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https://www.readbyqxmd.com/read/29928153/evaluation-of-pre-deliric-prediction-of-delirium-in-icu-patients-delirium-prediction-model-for-the-patients-in-the-intensive-care-unit
#1
Gabrielė Linkaitė, Mantas Riauka, Ignė Bunevičiūtė, Saulius Vosylius
Introduction: Delirium not only compromises patient care, but is also associated with poorer outcomes: increased duration of mechanical ventilation, higher mortality, and greater long-term cognitive dysfunction. The PRE-DELIRIC model is a tool used to calculate the risk of the development of delirium. The classification of the patients into groups by risk allows efficient initiation of preventive measures. The goal of this study was to validate the PRE-DELIRIC model using the CAM-ICU (The Confusion Assessment Method for the Intensive Care Unit) method for the diagnosis of delirium...
2018: Acta Medica Lituanica
https://www.readbyqxmd.com/read/29927776/critical-care-management-of-anti-n-methyl-d-asparate-receptor-encephalitis
#2
Ron R Neyens, George E Gaskill, Julio A Chalela
OBJECTIVES: Anti-N-methyl-D-asparate receptor encephalitis is considered an immune-mediated form of encephalitis with paraneoplastic and nonparaneoplastic forms. Delay in recognition is common and patients typically present to the ICU without a diagnosis or with complications following a delayed diagnosis. The aim of this review is to provide a focused overview for the ICU clinician regarding presentation, diagnosis, and critical care management. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: PubMed database search with manual review of articles involving anti-N-methyl-D-asparate receptor encephalitis...
June 20, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29926288/allostasis-and-sedation-practices-in-intensive-care-evaluation-an-observational-pilot-study
#3
John P R Moore, Chris Anstey, Lauren Murray, John F Fraser, Mervyn Singer
BACKGROUND: A dysregulated stress response has been implicated in the pathogenesis of critical illness. Sedative agents utilised in the critically unwell patient may impact upon the stress response with a downstream negative effect on multiple organ systems. This study was designed to assess the feasibility of investigating components of the stress response as a sub-study of the current SPICE-III study (NCT01728558). METHODS: This pilot observational cohort study was conducted in a single intensive care unit in Queensland, Australia...
June 20, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29925291/the-safety-and-utility-of-phenobarbital-use-for-the-treatment-of-severe-alcohol-withdrawal-syndrome-in-the-medical-intensive-care-unit
#4
Margarita Oks, Krystal L Cleven, Lauren Healy, Mabel Wei, Mangala Narasimhan, Paul H Mayo, Nina Kohn, Seth Koenig
BACKGROUND: Alcohol withdrawal syndrome (AWS) is a common reason for admission to a medical intensive care unit (MICU) and requires significant hospital resource utilization. Benzodiazepines are first-line therapy for AWS in many intensive care units. We propose the use of symptom-triggered phenobarbital for the treatment of AWS as a safe alternative to benzodiazepines. METHODS: This was a retrospective observational study of a 4-year period, 2011 to 2015, of all patients with AWS admitted to the MICU of 1 tertiary care hospital and treated with phenobarbital...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29923903/pressure-injury-risk-factors-in-critical-care-patients-a-descriptive-analysis
#5
Jill Cox, Sharon Roche, Virginia Murphy
BACKGROUND: Pressure injury (PI) development in the critical care population is multifactorial. Despite the application of evidence-based prevention strategies, PIs do occur and may be unavoidable in some patients. OBJECTIVES: To describe the risk factors associated with PI development in a sample of medical-surgical intensive care unit patients and determine whether these risk factors were congruent with the risk factors proposed in the work of the National Pressure Ulcer Advisory Panel on unavoidable PIs...
July 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29922905/treatment-of-refractory-and-super-refractory-status-epilepticus
#6
Samhitha Rai, Frank W Drislane
Refractory and super-refractory status epilepticus (SE) are serious illnesses with a high risk of morbidity and even fatality. In the setting of refractory generalized convulsive SE (GCSE), there is ample justification to use continuous infusions of highly sedating medications-usually midazolam, pentobarbital, or propofol. Each of these medications has advantages and disadvantages, and the particulars of their use remain controversial. Continuous EEG monitoring is crucial in guiding the management of these critically ill patients: in diagnosis, in detecting relapse, and in adjusting medications...
June 19, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/29913033/comparison-of-propofol-based-versus-volatile-based-anaesthesia-and-postoperative-sedation-in-cardiac-surgical-patients-a-prospective-randomized-study
#7
Marcin Wąsowicz, Angela Jerath, Warren Luksun, Vivek Sharma, Nicholas Mitsakakis, Massimilaino Meineri, Rita Katznelson, Terrence Yau, Vivek Rao, William Scott Beattie
BACKGROUND: Clinical trials have shown conflicting results regarding the use of volatile anesthesia before or after the ischemic insult in cardiac surgical patients and effect on myocardial injury. This may be attributable to the failure of continuing volatile agents into the early postoperative period. We hypothesized that combined volatile-based anesthesia and postoperative sedation would decrease the extent of myocardial injury after coronary artery bypass grafting (CABG) when compared to intravenous, propofol-based approach...
