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https://www.readbyqxmd.com/read/29230573/incidence-of-perioperative-stroke-in-clampless-aortic-anastomosis-during-off-pump-coronary-artery-bypass-grafting
#1
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/29227367/practice-patterns-and-outcomes-associated-with-early-sedation-depth-in-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#2
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/29226131/risk-factors-of-delirium-in-sequential-sedation-patients-in-intensive-care-units
#3
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/29223744/effect-of-various-antipsychotic-regimens-on-incidence-of-delirium-in-critically-ill-adults
#4
W Anthony Hawkins, Stephanie V Phan, Stacey L Campbell
PURPOSE: Delirium is common during critical illness but it is unknown whether the choice of antipsychotic or dosing strategy impacts delirium outcomes. We evaluated the incidence of delirium in critically ill adults receiving different antipsychotic regimens. MATERIALS AND METHODS: Single center retrospective cohort study of adult patients admitted to the intensive care unit (ICU). Patients who received haloperidol or quetiapine and scored negative on the Confusion Assessment Method for the ICU (CAM-ICU) prior to initiation were included...
November 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29208005/recovery-after-critical-illness-putting-the-puzzle-together-a-consensus-of-29
#5
REVIEW
Elie Azoulay, Jean-Louis Vincent, Derek C Angus, Yaseen M Arabi, Laurent Brochard, Stephen J Brett, Giuseppe Citerio, Deborah J Cook, Jared Randall Curtis, Claudia C Dos Santos, E Wesley Ely, Jesse Hall, Scott D Halpern, Nicholas Hart, Ramona O Hopkins, Theodore J Iwashyna, Samir Jaber, Nicola Latronico, Sangeeta Mehta, Dale M Needham, Judith Nelson, Kathleen Puntillo, Michael Quintel, Kathy Rowan, Gordon Rubenfeld, Greet Van den Berghe, Johannes Van der Hoeven, Hannah Wunsch, Margaret Herridge
In this review, we seek to highlight how critical illness and critical care affect longer-term outcomes, to underline the contribution of ICU delirium to cognitive dysfunction several months after ICU discharge, to give new insights into ICU acquired weakness, to emphasize the importance of value-based healthcare, and to delineate the elements of family-centered care. This consensus of 29 also provides a perspective and a research agenda about post-ICU recovery.
December 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29203991/postoperative-delirium-in-indian-patients-following-major-abdominal-surgery-for-cancer-risk-factors-and-associations
#6
Vibhawari Dhakharia, Subir Sinha, Jaydip Bhaumik
Postoperative delirium (POD) is not uncommon following major abdominal surgery with its incidence ranging between five and 51%. As cancer affects disproportionately, the population older than 65 years and as delirium is more common in the elderly, surgical oncology patients are at a higher risk of developing POD. The present study was undertaken to explore the impact and associations of POD in Indian patients undergoing oncological major abdominal surgery. A retrospective review of the electronic medical records in a tertiary cancer care institution of all postoperative patients who had undergone major gastrointestinal gynaecological and urological abdominal surgery for cancer and required psycho-oncology referral was performed...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29202534/-investigation-of-doctors-and-nurses-perceptions-and-implementation-of-delirium-management-in-intensive-care-unit
#7
H B Luo, X T Wang, B Tang, Z N Zhu, H L Guo, Z Z Li, J H Sun, D W Liu
Objective: To investigate doctors' and nurses' perceptions and implementation of delirium management in intensive care unit. Methods: A total of 197 doctors and nurses in 2 general ICUs and 3 special ICUs at Peking Union Medical College Hospital finished a self-designed questionnaire of delirium management. Results: There were 47 males and 150 females, 43 doctors and 154 nurses who participated in the survey.One hundred and twenty five participators were from general ICU and the others from special ICU. The ICU staff had a significant difference on the perceptions and implementation of delirium management(P< 0...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29202254/incidence-correlates-and-outcomes-associated-with-falls-in-the-intensive-care-unit-a-retrospective-cohort-study
#8
Drayton Trumble, Michael A Meier, Maryellen Doody, Xiaoming Wang, Sean M Bagshaw
BACKGROUND: Falls among hospitalised patients contribute to avoidable morbidity and prolonged hospital stay. We aimed to describe the incidence, circumstances and outcomes associated with patient falls occurring in intensive care units. METHODS: Retrospective cohort study of adult admissions to an academic, tertiary ICU in Edmonton, Canada between 1 January 2013 and 30 April 2016. Fall events were ascertained by interrogation of an electronic health record. Each fall was independently adjudicated by two intensivists to confirm that a fall did occur, and to determine if the fall was potentially avoidable...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29187230/decreasing-delirium-through-music-ddm-in-critically-ill-mechanically-ventilated-patients-in-the-intensive-care-unit-study-protocol-for-a-pilot-randomized-controlled-trial
#9
Sikandar H Khan, Sophia Wang, Amanda Harrawood, Stephanie Martinez, Annie Heiderscheit, Linda Chlan, Anthony J Perkins, Wanzhu Tu, Malaz Boustani, Babar Khan
BACKGROUND: Delirium is a highly prevalent and morbid syndrome in intensive care units (ICUs). Changing the stressful environment within the ICU via music may be an effective and a scalable way to reduce the burden of delirium. METHODS/DESIGN: The Decreasing Delirium through Music (DDM) study is a three-arm, single-blind, randomized controlled feasibility trial. Sixty patients admitted to the ICU with respiratory failure requiring mechanical ventilation will be randomized to one of three arms (20 participants per arm): (1) personalized music, (2) non-personalized relaxing music, or (3) attention-control...
