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İntensive care monitoring

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https://www.readbyqxmd.com/read/29777985/liquid-chromatography-tandem-mass-spectrometry-for-the-quantification-of-moxifloxacin-ciprofloxacin-daptomycin-caspofungin-and-isavuconazole-in-human-plasma
#1
Julian Hösl, André Gessner, Nahed El-Najjar
A simple and precise ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed for the simultaneous analysis of five anti-infective agents used to treat severe infections [three antibiotics (daptomycin, moxifloxacin, ciprofloxacin) and two antifungals (isavuconazole, caspofungin)] in human plasma. Sample preparation was based on protein precipitation with ice cold methanol. All five agents were analyzed with the corresponding isotopically labeled internal standards. All analytes were detected in multiple reactions monitoring (MRM) using API 4000 triple-quadrupole mass spectrometer with electrospray (ESI) source operating in positive mode...
May 12, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29777740/rapid-response-systems
#2
REVIEW
Patrick G Lyons, Dana P Edelson, Matthew M Churpek
INTRODUCTION: Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. AIMS: We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. DATA SOURCES: Articles written in English and published in PubMed...
May 16, 2018: Resuscitation
https://www.readbyqxmd.com/read/29775603/genetic-and-extracardiac-anomalies-are-associated-with-inferior-single-ventricle-palliation-outcomes
#3
Bahaaldin Alsoufi, Courtney McCracken, Matthew Oster, Subhadra Shashidharan, Kirk Kanter
BACKGROUND: We aim to examine the effect of genetic syndromes and extracardiac anomalies (GS/EC) on single ventricle (SV) palliation with focus on hospital death, interstage mortality, and progression towards subsequent palliation stages. METHODS: 530 neonates with SV underwent first-stage palliation: Norwood (n=284,53%), shunt (n=173,33%), band (n=73,14%). Outcomes were compared between those with GS/EC (n=121,23%) and without GS/EC (n=409,77%). Regression analyses were adjusted for other risk factors (age, gender, prematurity, weight, SV anomaly, first-stage palliation surgery)...
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29775080/mindfulness-meditation-and-interprofessional-cardiopulmonary-resuscitation-a-mixed-methods-pilot-study
#4
Diana J Kelm, Jennifer L Ridgeway, Becca L Gas, Monali Mohan, David A Cook, Darlene R Nelson, Roberto P Benzo
PROBLEM: Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress...
May 18, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29774595/long-term-schneiderian-membrane-thickness-changes-following-zygomatic-implant-placement-a-retrospective-radiographic-analysis-using-cone-beam-computed-tomography
#5
Kai Zhao, Meifei Lian, Shengchi Fan, Wei Huang, Feng Wang, Yiqun Wu
OBJECTIVES: The purpose of this retrospective study was to evaluate the long-term changes in the thickness of Schneiderian membranes after zygomatic implant placement using cone beam computed tomography (CBCT). MATERIAL AND METHODS: Twenty-five consecutive patients were included in this study. All the patients underwent bilateral zygomatic implant placement. Schneiderian membrane thickness (SMT) in 49 maxillary sinuses (one sinus was not included because of early loss of the zygomatic implants) was measured using CBCT before and at least 1 year after zygomatic implant placement...
May 17, 2018: Clinical Oral Implants Research
https://www.readbyqxmd.com/read/29772964/incidence-of-arterial-catheter-complications-a-retrospective-study-of-35-cats-2010-2014
#6
Shaina Mooshian, Sarah J Deitschel, Jamie M Haggerty, Christine L Guenther
Objectives The aim of this study was to investigate the incidence of complications associated with arterial catheterization in cats in a veterinary hospital, and to document which factors may increase the incidence of complications. Methods Medical records at a referral veterinary hospital were retrospectively reviewed to identify cats that had an arterial catheter placed between January 2010 and October 2014. Results Thirty-five cats having 38 arterial catheters were included in the study. There was a relatively high incidence of minor complications (23...
May 1, 2018: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29770557/developing-a-set-of-consensus-indicators-to-support-maternity-service-quality-improvement-using-core-outcome-set-methodology-including-a-delphi-process
#7
Kathryn J Bunch, Benjamin Allin, Matthew Jolly, Tom Hardie, Marian Knight
OBJECTIVE: To develop a core metric set to monitor the quality of maternity care. DESIGN: Delphi process followed by a face-to-face consensus meeting. SETTING: English Maternity units. POPULATION: Three representative expert panels: service designers, providers and users. MAIN OUTCOME MEASURES: Maternity care metrics judged important by participants. METHODS: Participants were asked to complete a two phase Delphi process, scoring metrics from existing local maternity dashboards...
