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https://www.readbyqxmd.com/read/29232263/can-the-critically-ill-patient-generate-sufficient-energy-to-facilitate-exercise-in-the-icu
#1
Danielle E Bear, Selina M Parry, Zudin A Puthucheary
PURPOSE OF REVIEW: Trials of physical rehabilitation post critical illness have yet to deliver improved health-related quality of life in critical illness survivors. Muscle mass and strength are lost rapidly in critical illness and a proportion of patients continue to do so resulting in increased mortality and functional disability. Addressing this issue is therefore fundamental for recovery from critical illness. RECENT FINDINGS: Altered mitochondrial function occurs in the critically ill and is likely to result in decreased adenosine tri-phosphate (ATP) production...
December 9, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29232063/exome-sequencing-helps-diagnose-infants-in-the-icu-test-results-changed-medical-management-for-more-than-half-of-diagnosed-babies
#2
(no author information available yet)
No abstract text is available yet for this article.
January 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29230596/distribution-of-potential-eye-and-tissue-donors-within-an-australian-teaching-hospital
#3
Martin J Dutch, Anthony F Denahy
Eye and Tissue donation has the capacity to transform lives, yet the vast majority of potential in-hospital donors are not recognised. Studies which describe the relative importance of specific units or wards in determining the size of the donor pool are limited. The aim of this study was to map the distribution of potential Eye and Tissue donors within the study hospital. A 12-month retrospective analysis of all patient deaths at the study hospital was undertaken. The ability to donate corneal, heart valve, bone and skin tissue was investigated...
December 11, 2017: Cell and Tissue Banking
https://www.readbyqxmd.com/read/29230573/incidence-of-perioperative-stroke-in-clampless-aortic-anastomosis-during-off-pump-coronary-artery-bypass-grafting
#4
Francesco Formica, Giuseppe Tata, Gurmeet Singh, Serena Mariani, Stefano D'Alessandro, Luigi Amerigo Messina, Fabio Sangalli, Giovanni Paolini
This study aimed to assess if clampless off-pump coronary artery bypass grafting (OPCAB) decreases the incidence of perioperative stroke (POS) rate and in-hospital mortality. The secondary aim was to evaluate 12-year rates of overall mortality. Between January 2003 to December 2015, data of 645 consecutive patients undergoing isolated CABG were retrospectively collected. 363 underwent aortic no-touch OPCAB (No-touch group) and 282 underwent OPCAB with the Heartstring device (HS group). In-hospital mortality and perioperative stroke rate as primary endpoint, as well as long-term follow-up outcome were analysed...
December 12, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29230562/risks-of-bleeding-and-thrombosis-in-intensive-care-unit-patients-with-haematological-malignancies
#5
Lene Russell, Lars Broksø Holst, Lars Kjeldsen, Jakob Stensballe, Anders Perner
BACKGROUND: Patients with malignant haematological disease and especially those who require intensive care have an increased risk of bleeding and thrombosis, but none of these data were obtained in ICU patients only. We assessed the incidence of bleeding and thrombotic complications, use of blood products and risk factors for bleeding in an adult population of ICU patients with haematological malignancies. METHODS: We screened all patients with acute leukaemia and myelodysplastic syndrome admitted to a university hospital ICU during 2008-2012...
December 11, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29229490/pseudomonas-aeruginosa-intensive-care-unit-outbreak-winnowing-of-transmissions-with-molecular-and-genomic-typing
#6
Benjamin J Parcell, Katarina Oravcova, Miguel Pinheiro, Matthew T G Holden, Gabby Phillips, Jane F Turton, Stephen H Gillespie
BACKGROUND: Pseudomonas aeruginosa healthcare outbreaks can be time consuming and difficult to investigate. Guidance does not specify which typing technique is most practical to base decisions on. AIM: We explore the usefulness of whole genome sequencing (WGS) in the investigation of a Pseudomonas aeruginosa outbreak describing how it compares with pulsed-field gel electrophoresis (PFGE) and variable number tandem repeat (VNTR) analysis. METHODS: Six patient isolates and six environmental samples from an Intensive Care Unit (ICU) positive for P...
December 8, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29229252/implementation-of-an-early-extubation-protocol-in-cardiac-surgical-patients-decreased-ventilator-time-but-not-intensive-care-unit-or-hospital-length-of-stay
#7
Matthew Richey, Ashley Mann, Jianghua He, Emmanuel Daon, Katy Wirtz, Allegra Dalton, Brigid C Flynn
OBJECTIVE: The optimal timing of extubation following cardiac surgery is currently unknown. Protocols implemented in order to achieve a rapid extubation may achieve this goal, but not prove beneficial in terms of outcomes. DESIGN: A prospective clinical trial. SETTING: Tertiary care cardiac surgical intensive care unit. PARTICIPANTS: Adult cardiac surgical patients. INTERVENTIONS: Implementation of an 8-tier multidisciplinary rapid weaning protocol...
