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ICU pneumonia rate

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https://www.readbyqxmd.com/read/28345309/a-survey-of-clinicians-regarding-respiratory-physiotherapy-intervention-for-intubated-and-mechanically-ventilated-patients-with-community-acquired-pneumonia-what-is-current-practice-in-australian-icus
#1
Lisa van der Lee, Anne-Marie Hill, Shane Patman
RATIONALE, AIMS, AND OBJECTIVES: Community-acquired pneumonia (CAP) is a common cause for intensive care unit (ICU) admission resulting in high morbidity and mortality. There is a paucity of evidence regarding respiratory physiotherapy for intubated and mechanically ventilated patients with CAP, and anecdotally clinical practice is variable in this cohort. The aims of this study were to identify the degree of variability in physiotherapy practice for intubated adult patients with CAP and to explore ICU physiotherapist perceptions of current practice for this cohort and factors that influence physiotherapy treatment mode, duration, and frequency...
March 27, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28341953/giant-rhinophyma-a-rare-case-of-total-nasal-obstruction-and-restitutio-ad-integrum
#2
Andreas Wolter, Till Scholz, Jutta Liebau
Rhinophyma is considered the end stage in the development of rosacea, accompanied by hypertrophy of the sebaceous glands, which causes an enlargement of the nose. It is an uncommon condition that often results in both functional and cosmetic impairment. A large variety of surgical and nonsurgical treatments have been published to treat it. Closure is usually obtained by wound granulating in by secondary intention, skin grafting or local flaps. Rarely these lesions can attain a giant size and pose a challenge in surgical treatment...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28323236/rationale-study-design-and-analysis-plan-of-the-lung-imaging-morphology-for-ventilator-settings-in-acute-respiratory-distress-syndrome-study-live-study-study-protocol-for-a-randomised-controlled-trial
#3
Matthieu Jabaudon, Thomas Godet, Emmanuel Futier, Jean-Etienne Bazin, Vincent Sapin, Laurence Roszyk, Bruno Pereira, Jean-Michel Constantin
Different acute respiratory distress syndrome (ARDS) phenotypes may explain controversial results in clinical trials. Lung-morphology is one of the ARDS-phenotypes and physiological studies suggest different responses in terms of positive-end-expiratory-pressure (PEEP) and recruitment-manoeuvres (RM) according to loss of aeration. To evaluate whether tailored ventilator regimens may impact ARDS outcomes, our group has designed a randomised-clinical-trial of ventilator settings according to lung morphology in moderate-to-severe ARDS (LIVE study)...
March 17, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28303301/impact-of-tapered-cuff-tracheal-tube-on-microaspiration-of-gastric-contents-in-intubated-critically-ill-patients-a-multicenter-cluster-randomized-cross-over-controlled-trial
#4
Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Hélène Behal, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacori, Isabelle Alves, Stéphanie Barrailler, Julien Labreuche, Laurent Robriquet, Fabienne Tamion, Emmanuel Delaporte, Damien Thellier, Claire Delcourte, Alain Duhamel, Saad Nseir
PURPOSE: Studies on the impact of tapered-cuff tracheal tubes on rates of microaspiration and ventilator-associated pneumonia (VAP) in intubated patients have reported conflicting results. The aim of this study was to determine the influence of this shape of tracheal cuff on abundant microaspiration of gastric contents in critically ill patients. METHODS: All patients intubated in the intensive care unit (ICU) and requiring mechanical ventilation for at least 48 h were eligible for this multicenter cluster-randomized controlled cross-over open-label study...
March 16, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28302496/community-acquired-pneumococcal-pneumonia-in-virologically-suppressed-hiv-infected-adult-patients-a-matched-case-control-study
#5
Catia Cillóniz, Antoni Torres, Christian Manzardo, Albert Gabarrús, Juan Ambrosioni, Adriana Salazar, Felipe García, Adrián Ceccato, Josep Mensa, Jorge Puig de la Bella Casa, Asunción Moreno, Jose M Miró
BACKGROUND: The study aimed to investigate whether the clinical presentations and outcomes (length-of-stay (LOS), intensive care unit (ICU) admission and 30-day mortality) of pneumococcal pneumonia in virologically suppressed HIV-infected patients on ART with a CD4+ T cell count >350 cells/mm(3) are comparable to those seen in non-HIV-infected patients, using a case-control design. METHODS: A case-control study was carried out in Hospital Clinic, Barcelona, Spain (2001-2016)...
