in adults with acute hypoxemic nonhypercapnic respiratory failure were included...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28441236/the-new-mirus-system-for-short-term-sedation-in-postsurgical-icu-patients
#4
Stefano Romagnoli, Cosimo Chelazzi, Gianluca Villa, Giovanni Zagli, Francesco Benvenuti, Paola Mancinelli, Giulio Arcangeli, Stefano Dugheri, Alessandro Bonari, Lorenzo Tofani, Andrea Belardinelli, A Raffaele De Gaudio
OBJECTIVES: To evaluate the feasibility and safety of the MIRUS system (Pall International, Sarl, Fribourg, Switzerland) for sedation with sevoflurane for postsurgical ICU patients and to evaluate atmospheric pollution during sedation. DESIGN: Prospective interventional study. SETTING: Surgical ICU. February 2016 to December 2016. PATIENTS: Postsurgical patients requiring ICU admission, mechanical ventilation, and sedation...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28441234/validation-of-an-administrative-definition-of-icu-admission-using-revenue-center-codes
#5
Gary E Weissman, Rebecca A Hubbard, Rachel Kohn, George L Anesi, Scott Manaker, Meeta Prasad Kerlin, Scott D Halpern
OBJECTIVES: Describe the operating characteristics of a proposed set of revenue center codes to correctly identify ICU stays among hospitalized patients. DESIGN: Retrospective cohort study. We report the operating characteristics of all ICU-related revenue center codes for intensive and coronary care, excluding nursery, intermediate, and incremental care, to identify ICU stays. We use a classification and regression tree model to further refine identification of ICU stays using administrative data...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28441233/acute-respiratory-distress-syndrome-due-to-tuberculosis-in-a-respiratory-icu-over-a-16-year-period
#6
Valliappan Muthu, Sahajal Dhooria, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal, Ritesh Agarwal
OBJECTIVE: Whether tuberculosis-related acute respiratory distress syndrome is associated with worse outcomes when compared with acute respiratory distress syndrome secondary to other causes remains unknown. Herein, we compare the outcomes between the two groups. DESIGN: Retrospective analysis of all subjects admitted with acute respiratory distress syndrome over the last 16 years. SETTING: Respiratory ICU of a tertiary care hospital in North India...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28441231/patient-specific-classification-of-icu-sedation-levels-from-heart-rate-variability
#7
Sunil B Nagaraj, Siddharth Biswal, Emily J Boyle, David W Zhou, Lauren M McClain, Ednan K Bajwa, Sadeq A Quraishi, Akeju Oluwaseun, Riccardo Barbieri, Patrick L Purdon, M Brandon Westover
OBJECTIVE: To develop a personalizable algorithm to discriminate between sedation levels in ICU patients based on heart rate variability. DESIGN: Multicenter, pilot study. SETTING: Several ICUs at Massachusetts General Hospital, Boston, MA. PATIENTS: We gathered 21,912 hours of routine electrocardiogram recordings from a heterogenous group of 70 adult ICU patients. All patients included in the study were mechanically ventilated and were receiving sedatives...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28440879/tick-borne-encephalitis-in-patients-vaccinated-against-this-disease
#8
S Lotrič-Furlan, P Bogovič, T Avšič-Županc, M Jelovšek, L Lusa, F Strle
BACKGROUND: Information on tick-borne encephalitis (TBE) in patients already vaccinated against the disease is limited. OBJECTIVES: To compare the course and outcome in patients with vaccination breakthrough TBE with findings in patients who developed TBE without previous vaccination. METHODS: All adult patients diagnosed with TBE at a single medical centre during a 16-year period and who had received at least two doses of TBE vaccine before the onset of illness qualified for the study...
April 25, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28440663/acupuncture-for-pain-and-nausea-in-the-intensive-care-unit-a-feasibility-study-in-a-public-safety-net-hospital
#9
Colin Feeney, Elizabeth Bruns, Gabrielle LeCompte, Anahita Forati, Thomas Chen, Amy Matecki
OBJECTIVES: To explore the feasibility and acceptability of providing acupuncture treatment to relieve pain and nausea symptoms in intensive care unit (ICU) patients. DESIGN: Prospective feasibility study. SETTINGS/LOCATION: Public safety net hospital with a 20-bed mixed medical/surgical ICU. SUBJECTS: Patients from all services admitted to the ICU from November 14, 2014 to April 2015. INTERVENTIONS: Three 20 min acupuncture treatments given for consented patients who were experiencing pain and/or nausea, in addition to usual care...