May 16, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29770293/current-monitoring-and-innovative-predictive-modeling-to-improve-care-in-the-pediatric-cardiac-intensive-care-unit
#8
REVIEW
Mary K Olive, Gabe E Owens
The objectives of this review are (I) to describe the challenges associated with monitoring patients in the pediatric cardiac intensive care unit (PCICU) and (II) to discuss the use of innovative statistical and artificial intelligence (AI) software programs to attempt to predict significant clinical events. Patients cared for in the PCICU are clinically fragile and at risk for fatal decompensation. Current monitoring modalities are often ineffective, sometimes inaccurate, and fail to detect a deteriorating clinical status in a timely manner...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29768983/anticoagulation-monitoring-under-ecmo-support-a-comparative-study-between-the-activated-coagulation-time-and-the-anti-xa-activity-assay
#9
Clément Delmas, Aemilia Jacquemin, Fanny Vardon-Bounes, Bernard Georges, Felipe Guerrero, Nicolas Hernandez, Bertrand Marcheix, Thierry Seguin, Vincent Minville, Jean-Marie Conil, Stein Silva
PURPOSE: Extra Corporeal Membrane Oxygenation (ECMO) is used in cases of severe respiratory and/or circulatory failure over periods of several days to several weeks. Its circuitry requires a closely monitored anticoagulation therapy that is empirically supported by activated clotting time (ACT)-a method often associated with large inter- and intraindividual variability. We aimed to compare the measurement of heparin activity with ACT and the direct measurement of the heparin activity (anti-Xa) in a large ECMO population...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#10
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29767742/bed-management-team-with-kanban-web-based-application
#11
Hermano Alexandre Lima Rocha, Ana Kelly Lima da Cruz Santos, Antônia Celia de Castro Alcântara, Carmen Sulinete Suliano da Costa Lima, Sabrina Gabriele Maia Oliveira Rocha, Roberto Melo Cardoso, Jair Rodrigues Cremonin
Objective: To measure the effectiveness of the bed management process that uses a web-based application with Kanban methodology to reduce hospitalization time of hospitalized patients. Design: Before-after study was performed. Setting: The study was conducted between July 2013 and July 2017, at the Unimed Regional Hospital of Fortaleza, which has 300 beds, of which 60 are in the intensive care unit (ICU). It is accredited by International Society for Quality in Healthcare...
May 15, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29766322/microdaimon-study-microcirculatory-daily-monitoring-in-critically-ill-patients-a-prospective-observational-study
#12
Claudia Scorcella, Elisa Damiani, Roberta Domizi, Silvia Pierantozzi, Stefania Tondi, Andrea Carsetti, Silvia Ciucani, Valentina Monaldi, Mara Rogani, Benedetto Marini, Erica Adrario, Rocco Romano, Can Ince, E Christiaan Boerma, Abele Donati
BACKGROUND: Until now, the prognostic value of microcirculatory alterations in critically ill patients has been mainly evaluated in highly selected subgroups. Aim of this study is to monitor the microcirculation daily in mixed group of Intensive Care Unit (ICU)-patients and to establish the association between (the evolution of) microcirculatory alterations and outcome. METHODS: This is a prospective longitudinal observational single-centre study in adult patients admitted to a 12-bed ICU in an Italian teaching hospital...
May 15, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29766137/after-the-embo-predicting-non-hemorrhagic-indications-for-splenectomy-after-angioembolization-in-patients-with-blunt-trauma
#13
John F Bilello, Victoria L Sharp, Rachel C Dirks, Krista L Kaups, James W Davis
Background: Successful non-operative management (NOM) of blunt splenic trauma is enhanced with splenic angioembolization (SAE). Patients may still require splenectomy post-SAE for splenic infarction/necrosis. Prior studies have used white blood cell count (WBC), platelet count (PLT), and PLT:WBC ratio after splenectomy to predict complications, but none have evaluated these findings prior to splenectomy in patients who have undergone SAE. Changes in these values may indicate clinically significant splenic infarction, facilitating management of these patients...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29764571/-efficiency-of-electrocardiogram-monitor-for-positioning-the-catheter-tip-in-peripherally-inserted-central-catheter-placement-in-neonates
#14
Qi-Ying Ling, Hong Chen, Min Tang, Yi Qu, Bin-Zhi Tang
OBJECTIVE: To study the efficiency of electrocardiogram (ECG) monitor for positioning the catheter tip in the placement of peripherally inserted central catheter (PICC) in neonates. METHODS: A total of 160 neonates who were admitted to the neonatal intensive care unit (NICU) from January 2015 to December 2017 and underwent the PICC placement via the veins of upper extremity were enrolled. They were randomly divided into an observation group and a control group, with 80 neonates in each group...
