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investigations in icu

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https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#1
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27919715/perioperative-brain-natriuretic-peptide-in-pediatric-cardiac-surgery-patients-its-association-with-postoperative-outcomes
#2
Tomoyuki Kanazawa, Moritoki Egi, Yuichiro Toda, Kazuyoshi Shimizu, Kentaro Sugimoto, Tatsuo Iwasaki, Hiroshi Morimatsu
OBJECTIVES: The aim of this study was to investigate the relationship between perioperative brain natriuretic peptide levels and the incidence of postoperative serious adverse events (SAEs) in pediatric cardiac patients. DESIGN: A prospective observational study. SETTING: A single-institution university hospital. PARTICIPANTS: Children under 15 years old who underwent cardiac surgery that required cardiopulmonary bypass from December 21, 2012 to February 26, 2014...
September 13, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27918901/clinical-utility-of-methicillin-resistant-staphylococcus-aureus-nasal-polymerase-chain-reaction-assay-in-critically-ill-patients-with-nosocomial-pneumonia
#3
Melanie N Smith, Michael J Erdman, Jason A Ferreira, Petra Aldridge, Christopher A Jankowski
PURPOSE: This study investigated the diagnostic performance characteristics of a methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) assay in critically ill patients with nosocomial pneumonia. MATERIALS AND METHODS: This retrospective, single-center study included adult patients admitted to an intensive care unit with suspected nosocomial pneumonia. Patients must have received an MRSA nasal PCR assay and respiratory culture within predetermined time intervals...
November 15, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27918475/association-between-the-osteoporosis-self-assessment-tool-for-asians-score-and-mortality-in-patients-with-isolated-moderate-and-severe-traumatic-brain-injury-a-propensity-score-matched-analysis
#4
Cheng-Shyuan Rau, Pao-Jen Kuo, Shao-Chun Wu, Yi-Chun Chen, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study population comprised 7855 patients aged ≥40 years who were hospitalized for treatment of isolated moderate and severe TBI (an Abbreviated Injury Scale (AIS) ≥3 points only in the head and not in other regions of the body) between 1 January 2009 and 31 December 2014...
December 3, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27918381/outbreak-of-piv-3-in-a-neonatal-intensive-care-unit-in-england
#5
Gemma Louise Dunn, Helen Tapson, Jonathan Davis, Maya Gobin
An outbreak of PIV-3 in a neonatal intensive care unit was investigated using a retrospective cohort study. Risk of infection increased with lower birth weight and gestational age. Contact with sick visitor(s)/staff was not associated with infection (P= 0.212, P=0.299). Transmission routes are difficult to identify, and the importance of visiting restrictions and sickness absence during outbreaks is recommended.
November 30, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27918254/clinical-implications-of-mycobacterium-chimaera-detection-in-thermoregulatory-devices-used-for-extracorporeal-membrane-oxygenation-ecmo-germany-2015-to-2016
#6
Franziska C Trudzinski, Uwe Schlotthauer, Annegret Kamp, Kai Hennemann, Ralf M Muellenbach, Udo Reischl, Barbara Gärtner, Heinrike Wilkens, Robert Bals, Mathias Herrmann, Philipp M Lepper, Sören L Becker
Mycobacterium chimaera, a non-tuberculous mycobacterium, was recently identified as causative agent of deep-seated infections in patients who had previously undergone open-chest cardiac surgery. Outbreak investigations suggested an aerosol-borne pathogen transmission originating from water contained in heater-cooler units (HCUs) used during cardiac surgery. Similar thermoregulatory devices are used for extracorporeal membrane oxygenation (ECMO) and M. chimaera might also be detectable in ECMO treatment settings...