November 29, 2017: Trials
https://www.readbyqxmd.com/read/29184454/sleep-quality-and-circadian-rhythm-disruption-in-the-intensive-care-unit-a-review
#10
REVIEW
Yuliya Boyko, Poul Jennum, Palle Toft
Sleep and circadian rhythm are reported to be severely abnormal in critically ill patients. Disturbed sleep can lead to the development of delirium and, as a result, can be associated with prolonged stay in the intensive care unit (ICU) and increased mortality. The standard criterion method of sleep assessment, polysomnography (PSG), is complicated in critically ill patients due to the practical challenges and interpretation difficulties. Several PSG sleep studies in the ICU reported the absence of normal sleep characteristics in many critically ill patients, making the standard method of sleep scoring insufficient in this patient group...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/29148046/delirium-and-effect-of-circadian-light-in-the-intensive-care-unit-a-retrospective-cohort-study
#11
S Estrup, C K W Kjer, L M Poulsen, I Gøgenur, O Mathiesen
BACKGROUND: Delirium is a serious condition often experienced by critically ill patients in intensive care units (ICUs). The role of circadian light for this condition is unclear. The aim of this study was to describe incidence of delirium, risk factors for delirium, and the association between delirium and circadian light for patients in the ICU. METHODS: This is a retrospective cohort study of all patients at a Danish ICU from 1 August 2015 to 31 January 2016...
November 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#12
Lauren E Payne, David J Gagnon, Richard R Riker, David B Seder, Elizabeth K Glisic, Jane G Morris, Gilles L Fraser
BACKGROUND: Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the blood-brain barrier and exhibit concentration-dependent ϒ-aminobutyric acid (GABA) antagonism. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Data suggest that up to 15% of ICU patients treated with cefepime may experience these adverse effects. Risk factors include renal dysfunction, excessive dosing, preexisting brain injury, and elevated serum cefepime concentrations...
November 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29136716/-the-impact-of-goal-directed-analgesia-on-mechanical-ventilated-patients-s-outcomes-in-intensive-care-unit-a-clinical-observational-study
#13
Q D Li, X Y Wan, Y L Zhang, S W Li, L L Han, W W Li, H Y Shi
To investigate the impact of goal directed analgesia on the outcome of patients with mechanical ventilation in intensive care unit.A total of 126 patients who needed mechanical ventilation were recruited.With a method of before and after paired comparison, they were divided into two group: (1) analgesia with empirical administration or control group; (2) goal directed analgesia based on critical-care pain observation tool (CPOT). Compared with the control group, after goal directed analgesia was applied, the consumption of midazolam significantly dropped from (368...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29132506/intensive-care-unit-delirium-and-intensive-care-unit-related-posttraumatic-stress-disorder
#14
REVIEW
Annachiara Marra, Pratik P Pandharipande, Mayur B Patel
Delirium is one of the most common behavioral manifestations of acute brain dysfunction in the intensive care unit (ICU) and is a strong predictor of worse outcome. Routine monitoring for delirium is recommended for all ICU patients using validated tools. In delirious patients, a search for all reversible precipitants is the first line of action and pharmacologic treatment should be considered when all causes have been ruled out, and it is not contraindicated. Long-term morbidity has significant consequences for survivors of critical illness and for their caregivers...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29123558/predictors-of-post-traumatic-stress-disorder-following-critical-illness-a-mixed-methods-study
#15
Ceri E Battle, Karen James, Tom Bromfield, Paul Temblett
Purpose: Post-traumatic stress disorder has been reported in survivors of critical illness. The aim of this study was to investigate the predictors of post-traumatic stress disorder in survivors of critical illness. Materials and methods: Patients attending the intensive care unit (ICU) follow-up clinic completed the UK-Post-Traumatic Stress Syndrome 14-Questions Inventory and data was collected from their medical records. Predictors investigated included age, gender, Apache II score, ICU length of stay, pre-illness psychopathology; delirium and benzodiazepine administration during ICU stay and delusional memories of the ICU stay following discharge...