May 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29764555/-role-of-noninvasive-mechanical-ventilation-in-patients-with-severe-avian-influenza-a-h7n9-complicated-with-acute-respiratory-distress-syndrome
#15
Haili Luo, Shaohong Wang, Feng Shen, Tongmei Yuan, Xianguo Pan, Jingtao Liu, Ling Yao, Juncheng Wu, Xuemei Long
Human infection with avian influenza A (H7N9) is an acute contagious respiratory disease. Acute respiratory distress syndrome (ARDS) is a common complication in patients with severe avian influenza A (H7N9), for whom mechanical ventilation (MV) is an important supportive method. A patient, suffered from severe avian influenza A (H7N9) and complicated with ARDS, was admitted to the Second Affiliated Hospital of Guizhou Medical University in January 2017. With very intensive care for oxygenation, respiration and consciousness, and monitoring, she was successfully cured by comprehensive managements, among which noninvasive mechanical ventilation (NIV) was the major respiratory support method...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29764550/-predictive-value-of-central-venous-to-arterial-carbon-dioxide-partial-pressure-difference-for-fluid-responsiveness-in-septic-shock-patients-a-prospective-clinical-study
#16
Guangyun Liu, Huibin Huang, Hanyu Qin, Bin Du
OBJECTIVE: To evaluate the accuracy of central venous-to-arterial carbon dioxide partial pressure difference (Pcv-aCO2 ) before and after rapid rehydration test (fluid challenge) in predicting the fluid responsiveness in patients with septic shock. METHODS: A prospective observation was conducted. Forty septic shock patients admitted to medical intensive care unit (ICU) of Peking Union Medical College Hospital from October 2015 to June 2017 were enrolled. All of the patients received fluid challenge in the presence of invasive hemodynamic monitoring...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#17
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29759717/low-level-vagus-nerve-stimulation-suppresses-post-operative-atrial-fibrillation-and-inflammation-a-randomized-study
#18
Stavros Stavrakis, Mary Beth Humphrey, Benjamin Scherlag, Omer Iftikhar, Purvi Parwani, Mubasher Abbas, Adrian Filiberti, Christian Fleming, Yanqing Hu, Paul Garabelli, Arthur McUnu, Marvin Peyton, Sunny S Po
OBJECTIVES: This study sought to examine the efficacy of low-level vagus nerve stimulation (LLVNS) in suppressing post-operative atrial fibrillation (POAF) and inflammatory cytokines in patients undergoing cardiac surgery. BACKGROUND: POAF often complicates cardiac surgery. METHODS: Patients undergoing cardiac surgery were randomized to active or sham LLVNS. In all patients, a bipolar wire was sutured to the vagus nerve pre-ganglionic fibers alongside the lateral aspect of the superior vena cava...
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29757913/association-between-muscle-wasting-and-muscle-strength-in-patients-who-developed-severe-sepsis-and-septic-shock
#19
Rodrigo Cerqueira Borges, Francisco Garcia Soriano
PURPOSE: To evaluate the association between the rectus femoris cross-sectional area (RFCSA) and the muscular strength obtained at the bedside in patients forwarded to the intensive care unit (ICU) for severe sepsis and septic shock. METHODS: A prospective cohort study. RFCSA was assessed by ultrasound on the following day of the ICU admission and monitored during hospitalization. The patients performed clinical tests of muscle strength (Medical Research Council (MRC) scale and handgrip dynamometry), when they could understand the verbal commands of the examiners...
May 11, 2018: Shock
https://www.readbyqxmd.com/read/29757672/enzyme-based-ultrasensitive-electrochemical-biosensors-for-rapid-assessment-of-nitrite-toxicity-recent-advances-and-perspectives
#20
Anjum Gahlaut, Vinita Hooda, Ashish Gothwal, Vikas Hooda
In the present era of rapid international globalization and industrialization, intensive use of nitrite as a fertilizing agent in agriculture, preservative, dyeing agent, food additive and as corrosion inhibitor in industrial sectors is adversely effecting environment, natural habitats and human health. The issue of toxicity and carcinogenicity due to excessive ingestion of nitrites via the dietary intake has led to an imminent need for its efficient real-time monitoring in situ. Nitrite detection employing electrochemical biosensors has been gaining high credibility in the field of clinical research...
May 14, 2018: Critical Reviews in Analytical Chemistry
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