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https://www.readbyqxmd.com/read/28343236/effects-of-restricting-perioperative-use-of-intravenous-chloride-on-kidney-injury-in-patients-undergoing-cardiac-surgery-the-licra-pragmatic-controlled-clinical-trial
#1
David McIlroy, Deirdre Murphy, Jessica Kasza, Dhiraj Bhatia, Lisa Wutzlhofer, Silvana Marasco
PURPOSE: The administration of chloride-rich intravenous (IV) fluid and hyperchloraemia have been associated with perioperative renal injury. The aim of this study was to determine whether a comprehensive perioperative protocol for the administration of chloride-limited IV fluid would reduce perioperative renal injury in adults undergoing cardiac surgery. METHODS: From February 2014 through to December 2015, all adult patients undergoing cardiac surgery within a single academic medical center received IV fluid according to the study protocol...
March 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28340935/individual-and-hospital-related-determinants-of-potentially-inappropriate-admissions-emerging-from-administrative-records
#2
Marco Fusco, Alessandra Buja, Paolo Piergentili, Maria Teresa Golfetto, Gianni Serafin, Silvia Gallo, Livio Dalla Barba, Vincenzo Baldo
INTRODUCTION: The appropriate use of health care is an important issue in developed countries. The purpose of this study was to ascertain the extent of potentially inappropriate hospital admissions and their individual, clinical and hospital-related determinants. METHODS: Medical records were analyzed for the year 2014 held by the Local Heath Unit n. 13 in the Veneto Region of north-east Italy (19,000 records). The outcomes calculated were: admissions for conditions amenable to day hospital care; brief medical admissions; outlier lengths of stay for elderly patients' medical admissions; and medical admissions to surgical wards...
November 2016: Health Policy
https://www.readbyqxmd.com/read/28340838/anesthetic-management-for-left-ventricular-assist-device-implantation-through-left-thoracotomy-evaluation-of-on-pump-versus-off-pump
#3
C Sahutoglu, E Turksal, U Bilic, S Kocabas, F Zekiye Askar, P Ozturk, S Ertugay, C Engin, T Yagdi, M Ozbaran
BACKGROUND: Ventricular assist devices (VADs) are alternative approaches to medical treatment in patients with acute or chronic heart failure. The goal of this study was to compare an anesthetic approach in patients undergoing implantation of a VAD with (on-pump) or without (off-pump) cardiopulmonary bypass (CPB) through left thoracotomy. METHODS: A total of 32 patients were divided into 2 groups: on-pump (group 1) and off-pump (group 2). A standard anesthesia protocol was used in all patients...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28337077/antithrombin-iii-doses-rounded-to-available-vial-sizes-in-critically-ill-pediatric-patients
#4
Winifred M Stockton, Eimeira Padilla-Tolentino, Carolyn E Ragsdale
OBJECTIVES: Children have decreased levels of antithrombin III (AT III) compared to adults. These levels may be further decreased during acute illness. Administration of exogenous AT III can increase anticoagulant efficacy. The objective of this study was to evaluate AT III doses rounded to available vial sizes compared to partial vial doses in critically ill pediatric patients, including patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT)...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28331489/reversible-atrial-fibrillation-following-crotalinae-envenomation
#5
Dan Quan, Kenneth Zurcher
BACKGROUND: Cardiotoxicity is a documented complication of Crotalinae envenomation. Reported cardiac complications following snake envenomation have included acute myocardial infarction, electrocardiogram abnormalities and arrhythmias. Few reports exist describing arrhythmia induced by viper envenomation and to our knowledge none describe arrhythmia induced by Crotalinae envenomation. This report concerns the first known case of atrial fibrillation precipitated by rattlesnake bite. CASE PRESENTATION: A 73-year-old Caucasian man with a past medical history of hypertension, hyperlipidemia, type 1 diabetes mellitus, and a baseline first-degree atrioventricular block presented to the emergency department following a rattlesnake bite to his left lower leg...
2017: Journal of Venomous Animals and Toxins Including Tropical Diseases
https://www.readbyqxmd.com/read/28329734/elevated-mif-2-levels-predict-mortality-in-critically-ill-patients
#6
Julia Pohl, Ulrike B Hendgen-Cotta, Pia Stock, Peter Luedike, Tienush Rassaf
PURPOSE: D-dopachrome tautomerase (MIF-2 or DDT) is a member of the macrophage migration inhibitory factor (MIF) superfamily and a close structural homolog to MIF. Circulating MIF-2 has been described to be elevated in patients suffering from sepsis, severe burn injury and after surgery. We sought to evaluate the prognostic value of MIF-2 in critically ill patients. METHODS: A total of 72 patients were studied upon admission to the medical intensive care unit (ICU)...
March 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28326826/predictive-value-of-the-c-reactive-protein-to-prealbumin-ratio-in-medical-icu-patients
#7
Li Li, Lihua Dai, Xiao Wang, Yao Wang, Luocheng Zhou, Miao Chen, Hairong Wang
AIM: This prospective study aimed to evaluate the relationship between the ratio of C-reactive protein-to-prealbumin (CRP/PAB) and clinical outcomes in medical intensive care unit patients. MATERIALS & METHODS: All 240 consecutive adult patients were enrolled in this study with demographic and clinical features collected. RESULTS: Compared with patients belonging to the CRP/PAB ≤0.24 group, hospital mortality and the total length of stay in hospital (TLSH) were significantly increased in patients in the CRP/PAB >0...