June 18, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29910546/comparision-of-analgesic-efficacy-of-tramadol-infusion-versus-tramadol-plus-ondansetron-infusion-in-medical-intensive-care-unit
#8
Surya Prakash Yarramalle, Kartik Munta, S Manimala Rao, Pradeep Marur Venkategowda, Sagar Sunka, Sai Kiran Dudam
Background: Tramadol, a preferred analgesic due to its less respiratory depression. It also has a central action that blocks the reuptake and enhances the release of serotonin at spinal antinociceptive pathways. Ondansetron, an antiemetic is a serotonin receptor antagonist. Due to the contradictory actions of the two drugs, co-administration of these drugs resulted in higher usage of tramadol. All these studies were done in the postoperative period. Aim: The aim of this study is to evaluate the analgesic efficacy of tramadol infusion versus tramadol plus ondansetron infusion in Medical Intensive Care Unit (ICU) patients...
May 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29909126/factors-associated-with-delirium-in-critical-patients-in-a-health-institution-in-bucaramanga-colombia
#9
C C Torres-Contreras, A N Páez-Esteban, A Hinestrosa-Díaz Del Castillo, M K Rincón-Romero, A Amaris-Vega, J P Martínez-Patiño
OBJECTIVE: To determine the incidence and the factors associated with delirium in intensive care unit patients. METHODS: A cohort study conducted on 134 patients in the intensive care unit at a clinic in Bucaramanga, Colombia., who were recruited in the first 24hours following admission and on whom the Richmond Agitation-Sedation Scale (RASS), PRE-DELIRIC version in Spanish, and Confusion Assessment method for Intensive Care Unit (CAM-ICU) were applied; the outcome was evaluated through daily monitoring with CAM-ICU...
June 13, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29908049/imaging-sublingual-microcirculatory-perfusion-in-pediatric-patients-receiving-procedural-sedation-with-propofol-a-pilot-study
#10
M A Riedijk, D M J Milstein
OBJECTIVE: Procedural sedation with propofol is widely used in the pediatric population. A well-known side effect of propofol is a decrease of peripheral vascular resistance resulting in hypotension, but little is known about the effects on the microcirculation in humans. We aimed to evaluate the effects of propofol on the sublingual microcirculatory perfusion by continuous video imaging in pediatric patients undergoing procedural sedation. METHODS: Patients admitted to the Pediatric Intensive Care Unit for procedural sedation were recruited...
June 16, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29907948/sedation-with-inhaled-agents-in-the-icu-what-are-we-waiting-for
#11
EDITORIAL
Jan Hendrickx, Jan Poelaert, Andre De Wolf
No abstract text is available yet for this article.
June 15, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29907211/comparison-of-dexmedetomidine-versus-propofol-on-hemodynamics-in-surgical-critically-ill-patients
#12
Ya-Fei Chang, Anne Chao, Po-Yuan Shih, Yen-Chun Hsu, Chen-Tse Lee, Yu-Wen Tien, Yu-Chang Yeh, Lee-Wei Chen
BACKGROUND: Sedation with dexmedetomidine and propofol may cause hypotension or bradycardia. This study aimed to compare the effects of dexmedetomidine and propofol on hemodynamics and clinical outcomes in surgical intensive care unit (ICU) patients after major abdominal surgery. MATERIALS AND METHODS: Enrolled patients were randomly allocated to the dexmedetomidine or propofol group. Cardiac index was measured using a continuous noninvasive cardiac output monitor on the basis of chest bioreactance...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29904429/effect-of-dexmedetomidine-midazolam-and-propofol-on-lipopolysaccharide-stimulated-dendritic-cells
#13
Feng Guo, Ying Ding, Xue Yu, Xiujun Cai
Dexmedetomidine, midazolam and propofol are common sedative drugs used in the intensive care unit. Lipopolysaccharides (LPS) are a potent inducer of human dendritic cells (DCs) maturation and survival, which induces cytokine production. The present study aimed to investigate the effect and mechanisms of sedative drugs on LPS-induced cytokine production in DCs. The mouse bone marrow-derived dendritic DC2.4 cell line was used in the present study. The Cell Counting Kit-8 assay was used to measure the viability of cells...
June 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29902554/resource-use-during-the-last-6-months-of-life-among-copd-patients-a-population-level-study
#14
Kristof Faes, Joachim Cohen, Lieven Annemans
CONTEXT: Chronic obstructive pulmonary disease (COPD) patients often have several comorbidities, such as cardiovascular diseases (CVD) or lung cancer (LC), which might influence resource use in the final months of life. However, no previous studies documented resource use in end-of-life COPD patients at a population level, thereby differentiating whether COPD patients die of their COPD, CVD or LC. AIM: To describe end-of-life resource use in people diagnosed with COPD and compare this resource use between those dying of COPD, CVD and LC...
