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electrolytes in icu patients

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https://www.readbyqxmd.com/read/27903458/cardiac-arrest-among-patients-with-infections-causes-clinical-practice-and-research-implications
#1
REVIEW
Davide Leoni, Jordi Rello
The incidence of sepsis is increasing, and the condition is now the leading cause of death in general intensive care units (ICUs). Our review failed to identify studies of the causes of cardiac arrest among infected patients, even though non-cardiac causes represent 15% of out-of-hospital cardiac arrests and though one-third of events have positive blood cultures. Sudden cardiac arrest is the result of local damage to the heart and of the impact of systemic and pulmonary conditions on cardiac performance, and its danger is underestimated...
November 26, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27881698/effects-of-electrolyte-replacement-protocol-implementation-in-a-medical-intensive-care-unit
#2
Daniel J Pearson, Anit Sharma, Joshua A Lospinoso, Michael J Morris, Edward T McCann
PURPOSE: To evaluate the effects of electrolyte replacement protocol (ERP) implementation in the medical intensive care unit (MICU) setting. We hypothesized that a protocol would reduce the time of replacement dose administration and increase provider satisfaction with the process of electrolyte replacement. METHODS: This was a retrospective review of electronic medical record data before and after implementation of a standardized ERP in an 18-bed military tertiary care MICU...
November 22, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27833483/acquired-hypernatremia-in-a-general-surgical-intensive-care-unit-incidence-and-prognosis
#3
Mariam A Alansari, Ahmed Abdulmomen, Mohammed Hussein, Ahmad Mohmmad Zubaidi, Jalal T Alswaiti
PURPOSE: Intensive Care Unit (ICU)-acquired hypernatremia (IAH) is a serious electrolyte disturbance that recently was shown to present an independent risk factor for mortality in critically ill patients. IAH has not been widely investigated in Surgical ICU (SICU) patients. No study has specifically investigated IAH epidemiology in the Kingdome of Saudi Arabia (KSA) in general SICU. The objectives of this study are to assess the epidemiological characteristics and prognostic impact of IAH on SICU mortality and outcome in KSA and compare it with international figures...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#4
Jon Kaufman, Daniel Phadke, Suhong Tong, Jennifer Eshelman, Sarah Newman, Christopher Ruzas, Eduardo M da Cruz, Suzanne Osorio
: Dysnatremias (DN) are common electrolyte disturbances in cardiac critical illness and are known risk factors for adverse outcomes in certain populations. Little information exists on DN in children with cardiac disease admitted to the cardiac intensive care unit (CICU) after undergoing cardiac surgery, either corrective or palliative. The aim was to determine the incidence and adverse outcomes associated with DN in neonates and infants undergoing cardiac surgery. Retrospective cohort and single center study performed at Children's Hospital Colorado from May 2013 to May 2014, in children under 1 year old admitted to the CICU after undergoing surgery for congenital or acquired cardiac disease...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27796127/-impact-of-reorganization-of-the-hungarian-system-of-intensive-care-units-in-2012
#5
Miklós Gresz
INTRODUCTION: In 2012, the Hungarian system of intensive care units was reorganized. During this process, multidisciplinary units were separated from observation units. AIM: The author analysed certain indicators of the remaining intensive care units. METHOD: The study was based on reports of National Health Insurance Fund between 2000 and 2015. RESULTS: After reorganization the number of the multidisciplinary intensive care units decreased by 20% and the number of beds decreased by 10%...
October 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27770618/diabetic-ketoacidosis-in-a-pediatric-intensive-care-unit
#6
Clarice L S Lopes, Paula Pitta Pinheiro, Luzia S Barberena, Guilherme U Eckert
OBJECTIVE: To describe the characteristics of children aged 0-14 years diagnosed with diabetic ketoacidosis and compare the following outcomes between children with prior diagnosis of type 1 diabetes mellitus (DM1) and children without prior diagnosis of DM1: length of hospital stay, severity on admission, insulin dosage, time of continuous insulin use, volume of fluids infused during treatment, and complications. METHODS: A retrospective descriptive study with review of medical records of patients admitted to the pediatric intensive care unit of a referral hospital from June 2013 to July 2015...
October 19, 2016: Jornal de Pediatria
https://www.readbyqxmd.com/read/27749633/etiology-and-outcome-of-severe-apparent-life-threatening-events-in-infants
#7
Tanja Radovanovic, Slobodan Spasojevic, Vesna Stojanovic, Aleksandra Doronjski
INTRODUCTION: An apparent life-threatening event (ALTE) is defined as "an episode that is frightening to the observer and is characterized by some combination of apnea, color change, marked change of muscle tone, choking, or gagging." OBJECTIVE: The aims of this study were to determine etiology and outcome of severe ALTE (requiring resuscitation measures) and to review diagnostic approaches in infants hospitalized after such an episode of ALTE. METHODS: Retrospective analysis included patients hospitalized at the Intensive Care Unit, Institute of Child and Youth Healthcare of Vojvodina, after an episode of severe ALTE over a 4-year period...