November 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29228951/hypovitaminosis-c-and-vitamin-c-deficiency-in-critically-ill-patients-despite-recommended-enteral-and-parenteral-intakes
#8
Anitra C Carr, Patrice C Rosengrave, Simone Bayer, Steve Chambers, Jan Mehrtens, Geoff M Shaw
BACKGROUND: Vitamin C is an essential water-soluble nutrient which cannot be synthesised or stored by humans. It is a potent antioxidant with anti-inflammatory and immune-supportive roles. Previous research has indicated that vitamin C levels are depleted in critically ill patients. In this study we have assessed plasma vitamin C concentrations in critically ill patients relative to infection status (septic shock or non-septic) and level of inflammation (C-reactive protein concentrations)...
December 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29228795/comparing-vitamin-a-and-moist-chamber-in-preventing-ocular-surface-disorders
#9
Hassan Babamohamadi, Monir Nobahar, Jalaladin Razi, Raheb Ghorbani
The present study was conducted to determine the effectiveness of vitamin A eye ointment (VAEO) and moist chamber (MC) in preventing ocular surface disorders (OSD) in intensive care unit (ICU) patients. A total of 38 eligible patients were selected for participation in the present clinical trial. All the patients were randomly administered VAEO in one eye every 6 hr for 5 days and had a polyethylene cover (PC) placed on their other eye to create an MC that was replaced every 12 hr as well. The results of Schirmer's test also increased by 2...
February 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/29228380/elderly-versus-nonelderly-patients-with-invasive-aspergillosis-in-the-icu-a-comparison-and-risk-factor-analysis-for-mortality-from-the-aspicu-cohort
#10
D K Matthaiou, G Dimopoulos, F S Taccone, P Bulpa, A M Van den Abeele, B Misset, W Meersseman, H Spapen, T Cardoso, P E Charles, D Vogelaers, S Blot
Data regarding the epidemiology and diagnosis of invasive aspergillosis in the critically ill population are limited, with data regarding elderly patients (≥75 years old) even scarcer. We aimed to further compare the epidemiology, characteristics and outcome of elderly versus nonelderly critically ill patients with invasive aspergillosis (IA) Prospective, international, multicenter observational study (AspICU) including adult intensive care unit (ICU) patients, with a culture and/or direct examination and/or histopathological sample positive for Aspergillus spp...
December 8, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29228133/regional-epidemiology-of-methicillin-resistant-staphylococcus-aureus-among-adult-intensive-care-unit-patients-following-state-mandated-active-surveillance
#11
Michael Y Lin, Mary K Hayden, Rosie D Lyles, Karen Lolans, Louis F Fogg, Alexander J Kallen, Stephen G Weber, Robert A Weinstein, William E Trick
Background: In 2007, Illinois became the first state in the United States to mandate active surveillance of methicillin-resistant Staphylococcus aureus (MRSA). The Illinois law applies to intensive care unit (ICU) patients; contact precautions are required for patients found to be MRSA-colonized. However, the effectiveness of a legislated "search and isolate" approach to reduce MRSA burden among critically ill patients is uncertain. We evaluated whether the prevalence of MRSA colonization declined in the 5 years after the start of mandatory active surveillance...
December 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29227565/limited-utility-of-routine-chest-x-ray-in-initial-evaluation-of-neutropenic-fever-in-patients-with-haematological-diseases-undergoing-chemotherapy
#12
Ortis Estacio, Zoe Loh, Amy Baker, Geoff Chong, Andrew Grigg, Leonid Churilov, Eliza A Hawkes
BACKGROUND: Routine chest X-Ray (CXR) is recommended for neutropenic fever(NF) management however its role is relatively understudied in haematology patients. METHODS: Retrospective, single-centre analysis of haematology patients admitted with NF between January 2011-December 2015. Baseline demographics, treatment details and outcomes were collected from electronic patient records. CXRs underwent independent radiology review. Primary endpoints were proportion of NF episodes in which CXR detected a probable chest infection in the absence of respiratory symptoms/signs, and/or resulted in a change in antibiotic management...
December 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29227436/the-effect-of-acetaminophen-on-temperature-in-critically-ill-children-a-retrospective-analysis-of-over-50-000-doses
#13
Samiran Ray, Libby Rogers, Katherine L Brown, Mark J Peters
OBJECTIVES: Acetaminophen is widely used in PICUs. Although randomized controlled trials suggest that acetaminophen significantly reduces body temperature in adults, the effect of acetaminophen on temperature in critically ill children has not been previously quantified. DESIGN: Retrospective observational cohort study. SETTING: Single-center general and cardiac PICU in a specialist children's hospital. PATIENTS: All children who received acetaminophen or had a fever (temperature ≥ 38°C) while on the ICU over a 40-month period (September 2012 to December 2015)...