November 17, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/27918253/placental-growth-factor-alone-or-in-combination-with-soluble-fms-like-tyrosine-kinase-1-as-an-aid-to-the-assessment-of-women-with-suspected-pre-eclampsia-systematic-review-and-economic-analysis
#7
Geoff K Frampton, Jeremy Jones, Micah Rose, Liz Payne
BACKGROUND: Pre-eclampsia (PE) prediction based on blood pressure, presence of protein in the urine, symptoms and laboratory test abnormalities can result in false-positive diagnoses. This may lead to unnecessary antenatal admissions and preterm delivery. Blood tests that measure placental growth factor (PlGF) or the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to PlGF could aid prediction of PE if either were added to routine clinical assessment or used as a replacement for proteinuria testing...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27917855/identification-of-microorganisms-on-mobile-phones-of-intensive-care-unit-health-care-workers-and-medical-students-in-the-tertiary-hospital
#8
Ivan Kotris, Domagoj Drenjančević, Jasminka Talapko, Suzana Bukovski
Aim To identify and investigate a difference between microorganisms present on intensive care unit (ICU) health care workers' (HCW, doctors, nurses or medical technicians) and medical students' mobile phones as well as to investigate a difference between the frequency and the way of cleaning mobile phones. Methods Fifty swabs were collected from HCWs who work in the ICU (University Hospital Centre Osijek) and 60 swabs from medical students (School of Medicine, University of Osijek). Microorganisms were identified according to standard microbiological methods and biochemical tests to the genus/species level...
February 1, 2017: Medicinski Glasnik
https://www.readbyqxmd.com/read/27916603/oxidative-stress-in-sepsis-possible-production-of-free-radicals-through-an-erythrocyte-mediated-positive-feedback-mechanism
#9
Yanaihara Pichemel Amorim de Oliveira, Lain Carlos Pontes-de-Carvalho, Ricardo David Couto, Alberto Augusto Noronha-Dutra
BACKGROUND: Sepsis is an illness with a high morbidity for which no effective treatment exists. Its treatment has a high cost because it usually requires an intensive care unit and expensive antibiotics. The present study focus in the production of reactive oxygen species (ROS) in the early stages of sepsis. This study aimed at investigating the production of ROS during the inflammatory response in patients with sepsis. METHODS: ROS production and insoluble myeloperoxidase obtained from fresh whole blood were measured by photon counting chemiluminescence in the blood of 18 septic patients and 12 healthy individuals...
December 1, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27916077/-intestinal-barrier-dysfunction-and-its-related-factors-in-patients-with-sepsis
#10
W Liu, X H Wang, X J Yang, X Y Zhang, W J Qi
Objective: To investigate the relationship between related factors of intestinal barrier dysfunction in patients with sepsis or septic shock and severity of the condition. Methods: A prospective observational study was conducted in 31 sepsis patients, 28 septic shock patients, and 21 postoperative patients without sepsis (control group) who were admitted to intensive care unit (ICU) of General Hospital of Ningxia Medical University between November 2015 and June 2016. Blood samples were collected from the patients within 24 hours following admission to ICU...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27914907/psychometric-assessment-of-the-family-satisfaction-in-the-intensive-care-unit-questionnaire-in-the-united-kingdom
#11
David A Harrison, Paloma Ferrando-Vivas, Stephen E Wright, Elaine McColl, Daren K Heyland, Kathryn M Rowan
PURPOSE: To establish the psychometric properties of the Family Satisfaction in the Intensive Care Unit 24-item (FS-ICU-24) questionnaire in the United Kingdom. MATERIALS AND METHODS: The Family-Reported Experiences Evaluation study recruited family members of patients staying at least 24 hours in 20 participating intensive care units. Questionnaires were evaluated for nonresponse, floor/ceiling effects, redundancy, and construct validity. Internal consistency was evaluated with item-to-own scale correlations and Cronbach α...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#12
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27914649/nosocomial-outbreak-of-extensively-drug-resistant-pseudomonas-aeruginosa-associated-with-aromatherapy
#13
Astrid Mayr, Guido Hinterberger, Ingo H Lorenz, Peter Kreidl, Wolfgang Mutschlechner, Cornelia Lass-Flörl
An increase of extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) in various clinical specimens among intensive care unit patients (n = 7) initiated an outbreak investigation consisting of patient data analyses, control of adherence to infection control guidelines, microbiologic surveys, and molecular-based studies. XDR-PA was detected in a jointly used aroma-oil nursing bottle for aromatherapy. We implemented the restriction of oil sharing among patients. Hence, the outbreak was controlled successfully...