April 25, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28439517/incidence-and-risk-factors-for-organ-space-infection-after-radiofrequency-assisted-hepatectomy-or-ablation-of-liver-tumors-in-a-single-center-more-than-meets-the-eye
#10
Ioannis Karavokyros, Stamatios Orfanos, Anastasios Angelou, Antonia Meropouli, Dimitrios Schizas, John Griniatsos, Emmanouil Pikoulis
INTRODUCTION: Surgical site infections (SSIs) and especially organ/space infection (O/SI) after resection or ablation of liver tumors are associated with increased morbidity and mortality. A secondary blood stream infection (BSI) is considered an O/SI but the exact prevalence is unknown. We aimed to investigate the incidence of O/SI and BSIs in a cohort of consecutive patients after liver resection or ablation, to seek for a possible connection between them and to search for potential risk factors...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28439187/body-mass-index-and-intensive-care-unit-outcomes-in-african-american-patients
#11
O'Dene Lewis, Julius Ngwa, Angesom Kibreab, Marc Phillpotts, Alicia Thomas, Alem Mehari
PURPOSE: We sought to determine whether body mass index (BMI) is associated with worse intensive care unit (ICU) outcomes among Black patients. METHODS: Patients admitted to the medical ICU during 2012 were categorized into six BMI groups based on the World Health Organization criteria. ICU mortality, ICU and hospital length of stay (LOS), need for and duration of mechanical ventilation and organ failure rate were assessed. RESULTS: A total of 605 patients with mean age 58...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28438605/identifying-barriers-to-delivering-the-abcde-bundle-to-minimize-adverse-outcomes-for-mechanically-ventilated-patients-a-systematic-review
#12
Deena Kelly Costa, Matthew White, Emily Ginier, Milisa Manojlovich, Sushant Govindan, Theodore J Iwashyna, Anne E Sales
BACKGROUND: Improved outcomes are associated with the Awakening, Breathing Coordination, Delirium and Early mobility/exercise (ABCDE) bundle; however, implementation issues are common. As yet, no study has integrated the barriers to ABCDE to provide an overview of reasons for less successful efforts. The purpose of this review was to identify and catalog the barriers to ABCDE delivery based on a widely used implementation framework, and provide a resource to guide clinicians in overcoming barriers to implementation...
April 21, 2017: Chest
https://www.readbyqxmd.com/read/28438584/strategies-for-enhancing-family-participation-in-research-in-the-icu-findings-from-a-qualitative-study
#13
Danae Dotolo, Elizabeth L Nielsen, J Randall Curtis, Ruth A Engelberg
CONTEXT: Family members of critically ill patients who participate in research focused on palliative care issues have been found to be systematically different from those who do not. These differences threaten the validity of research and raise ethical questions about worsening disparities in care by failing to represent diverse perspectives. OBJECTIVES: This study's aims were to explore: 1) barriers and facilitators influencing family members' decisions to participate in palliative care research; and 2) potential methods to enhance research participation...
April 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28438261/the-affordable-care-act-and-its-association-with-length-of-stay-and-payer-status-for-trauma-patients-at-a-level-i-trauma-center
#14
Vicente Jose Undurraga Perl, Chris Dodgion, Kyle Hart, Bruce Ham, Martin Schreiber, David Zonies
BACKGROUND: We hypothesized that the ACA would shorten length of stay and increase numbers of insured patients without changing trauma patient outcomes. METHODS: A retrospective review of adult trauma patients admitted to a level I trauma center between 2012 and 2014 was performed. Demographics, length of stay, payer status, discharge disposition, and complications before and after the ACA implementation were analyzed. RESULTS: 4448 trauma patients were admitted during the study period...
April 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28438186/mortality-and-infectious-complications-of-therapeutic-endovascular-interventional-radiology-a-systematic-and-meta-analysis-protocol
#15
Kaoutar Mellouk Aid, Hervé Tchala Vignon Zomahoun, Abdelmajid Soulaymani, Karin Lebascle, Stephane Silvera, Pascal Astagneau, Benoit Misset
BACKGROUND: Endovascular interventional radiology (EIR) is an increasingly popular, mini invasive treatment option for patient with symptomatic vascular disease. The EIR practiced by qualified hands is an effective, well-tolerated procedure that offers relief of patient's symptoms with a low risk of complications. During acute post procedural period, immediate complications may relate to vascular access, restenosis, thromboembolic events, uterine ischemia, infection, necrosis, sepsis, ICU stay, surgical recovery, pain management, treatment failure, and death...