September 30, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27720664/pharmacological-management-of-acute-kidney-injury-and-chronic-kidney-disease-in-neonates
#8
Jennifer G Jetton, Mark Sorenson
Both acute kidney injury (AKI) and chronic kidney disease (CKD) are seen more frequently in the neonatal intensive care unit (NICU) as advances in supportive care improve the survival of critically ill infants as well as those with severe, congenital kidney and urinary tract anomalies. Many aspects of the infant's care, including fluid balance, electrolyte and mineral homeostasis, acid-base balance, and growth and nutrition require close monitoring by and collaboration among neonatologists, nephrologists, dieticians, and pharmacologists...
October 6, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27713674/impact-of-computerized-provider-order-entry-on-total-parenteral-nutrition-in-the-neonatal-intensive-care-unit
#9
Kyle A Franco, Keliana O'Mara
OBJECTIVES: To determine if computerized provider order entry (CPOE) implementation impacts the time it takes for preterm neonates to reach their parenteral macronutrient goals. METHODS: Retrospective review of neonates <1750 g receiving parenteral nutrition (PN) before and after the implementation of CPOE. Primary outcome was the attainment of parenteral macronutrient goals. Secondary outcomes included time to attainment, the frequency of electrolyte abnormalities, and the incidence of required adjustments made to PN orders by verification pharmacists...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27703360/delirium-as-a-complication-of-the-surgical-intensive-care
#10
Rostislav Horacek, Barbora Krnacova, Jan Prasko, Klara Latalova
BACKGROUND: The aim of this study was to examine the impact of somatic illnesses, electrolyte imbalance, red blood cell count, hypotension, and antipsychotic and opioid treatment on the duration of delirium in Central Intensive Care Unit for Surgery. PATIENTS AND METHODS: Patients who were admitted to the Department of Central Intensive Care Unit for Surgery in the University Hospital Olomouc from February 2004 to November 2008 were evaluated using Riker sedation-agitation scale...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27703296/rhabdomyolysis-in-critically-ill-surgical-patients
#11
Biljana Kuzmanovska, Emilija Cvetkovska, Igor Kuzmanovski, Nikola Jankulovski, Mirjana Shosholcheva, Andrijan Kartalov, Tatjana Spirovska
INTRODUCTION: Rhabdomyolysis is a syndrome of injury of skeletal muscles associated with myoglobinuria, muscle weakness, electrolyte imbalance and often, acute kidney injury as severe complication. THE AIM: of this study is to detect the incidence of rhabdomyolysis in critically ill patients in the surgical intensive care unit (ICU), and to raise awareness of this medical condition and its treatment among the clinicians. MATERIAL AND METHODS: A retrospective review of all surgical and trauma patients admitted to surgical ICU of the University Surgical Clinic "Mother Teresa" in Skopje, Macedonia, from January 1(st) till December 31(st) 2015 was performed...
July 27, 2016: Medical Archives
https://www.readbyqxmd.com/read/27639981/impact-of-chloride-and-strong-ion-difference-on-icu-and-hospital-mortality-in-a-mixed-intensive-care-population
#12
Niels Van Regenmortel, Walter Verbrugghe, Tim Van den Wyngaert, Philippe G Jorens
BACKGROUND: Abnormal chloride levels are commonly observed in critically ill patients, but their clinical relevance remains a matter of debate. We examined the association between abnormal chloremia and ICU and hospital mortality. To further refine findings and integrate them into the ongoing discussion on the detrimental effects of chloride-rich solutions, the impact of strong ion difference (SID) on the same end points was assessed. METHODS: Retrospective cohort study in an academic tertiary intensive care unit on 8830 adult patients who stayed at least 24 h in the ICU was carried out...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27608686/clinical-profile-of-patients-requiring-prolonged-mechanical-ventilation-and-their-outcome-in-a-tertiary-care-medical-icu
#13
Chakor S Vora, Niteen D Karnik, Vishal Gupta, Milind Y Nadkar, Jaimala V Shetye
INTODUCTION: An increasing number of patients require mechanical ventilation and there has been a proportional increase in patients needing prolonged mechanical ventilation (ventilated for ≥ 21 days, for atleast 6 hours per day). It accounts for about 10% of all mechanically ventilated patients. Although these patients represent a smaller proportion of intensive care unit (ICU) patients, they consume substantial ICU resources. We studied etiology, metabolic and clinical profile, complications and outcome of these patients...