December 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29227368/septic-cardiomyopathy
#14
Sarah J Beesley, Gerhard Weber, Todd Sarge, Sara Nikravan, Colin K Grissom, Michael J Lanspa, Sajid Shahul, Samuel M Brown
OBJECTIVES: To describe, with an emphasis on clinical applications, what is known about the pathophysiology, management, and implications of septic cardiomyopathy in the adult ICU. DATA SOURCES AND STUDY SELECTION: A PubMed literature review was performed for relevant articles. Only articles in English that studied human adults with sepsis were included. DATA EXTRACTION AND DATA SYNTHESIS: Multiple competing definitions for septic cardiomyopathy hinder understanding of this entity...
December 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29227367/practice-patterns-and-outcomes-associated-with-early-sedation-depth-in-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#15
Robert J Stephens, Matthew R Dettmer, Brian W Roberts, Enyo Ablordeppey, Susan A Fowler, Marin H Kollef, Brian M Fuller
OBJECTIVES: Emerging data suggest that early deep sedation may negatively impact clinical outcomes. This systematic review and meta-analysis defines and quantifies the impact of deep sedation within 48 hours of initiation of mechanical ventilation, as described in the world's literature. The primary outcome was mortality. Secondary outcomes included hospital and ICU lengths of stay, mechanical ventilation duration, and delirium and tracheostomy frequency. DATA SOURCES: The following data sources were searched: MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews and Effects, Cochrane Database of Systematic Reviews databases, ClinicalTrials...
December 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29227053/quantifying-the-funding-gap-for-management-of-traumatic-brain-injury-at-a-major-trauma-centre-in-south-africa
#16
V Y Kong, J J Odendaal, J L Bruce, G L Laing, E Jerome, B Sartorius, P Brysiewicz, D L Clarke
BACKGROUND: Trauma is an eminently preventable disease. However, prevention programs divert resources away from other priorities. Costing trauma related diseases helps policy makers to make decisions on re-source allocation. We used data from a prospective digital trauma registry to cost Traumatic Brain Injury (TBI) at our institution over a two-year period and to estimate the funding gap that exists in the care of TBI. METHOD: All patients who were admitted to the Pietermaritzburg Metropolitan Trauma Service (PMTS) with TBI were identified from the Hybrid Electronic Medical Registry (HMER)...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227049/rib-fracture-fixation-in-a-south-african-public-trauma-service
#17
G V Oosthuizen, J De Wet, J L Bruce, D L Clarke
BACKGROUND: Rib fractures and flail chests have traditionally been treated nonoperatively. Current literature suggests that it is not only safe and feasible but also desirable to perform fixation of severe rib fractures. Our unit in the Pietermaritzburg public sector adopted rib fracture fixation in 2014 and in this audit we assess its feasibility in our setting. METHODS AND RESULTS: We audited our first nine cases of rib fracture fixation performed to date, of which seven were males...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29226131/risk-factors-of-delirium-in-sequential-sedation-patients-in-intensive-care-units
#18
Jie Yang, Yongfang Zhou, Yan Kang, Binbin Xu, Peng Wang, Yinxia Lv, Zhen Wang
Background: Delirium is a primary adverse event in ventilated patients who receive long-term monosedative treatment. Sequential sedation may reduce these adverse effects. This study evaluated risk factors for delirium in sequential sedation patients. Methods: A total of 141 patients who underwent sequential sedation were enrolled. Delirium was diagnosed using Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) scale. Univariate and multivariate Cox proportional hazards regressions were used to predict risk factors...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29225976/intensive-care-in-a-patient-with-toxic-epidermal-necrolysis
#19
J Wallenborn, M Fischer
Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29225888/contribution-to-diagnosis-and-treatment-of-bone-marrow-aspirate-results-in-critically-ill-patients-undergoing-bone-marrow-aspiration-a-retrospective-study-of-193-consecutive-patients
#20
Laure Calvet, Bruno Pereira, Anne-Françoise Sapin, Gabrielle Mareynat, Alexandre Lautrette, Bertrand Souweine
Background: The purpose of the work was to assess the contribution to diagnosis and/or treatment (CDT) of bone marrow aspiration (BMA) in the critically ill patient. Methods: The retrospective study included 193 patients. On the basis of BMA findings, contribution to diagnosis was defined by one of four previously unestablished diagnoses (maturation arrest of granulocyte precursors, hemophagocytic lymphohistiocytosis, hematological malignancy, marrow infiltration with cancer cells) and to treatment as the initiation or withdrawal of a specific treatment including the decision to forgo life-sustaining treatment (DFLST)...
2017: Journal of Intensive Care
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