November 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29109065/the-impact-of-chronic-kidney-disease-on-post-operative-outcomes-in-patients-undergoing-lumbar-decompression-and-fusion
#16
Owoicho Adogwa, Aladine A Elsamadicy, Amanda Sergesketter, Deborah Oyeyemi, Diego Galan, Victoria D Vuong, Syed Khalid, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: Little is known of the impact of pre-operative chronic kidney disease (CKD) on post-operative complications in patients undergoing lumbar arthrodesis. The aim of this study is to determine whether pre-operative CKD is associated with inferior peri-operative outcomes. METHODS: The medical records of 293 adult (≥18 years-old) spine deformity patients undergoing elective lumbar spine decompression and fusion at a major academic institution from 2006 to 2015 were reviewed...
November 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29092867/subsyndromal-delirium-and-institutionalization-among-patients-with-critical-illness
#17
Nathan E Brummel, Leanne M Boehm, Timothy D Girard, Pratik P Pandharipande, James C Jackson, Christopher G Hughes, Mayur B Patel, Jin H Han, Eduard E Vasilevskis, Jennifer L Thompson, Rameela Chandrasekhar, Gordon R Bernard, Robert S Dittus, E Wesley Ely
BACKGROUND: The prognostic importance of subsyndromal delirium is unknown. OBJECTIVE: To test whether duration of subsyndromal delirium is independently associated with institutionalization. METHODS: The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was used twice daily to assess for subsyndromal delirium in patients with respiratory failure or shock. Delirium was considered present if the assessment was positive. Subsyndromal delirium was considered present if the assessment was negative but the patient exhibited any CAM-ICU features...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29076929/delirium-in-the-pediatric-cardiac-extracorporeal-membrane-oxygenation-patient-population-a-case-series
#18
Anita K Patel, Katherine V Biagas, Eunice C Clark, Chani Traube
OBJECTIVE: To determine the prevalence of delirium in children who require extracorporeal membrane oxygenation. DESIGN: Prospective observational longitudinal cohort study. SETTING: Urban academic cardiothoracic ICU. PATIENTS: All consecutive admissions to the cardiothoracic ICU who required venoarterial extracorporeal membrane oxygenation support. INTERVENTIONS: Daily delirium screening with the Cornell Assessment for Pediatric Delirium...
October 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29073537/diagnostic-accuracy-of-delirium-assessment-methods-in-critical-care-patients
#19
Angkita Barman, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Anirban Bhattacharjee, Sonali Shinde Tesia, Jayanta Kumar Mitra
PURPOSE: Delirium is a disorder of decreased ability to focus, sustain or shift attention, change in cognition and or perception. The main objective was to evaluate the diagnostic accuracy of Confusion Assessment Method for the ICU (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) among the nursing and medical staff in a multidisciplinary ICU. METHODS AND MATERIAL: Three hundred ten verbally communicating and non-communicating patients (mean age in years 47...
October 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29061618/critical-care-cycling-study-cyclist-trial-protocol-a-randomised-controlled-trial-of-usual-care-plus-additional-in-bed-cycling-sessions-versus-usual-care-in-the-critically-ill
#20
Marc R Nickels, Leanne M Aitken, James Walsham, Adrian G Barnett, Steven M McPhail
INTRODUCTION: In-bed cycling with patients with critical illness has been shown to be safe and feasible, and improves physical function outcomes at hospital discharge. The effects of early in-bed cycling on reducing the rate of skeletal muscle atrophy, and associations with physical and cognitive function are unknown. METHODS AND ANALYSIS: A single-centre randomised controlled trial in a mixed medical-surgical intensive care unit (ICU) will be conducted. Adult patients (n=68) who are expected to be mechanically ventilated for more than 48 hours and remain in ICU for a further 48 hours from recruitment will be randomly allocated into either (1) a usual care group or (2) a group that receives usual care and additional in-bed cycling sessions...
October 22, 2017: BMJ Open
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