June 11, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29901425/novel-metabolomic-comparison-of-arterial-and-jugular-venous-blood-in-severe-adult-tbi-patients-and-the-impact-of-pentobarbital-infusion
#15
Stephanie M Wolahan, Elliott Lebby, Howard C Mao, David McArthur, Courtney Real, Paul M Vespa, Daniel Braas, Thomas C Glenn
Treatment of severe traumatic brain injury (TBI) in the intensive care unit focuses on controlling intracranial pressure, ensuring sufficient cerebral perfusion, and monitoring for secondary injuries. Yet there are limited prognostic tools and no biomarkers or tests of the evolving neuropathology. Metabolomics has the potential to be a powerful tool to indirectly monitor evolving dysfunctional metabolism. We compared metabolite levels in simultaneously collected arterial and jugular venous samples in acute TBI patients undergoing intensive care as well as in healthy control volunteers...
June 14, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29895289/intravenous-morphine-versus-intravenous-paracetamol-after-cardiac-surgery-in-neonates-and-infants-a-study-protocol-for-a-randomized-controlled-trial
#16
Gerdien A Zeilmaker-Roest, Joost van Rosmalen, Monique van Dijk, Erik Koomen, Nicolaas J G Jansen, Martin C J Kneyber, Sofie Maebe, Greet van den Berghe, Dirk Vlasselaers, Ad J J C Bogers, Dick Tibboel, Enno D Wildschut
BACKGROUND: Morphine is worldwide the analgesic of first choice after cardiac surgery in children. Morphine has unwanted hemodynamic and respiratory side effects. Therefore, post-cardiac surgery patients may potentially benefit from a non-opioid drug for pain relief. A previous study has shown that intravenous (IV) paracetamol is effective and opioid-sparing in children after major non-cardiac surgery. The aim of the study is to test the hypothesis that intermittent IV paracetamol administration in children after cardiac surgery will result in a reduction of at least 30% of the cumulative morphine requirement...
June 13, 2018: Trials
https://www.readbyqxmd.com/read/29889729/comparing-n-pass-and-nips-improving-pain-measurement-in-the-neonate
#17
Amita Desai, Susan Aucott, Karen Frank, JoAnne Silbert-Flagg
BACKGROUND: Proper assessment of pain is essential to allow for safe and compassionate care of infants in the neonatal intensive care unit (NICU). The Neonatal Infant Pain Scale (NIPS) used in an urban level IV NICU addresses acute pain but may not adequately measure chronic neonatal pain. PURPOSE: The purpose of this quality improvement study was to improve acute and chronic pain measurements for neonates in an NICU through implementation of the Neonatal Pain, Agitation, and Sedation Scale (N-PASS)...
June 8, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29883981/oral-feeding-outcome-after-analgesic-and-sedative-exposure-in-vlbw-preterm-infant
#18
Mark T Astoria, Leroy Thacker, Karen D Hendricks-Muñoz
OBJECTIVE:  The objective of this study was to assess the association of analgesics and sedatives on oral feeding function and need for feeding tube at discharge in the very low birth weight (VLBW) (<1,500 g) preterm infant. STUDY DESIGN:  A retrospective review of surviving inborn infants < 1,500 g and < 32 weeks' gestation ( n  = 209), discharged between January 1, 2012, and December 31, 2014, from the neonatal intensive care unit identified exposure to analgesic and sedative medications, demographics, medical course, and nasogastric or gastrostomy tube (GT) feeding at discharge...
June 8, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29882581/icu-delirium-a-diagnostic-and-therapeutic-challenge-in-the-intensive-care-unit
#19
Katarzyna Kotfis, Annachiara Marra, Eugene Wesley Ely
Many patients treated in the intensive care unit (ICU) experience pain, that is a source of suffering and leaves a long-term imprint (chronic pain, post-traumatic stress disorder). Nearly 30% of patients experience pain at rest, the percentage increases to 50% during nursing procedures. Pain in ICU patients can be divided into four categories: continuous ICU treatment-related pain/discomfort, acute illness-related pain, intermittent procedural pain and pre-existing chronic pain present before ICU admission...
June 8, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29881956/the-safety-and-efficacy-of-nicotine-replacement-therapy-in-the-intensive-care-unit-a-randomised-controlled-pilot-study
#20
Ben de Jong, Anne Sophie Schuppers, Arriette Kruisdijk-Gerritsen, Maurits Erwin Leo Arbouw, Hubertus Laurentius Antonius van den Oever, Arthur R H van Zanten
BACKGROUND: Studies evaluating nicotine replacement therapy (NRT) to prevent nicotine withdrawal symptoms in ICU patients have yielded conflicting results. We performed a randomised controlled double-blind pilot study to assess the safety and efficacy of NRT in critically ill patients. Mechanically ventilated patients admitted to two medical-surgical intensive care units and smoking more than 10 cigarettes per day before ICU admission were enrolled in this study. Participants were randomised to transdermal NRT (14 or 21 mg per day) or placebo until ICU discharge or day 30...
June 7, 2018: Annals of Intensive Care
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