October 2015: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27578606/review-of-drug-utilization-patterns-in-nicus-worldwide
#14
N Krzyżaniak, I Pawłowska, B Bajorek
WHAT IS KNOWN AND OBJECTIVES: When considering acute care settings, such as the neonatal intensive care unit (NICU), the inappropriate use of medicines poses a great risk to vulnerable babies at the start of their lives. However, there is limited published literature that explores the current medication management practices in NICUs and where the main misuse issues lie. Therefore, the purpose of this review was to give an overview of medicine use in NICUs worldwide and identify therapeutic areas requiring more targeted pharmaceutical care...
August 31, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27544004/hyperglycemia-and-subsequent-torsades-de-pointes-with-marked-qt-prolongation-during-refeeding
#15
Takashi Nakashima, Tomoki Kubota, Nobuhiro Takasugi, Yuichiro Kitagawa, Takahiro Yoshida, Hiroaki Ushikoshi, Masanori Kawasaki, Kazuhiko Nishigaki, Shinji Ogura, Shinya Minatoguchi
OBJECTIVE: A fatal cardiac complication can occasionally present in malnourished patients during refeeding; this is known as refeeding syndrome. However, to our knowledge, hyperglycemia preceding torsades de pointes with QT prolongation during refeeding has not been reported. In the present study, we present a case in which hyperglycemia preceded torsades de pointes with QT prolongation during refeeding. The aim of this study was to determine the possible mechanism underlying QT prolongation during refeeding and indicate how to prevent it...
January 2017: Nutrition
https://www.readbyqxmd.com/read/27540237/medication-management-of-the-extremely-premature-neonate-the-impact-of-a-specialist-pharmacist
#16
Karen Whitfield, Claudia Barkeij, Angela North
AIM: To present a case of an extremely premature infant and the role that the specialist neonatal pharmacist has on the quality of care of these patients. METHOD: Interventions and recommendations made by the pharmacists over the admission of a triplet born at 23 weeks and 5 days gestation were recorded. The type of interventions were categorised and classified for risk using a consequence/probability matrix.1 RESULTS: The patient required admission to the intensive care unit and subsequently the special care unit for a period of 163 days before discharge home...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27464280/-state-of-the-art-intensive-care-therapy-of-septic-patients
#17
Sebastian Reith, Jan Rudolf Ortlepp
After recognition of the diagnosis sepsis early resuscitation of the patient is mandatory. Patients should have a mean arterial pressure (MAP) ≥65 mmHg. Patients with hypotension should receive initial fluid challenge with approximately 30 mL/kg of balanced electrolyte solutions. However, iatrogenic volume overload should be avoided. If MAP remains < 65mmHg despite adequate volume norepinephrine is the first choice catecholamine. Oxygen should be delivered when oxygen saturation is below 90% to avoid hypoxemia...
July 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27447787/real-time-urinary-electrolyte-monitoring-after-furosemide-administration-in-surgical-icu-patients-with-normal-renal-function
#18
Luca Zazzeron, Davide Ottolina, Eleonora Scotti, Michele Ferrari, Paola Bruzzone, Silvio Sibilla, Cristina Marenghi, Luciano Gattinoni, Pietro Caironi
BACKGROUND: Although the loop-diuretic furosemide is widely employed in critically ill patients with known long-term effects on plasma electrolytes, accurate data describing its acute effects on renal electrolyte handling and the generation of plasma electrolyte alterations are lacking. We hypothesized that the long-term effects of furosemide on plasma electrolytes and acid-base depend on its immediate effects on electrolyte excretion rate and patient clinical baseline characteristics...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27432036/identification-of-high-utilization-inpatients-on-internal-medicine-services
#19
Marc Heincelman, Samuel O Schumann, Jenny Riley, Jingwen Zhang, Justin E Marsden, Patrick D Mauldin, Don C Rockey
BACKGROUND: As healthcare reform moves toward value based care, hospitals must reduce costs. As a first step, here we developed a predictive model to identify high-cost patients on admission. METHODS: We performed a retrospective observational study of 7,571 adults admitted to internal medicine services from July 1, 2013 to June 30, 2014. We compared the top 10% highest cost patients to other patients (controls) and identified clinical variables associated with high inpatient costs...
July 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27387786/effect-of-ondansetron-on-qt-interval-in-patients-cared-for-in-the-picu
#20
Sangita Trivedi, Brenda Schiltz, Rakesh Kanipakam, Johan Martijn Bos, Michael J Ackerman, Yves Ouellette
OBJECTIVES: There is no evidence regarding the effect of ondansetron on the QT interval in pediatric patients in the ICU. This study aimed to describe the effect of ondansetron on the corrected QT interval in patients cared for in the PICU. DESIGN: Retrospective cohort, consecutive enrollment study. SETTING: Single-center, tertiary-level, medical/surgical PICU. PATIENTS: All patients less than 8 years old who received ondansetron over an 11-month period were included...
July 2016: Pediatric Critical Care Medicine
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