March 13, 2017: Chest
https://www.readbyqxmd.com/read/28302375/risk-factors-for-unplanned-transfer-to-the-intensive-care-unit-after-emergency-department-admission
#6
Lena M Boerma, Eef P J Reijners, Roger A P A Hessels, Martijn A A V Hooft
INTRODUCTION: Unplanned Intensive Care Unit (ICU) admission has been used as a surrogate marker of adverse events, and is used by the Australian Council of Healthcare Accreditation as a reportable quality indicator. If we can identify independent variables predicting deterioration which require ICU transfer within 24h after emergency department (ED) admission, direct ICU admission should be considered. This may improve patient safety and reduce adverse events by appropriate disposition of patients presenting to the ED...
March 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28301956/the-effect-of-tracheostomy-performed-within-72%C3%A2-h-after-traumatic-brain-injury
#7
Keita Shibahashi, Kazuhiro Sugiyama, Hidenori Houda, Yuichi Takasu, Yuichi Hamabe, Akio Morita
The optimal timing of tracheostomy in patients with traumatic brain injury (TBI) remains unclear. The purpose of this study was to examine the effects of tracheostomy performed within 72 h after admission. In this retrospective cohort study, the authors reviewed the data for a series of 120 consecutive patients who underwent tracheostomy after suffering TBI with an Abbreviated Injury Scale (AIS) score of ≥4. The exclusion criteria were as follows: age <18 years, severe chest injury with an AIS score of ≥4, and a requirement for intubation because of upper airway obstruction...
March 16, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28289522/device-associated-infection-rates-mortality-length-of-stay-and-bacterial-resistance-in-intensive-care-units-in-ecuador-international-nosocomial-infection-control-consortium-s-findings
#8
Estuardo Salgado Yepez, Maria M Bovera, Victor D Rosenthal, Hugo A González Flores, Leonardo Pazmiño, Francisco Valencia, Nelly Alquinga, Vanessa Ramirez, Edgar Jara, Miguel Lascano, Veronica Delgado, Cristian Cevallos, Gasdali Santacruz, Cristian Pelaéz, Celso Zaruma, Diego Barahona Pinto
AIM: To report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted in Quito, Ecuador. METHODS: A device-associated healthcare-acquired infection (DA-HAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units (ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN) definitions and INICC methods. RESULTS: We followed 776 ICU patients for 4818 bed-days...
February 26, 2017: World Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28275224/aggressive-versus-conservative-antibiotic-use-to-prevent-and-treat-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-comparison-of-two-case-series
#9
Arturo Chieregato, Paolo Malacarne, Francesco Cocciolo, Maurizio Ravaldini, Emanuele Russo, Bruno Viaggi, Michele Giardino, Carlotta Rossi, Bruno Simini, Guido Bertolini
BACKGROUND: In patients with traumatic brain injury (TBI), ventilator-associated pneumonia (VAP) is considered a dangerous complication, prompting early aggressive antibiotic treatment and prophylaxis. While this approach increases the selection of multidrug-resistant bacteria (MDR), its clinical benefit has not been demonstrated. METHODS: One-year incidence of VAP in severe TBI patients (ICU stay >48 hours, with either Glasgow Coma Scale 8 or receiving intracranial pressure monitoring, or having undergone emergency surgery) and the prevalence of MDR among those who eventually developed it, were compared in two Italian intensive care units (ICUs) adopting different antibiotic approaches...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28268024/presence-distribution-and-molecular-epidemiology-of-multi-drug-resistant-gram-negative-bacilli-from-medical-personnel-of-intensive-care-units-in-tianjin-china-2007-2015
#10
H Liu, C N Fei, Y Zhang, G W Liu, J Liu, J Dong
BACKGROUND: Multi-drug-resistant Gram-negative bacteria (MDRGNB) have become an important cause of nosocomial infection in intensive care units (ICUs). AIMS: To investigate the molecular epidemiology of MDRGNB isolated from medical personnel (MP) and non-medical personnel (NMP) at 69 ICUs in Tianjin, China. METHODS: From April 2007 to October 2015, 2636 nasal and hand swab samples from 1185 MP and 133 NMP were cultured for GNB (including MDRGNB), meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE)...