November 30, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27914275/inter-observer-agreement-of-the-general-movements-assessment-with-infants-following-surgery
#14
Cathryn Crowle, Claire Galea, Catherine Morgan, Iona Novak, Karen Walker, Nadia Badawi
BACKGROUND: The General Movements Assessment (GMA) is a validated and reliable method of identifying infants at risk of adverse neurodevelopmental outcomes, however there is minimal data available on the use of the GMA with infants following surgery. AIMS: The aim of this study was to investigate the inter-observer agreement for the GMA with this infant population. STUDY DESIGN: Reliability and agreement study. SUBJECTS: This was a prospective cohort study of 190 infants (male n=112) born at term (mean 38weeks, SD 2weeks)...
November 30, 2016: Early Human Development
https://www.readbyqxmd.com/read/27912070/cardiac-complications-associated-with-the-influenza-viruses-a-subtype-h7n9-or-pandemic-h1n1-in-critically-ill-patients-under-intensive-care
#15
Jiajia Wang, Hua Xu, Xinjing Yang, Daguo Zhao, Shenlang Liu, Xue Sun, Jian-An Huang, Qiang Guo
BACKGROUND AND OBJECTIVE: The clinical presentations and disease courses of patients hospitalized with either influenza A virus subtype H7N9 (H7N9) or 2009 pandemic H1N1 influenza virus (pH1N1) were compared in a recent report, but associated cardiac complications remain unclear. The present retrospective study investigated whether cardiac complications in critically ill patients with H7N9 infections differed from those infected with the pH1N1 strain. METHODS: Suspect cases were confirmed by reverse transcription polymerase chain reaction assays with specific confirmation of the pandemic H1N1 strain at the Centers for Disease Control and Prevention...
November 29, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27911257/individualized-antibiotic-therapy-in-patients-with-ventilator-associated-pneumonia
#16
Gurdal Yilmaz, Sedat Saylan, Firdevs Aksoy, Iftihar Koksal
The optimal duration of treatment of ventilator-associated pneumonia (VAP) is still the subject of debate. While 1-week treatment has been reported as possibly sufficient, patients generally receive antibiotic therapy for 10-14 days. The purpose of our study was to investigate whether length of treatment in patients with VAP can be reduced with an individualized therapeutic strategy. The study was performed prospectively with patients diagnosed with VAP in our hospital's intensive care units between 1 January and 31 December, 2015...
December 1, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27909593/our-anaesthetic-experiences-in-patients-undergoing-percutaneous-mitraclip-implantation
#17
Ezgi Erkılıç, Elvin Kesimci, Cihan Döğer, Tülin Gümüş, Süleyman Ellik, Orhan Kanbak
OBJECTIVE: Percutaneous mitraclip implantation system, is a new technique developed for patients with high surgical risks. It is generally performed in a catheterisation laboratory with the guidance of fluoroscopy and transesophageal echocardiography. In this study, we aimed to share our experiences on anaesthetic in patients undergoing mitraclip implantation under general anaesthesia. METHODS: Eighty four patients with severe, symptomatic mitral insufficiency, who had undergone MitraClip implantation under general anaesthesia between July 2012 and March 2015 (54 male, 30 female; mean age: 68...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#18
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906423/analysis-of-factors-influenced-by-the-effectiveness-of-non-invasive-ventilation-in-the-treatment-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-different-severities
#19
J-J Zhu, L-J Liu
OBJECTIVE: To investigate the correlation of levels of procalcitonin (PCT) and blood lactic acid with the effectiveness of the non-invasive ventilation (NIV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with different severities. PATIENTS AND METHODS: We used a case-control method to study patients who were admitted for AECOPD to the ICU at the Second Affiliated Hospital of Soochow University from January 1, 2012, to December 31, 2014...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27904850/the-safety-and-risk-factors-of-major-hepatobiliary-pancreatic-surgery-in-patients-older-than-80-years
#20
Jong Hun Kim, Seog Ki Min, Huisong Lee, Geun Hong, Hyeon Kook Lee
PURPOSE: Recently, the number of elderly patients has increased due to a longer life expectancy. Among these elderly patients, more octogenarians will be diagnosed with major hepatobiliary pancreatic (HBP) diseases. Therefore, we need to evaluate the safety and risk factors of major HBP surgery in patients older than 80 years. METHODS: From January 2000 to April 2015, patients who underwent major HBP surgery were identified. The patients were divided into 2 groups according to their age at the time of surgery: Group O (≥80 years) and group Y (<80 years)...
December 2016: Annals of Surgical Treatment and Research
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