April 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28437376/organizational-issues-structure-and-processes-of-care-in-257-icus-in-latin-america-a-study-from-the-latin-america-intensive-care-network
#16
Elisa Estenssoro, Leyla Alegría, Gastón Murias, Gilberto Friedman, Ricardo Castro, Nicolas Nin Vaeza, Cecilia Loudet, Alejandro Bruhn, Manuel Jibaja, Gustavo Ospina-Tascon, Fernando Ríos, Flavia R Machado, Alexandre Biasi Cavalcanti, Arnaldo Dubin, F Javier Hurtado, Arturo Briva, Carlos Romero, Guillermo Bugedo, Jan Bakker, Maurizio Cecconi, Luciano Azevedo, Glenn Hernandez
OBJECTIVE: Latin America bears an important burden of critical care disease, yet the information about it is scarce. Our objective was to describe structure, organization, processes of care, and research activities in Latin-American ICUs. DESIGN: Web-based survey submitted to ICU directors. SETTINGS: ICUs located in nine Latin-American countries. SUBJECTS: Individual ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred fifty-seven of 498 (52%) of submitted surveys responded: 51% from Brazil, 17% Chile, 13% Argentina, 6% Ecuador, 5% Uruguay, 3% Colombia, and 5% between Mexico, Peru, and Paraguay...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437374/icu-patients-requiring-renal-replacement-therapy-initiation-fewer-survivors-and-more-dialysis-dependents-from-80-years-old
#17
Morgane Commereuc, Emmanuel Guérot, Anais Charles-Nelson, Adrien Constan, Sandrine Katsahian, Frédérique Schortgen
OBJECTIVES: To assess the role of advanced age on survival and dialysis dependency after initiation of renal replacement therapy for acute kidney injury. DESIGN: Retrospective pooled analysis of prospectively collected data. SETTING: ICUs of two teaching hospitals in Paris area, France. SUBJECTS: One thousand five hundred thirty adult patients who required renal replacement therapy initiation in the ICU. INTERVENTIONS: None...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437365/a-method-to-account-for-variation-in-congenital-heart-surgery-length-of-stay
#18
Andrew Brennan, Kimberlee Gauvreau, Jean Connor, Melvin Almodovar, James DiNardo, Puja Banka, Meena Nathan, Derek Mathieu, Aditya Kaza, John E Mayer, Lisa Bergersen
OBJECTIVES: We sought to develop a risk-adjustment methodology for length of stay in congenital heart surgery, as none exist. DESIGN: Prospective cohort analysis combined with previously obtained retrospective cohort analysis of a Department of Cardiovascular Surgery clinical database. PATIENTS: Patients discharged from Boston Children's Hospital between October 1, 2006, and May 31, 2014, that underwent a congenital heart surgery procedure(s) linked to one of 103 surgical procedure types...
April 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28437224/structure-process-and-culture-of-intensive-care-units-treating-patients-with-severe-traumatic-brain-injury-survey-of-centers-participating-in-the-american-college-of-surgeons-trauma-quality-improvement-program
#19
Aziz S Alali, Victroia McCredie, Todd G Mainprize, David Gomez, Avery B Nathens
Outcome after severe traumatic brain injury (TBI) differs substantially between hospitals. Explaining this variation begins with understanding the differences in structures and processes of care, particularly at intensive care units (ICUs) where acute TBI care takes place. We invited trauma medical directors (TMDs) from 187 centers participating in the American College of Surgeons Trauma Quality Improvement Program to complete a survey. The survey domains included ICU model, type, availability of specialized units, staff, training programs, standard protocols and order sets, approach to withdrawal of life support, and perceived level of neurosurgeons' engagement in the ICU management of TBI...
February 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28436579/infection-related-mortality-in-hispanic-and-non-hispanic-children-with-cancer
#20
Rochelle R Smits-Seemann, Jacob Pettit, Hongyan Li, Anne C Kirchhoff, Mark N Fluchel
BACKGROUND: Hispanic children with cancer experience poorer survival than their White counterparts. Infection is a known cause of cancer-related mortality; however, little is known about the risk of infection-related death among Hispanic children with cancer. We examine the association of Hispanic ethnicity with infection-related mortality and life-threatening events among children with cancer. PROCEDURE: For a cohort of all pediatric cancer patients diagnosed from 1986 to 2012 and treated at a single tertiary care center, we obtained national death records to determine all-cause mortality and infection-related mortality, as well as intensive care unit (ICU) admissions as a surrogate for life-threatening events...
April 24, 2017: Pediatric Blood & Cancer
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