January 28, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28254541/an-experience-with-traumatic-brain-injury-is-early-tracheostomy-associated-with-better-prognosis
#11
Hosseinali Khalili, Shahram Paydar, Rasool Safari, Peyman Arasteh, Amin Niakan, Amin Abolhasani Foroughi
OBJECTIVE: In this study we compared the effects of early tracheostomy (ET) versus late tracheostomy (LT) on traumatic brain injury (TBI) related outcomes and prognosis. PATIENTS AND METHODS: Data on 152 TBI patients with a Glasgow coma scale (GCS) of ≤8, admitted to Rajaee hospital, between March 1, 2014 and August 23, 2015, were collected. Rajaee hospital is the main referral trauma center in southern Iran and is affiliated to Shiraz University of Medical Sciences...
February 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28253353/effect-of-goal-directed-therapy-on-outcome-after-esophageal-surgery-a-quality-improvement-study
#12
Denise P Veelo, Mark I van Berge Henegouwen, Kirsten S Ouwehand, Bart F Geerts, Maarten C J Anderegg, Susan van Dieren, Benedikt Preckel, Jan M Binnekade, Suzanne S Gisbertz, Markus W Hollmann
BACKGROUND: Goal-directed therapy (GDT) can reduce postoperative complications in high-risk surgery patients. It is uncertain whether GDT has the same benefits in patients undergoing esophageal surgery. Goal of this Quality Improvement study was to evaluate the effects of a stroke volume guided GDT on post-operative outcome. METHODS AND FINDINGS: We compared the postoperative outcome of patients undergoing esophagectomy before (99 patients) and after (100 patients) implementation of GDT...
2017: PloS One
https://www.readbyqxmd.com/read/28241370/evolution-of-laparoscopic-liver-surgery-as-standard-procedure-for-hcc-in-cirrhosis
#13
Daniel Seehofer, Robert Sucher, Moritz Schmelzle, Robert Öllinger, Andri Lederer, Timm Denecke, Eckart Schott, Johann Pratschke
Patients with hepatocellular carcinoma (HCC) in cirrhosis have an increased risk for postoperative complications including liver failure. However, there is some evidence that the use of laparoscopy markedly decreases this risk. Patients Between 2010 - 2015, a total of 21 laparoscopic liver resections were performed for HCC in Child-A cirrhosis at our center. Mean MELD score was 9 (6 - 12), and the mean LiMAx was 261 µg/h/kg (101 - 489). All resections were performed by conventional laparoscopy using 4 - 6 trocars...
February 27, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28236797/community-acquired-pneumonia-caused-by-methicillin-resistant-staphylococcus-aureus-in-critically-ill-patients-systematic-review
#14
Nuria Carballo, Marta De Antonio-Cuscó, Daniel Echeverría-Esnal, Sonia Luque, Esther Salas, Santiago Grau
INTRODUCTION: Community-acquired pneumonia (CAP) is associated with high morbidity and mortality rates. Despite methicillin-resistant Staphylococcus aureus (MRSA) having often been associated with nosocomial pneumonia, the condition of some MRSA CAP patients is severe enough to warrant their being admitted to ICU. OBJECTIVE: The purpose of this study is to conduct a systematic review of the literature on antibiotic treatment of MRSA CAP in critically-ill patients...
March 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28215789/a-ten-year-review-of-total-hospital-onset-intensive-care-unit-bloodstream-infections-at-an-academic-medical-center
#15
Anna M Civitarese, Eric Ruggieri, J Matthias Walz, Deborah Ann Mack, Stephen O Heard, Michael Mitchell, Craig M Lilly, Karen E Landry, Richard T Ellison
OBJECTIVE: The rates of central line-associated bloodstream infections (CLABSIs) in United States intensive care units (ICU) have decreased significantly, and a parallel reduction in the rates of total hospital onset bacteremias in these units should also be expected. We report 10-year trends for total hospital onset ICU-associated bacteremias at a tertiary care academic medical center. DESIGN: This was a retrospective analysis of all positive blood cultures among patients admitted to seven adult ICUs for the period FY2005 through FY2014 according to Centers for Disease Control and Prevention National Healthcare Safety Network definitions...
February 16, 2017: Chest
https://www.readbyqxmd.com/read/28209197/accuracy-and-generalizability-of-using-automated-methods-for-identifying-adverse-events-from-electronic-health-record-data-a-validation-study-protocol
#16
Christian M Rochefort, David L Buckeridge, Andréanne Tanguay, Alain Biron, Frédérick D'Aragon, Shengrui Wang, Benoit Gallix, Louis Valiquette, Li-Anne Audet, Todd C Lee, Dev Jayaraman, Bruno Petrucci, Patricia Lefebvre
BACKGROUND: Adverse events (AEs) in acute care hospitals are frequent and associated with significant morbidity, mortality, and costs. Measuring AEs is necessary for quality improvement and benchmarking purposes, but current detection methods lack in accuracy, efficiency, and generalizability. The growing availability of electronic health records (EHR) and the development of natural language processing techniques for encoding narrative data offer an opportunity to develop potentially better methods...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28181033/clinical-and-microbiological-determinants-of-severe-and-fatal-outcomes-in-patients-infected-with-enterobacteriaceae-producing-extended-spectrum-%C3%AE-lactamase
#17
L Surgers, A Boyd, P-Y Boelle, V Lalande, P-A Jolivot, P-M Girard, G Arlet, C Cambier, A Homor, D Decre, J-L Meynard
Although extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae have become a worldwide public health concern, little is known regarding the clinical course of colonized or infected individuals. Our objective was to characterize the determinants of fatal outcomes related to ESBL-producing microorganisms at a large hospital in Paris, France. In 2012-2013, all consecutive patients with clinical samples testing positive for ESBL-producing Enterobacteriaceae at Saint-Antoine Hospital were identified...
February 8, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28164671/urinary-intestine-fatty-acid-binding-protein-is-associated-with-poor-outcome-of-pneumonia-patients-in-intensive-care-unit
#18
Sai-Wai Ho, Shi-Chuan Chang, Lee-Wei Chen
BACKGROUND: Urinary intestine fatty acid binding protein (U-IFABP) is a biomarker for gut injury. Previous studies showed that enterocyte damage in critically ill patients was common and appeared to be associated with poor prognosis. However, the impact of enterocyte damage on the outcome of critically ill patients with pneumonia has not yet been well investigated. The aim of the study is to evaluate the prognostic value of U-IFABP in critically ill patients with pneumonia. METHODS: A prospective observational study was performed in the intensive care unit (ICU) from September 1, 2013 to April 30, 2014...
November 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28164259/five-year-mortality-in-patients-treated-for-severe-community-acquired-pneumonia-a-retrospective-study
#19
H Lenz, G O Norby, V Dahl, T E Ranheim, R E Haagensen
BACKGROUND: The mortality rate in patients with severe community-acquired pneumonia (SCAP) is high. We investigated the 5-year mortality rate and causes of death in a patient population treated for SCAP in our intensive care unit (ICU), and compared the mortality rate in patients with or without chronic obstructive pulmonary disease (COPD) as comorbidity. METHODS: This retrospective study, which covers a period of 10 years, included patients aged > 18 years admitted to our ICU with SCAP as primary diagnosis and in need of mechanical ventilation for more than 24 h...
April 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28159015/a-randomized-placebo-controlled-phase-ii-study-of-a-pseudomonas-vaccine-in-ventilated-icu-patients
#20
Jordi Rello, Claus-Georg Krenn, Gottfried Locker, Ernst Pilger, Christian Madl, Laura Balica, Thierry Dugernier, Pierre-Francois Laterre, Herbert Spapen, Pieter Depuydt, Jean-Louis Vincent, Lajos Bogár, Zsuzsanna Szabó, Barbara Völgyes, Rafael Máñez, Nahit Cakar, Atilla Ramazanoglu, Arzu Topeli, Maria A Mastruzzo, Abel Jasovich, Christian G Remolif, Liliana Del Carmen Soria, Max A Andresen Hernandez, Carolina Ruiz Balart, Ildikó Krémer, Zsolt Molnár, Frank von Sonnenburg, Arthur Lyons, Michael Joannidis, Heinz Burgmann, Tobias Welte, Anton Klingler, Romana Hochreiter, Kerstin Westritschnig
BACKGROUND: Currently, no vaccine against Pseudomonas is available. IC43 is a new, recombinant, protein (OprF/I)-based vaccine against the opportunistic pathogen, Pseudomonas aeruginosa, a major cause of serious hospital-acquired infections. IC43 has proven immunogenicity and tolerability in healthy volunteers, patients with burns, and patients with chronic lung diseases. In order to assess the immunogenicity and safety of IC43 in patients who are most at risk of acquiring Pseudomonas infections, it was evaluated in mechanically ventilated ICU patients...
February 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
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