March 14, 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28326633/bias-from-depletion-of-susceptibles-the-example-of-hormone-replacement-therapy-and-the-risk-of-venous-thromboembolism
#8
Christel Renoux, Sophie Dell'Aniello, Benjamin Brenner, Samy Suissa
PURPOSE: The data on the association between hormone replacement therapy and the increased risk of venous thromboembolism (VTE) in postmenopausal women are conflicting. The observed differences between oral estrogen and oral estrogen-progestogen combination formulations may be the result of bias from depletion of susceptibles. METHODS: We used United Kingdom's Clinical Practice Research Datalink to identify the cohort of all women aged 50 to 79 during 1987-2008, with all incident cases of VTE occurring during the study period identified...
March 22, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28325586/-prognostic-indices-for-older-adults-during-the-year-following-hospitalization-in-an-acute-medical-ward-an-update
#9
Josephine Thomazeau, Samantha Huo Yung Kai, Yves Rolland, Sandrine Sourdet, Nicolas Saffon, Fati Nourhashemi
CONTEXT: As population grow older, chronic diseases are more prevalent. It leads to an increase of hospitalization for acute decompensation, sometimes iterative. Management of these patients is not always clear, and care provided is not always proportional to life expectancy. Making decisions in acute situations is not easy. OBJECTIVE: This review aims to list and describe mortality scores within a year following hospitalization of patients of 65 years or older...
March 18, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28325097/regaining-water-swallowing-function-in-the-rehabilitation-of-critically-ill-patients-with-intensive-care-unit-acquired-muscle-weakness
#10
Simone Thomas, Wolfgang Sauter, Ulrike Starrost, Marcus Pohl, Jan Mehrholz
PURPOSE: Treatment in intensive care units (ICUs) often results in swallowing dysfunction. Recent longitudinal studies have described the recovery of critically ill people, but we are not aware of studies of the recovery of swallowing function in patients with ICU-acquired muscle weakness. This paper aims to describe the time course of regaining water swallowing function in patients with ICU-acquired weakness in the post-acute phase and to describe the risks of regaining water swallowing function and the risk factors involved...
March 21, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28323687/multilevel-factors-associated-with-injurious-falls-in-acute-care-hospitals
#11
Yunchuan Lucy Zhao, Marjorie Bott, Jianghua He, Heejung Kim, Shin Hye Park, Nancy Dunton
Using National Database of Nursing Quality Indicators data from July 2013 to June 2014, this correlational study examined the associations of injurious falls among all patient falls with multilevel factors in hospitals. The sample included all falls recorded in adult medical, surgical, combined medical-surgical, and step-down units (N = 2299) in participating hospitals (N = 488). Hierarchical negative binominal regression analyses were performed. Results revealed hospital and unit organizational factors associated with inpatient injurious falls...
March 20, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28323290/incidence-and-risk-factors-for-delirium-development-in-icu-patients-a-prospective-observational-study
#12
Marcela Kanova, Peter Sklienka, Roman Kula, Michal Burda, Jana Janoutova
BACKGROUND AND AIMS: Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. METHODS: A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period...
March 14, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28322639/the-symbolic-functions-of-nurses-cognitive-artifacts-on-a-medical-oncology-unit
#13
Jacquelyn W Blaz, Alexa K Doig, Kristin G Cloyes, Nancy Staggers
Acute care nurses continue to rely on personally created paper-based tools-their "paper brains"-to support work during a shift, although standardized handoff tools are recommended. This interpretive descriptive study examines the functions these paper brains serve beyond handoff in the medical oncology unit at a cancer specialty hospital. Thirteen medical oncology nurses were each shadowed for a single shift and interviewed afterward using a semistructured technique. Field notes, transcribed interviews, images of nurses' paper brains, and analytic memos were inductively coded, and analysis revealed paper brains are symbols of patient and nurse identity...
December 1, 2016: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28321141/adjunct-analgesic-use-for-acute-pain-in-the-emergency-department
#14
James Priano, Brian Faley, Gabrielle Procopio, Kevin Hewitt, Joseph Feldman
Purpose: Multimodal analgesia is common practice in the postoperative setting, but the utility of adjunctive analgesia in the emergency department (ED) is less understood. The primary objective of this study was to analyze ED prescriber ordering habits for adjunct nonopioid pain medication for opioid-naïve patients who require intravenous (IV) morphine or hydromorphone for acute pain. Secondary objectives were to assess initial and total opioid consumption in morphine equivalent units (MEU), pain scores, and ED length of stay (LOS) between groups...
February 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28321022/administration-of-ticagrelor-and-double-dose-clopidogrel-based-on-platelet-reactivity-determined-by-verifynow-p2y12-for-chinese-subjects-after-elective-pci
#15
Xi Wu, Gang Liu, Jie Lu, Xin-Xin Zheng, Jin-Gang Cui, Xue-Yan Zhao, Xiao-Hong Huang
Previous studies have identified high on treatment platelet reactivity (HTPR) as a potent factor predicting ischemic events for patients with coronary heart disease. We assessed the efficacy and safety of ticagrelor (90 mg twice-daily) and double-dose of clopidogrel (150 mg once-daily) among Chinese patients for elective percutaneous coronary intervention. We enrolled 40 patients with HTPR from among 317 patients with non-ST-segment elevation acute coronary syndromes after a successful elective percutaneous coronary intervention (PCI)...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28320608/antithrombotic-agents-for-secondary-prevention-after-acute-coronary-syndromes-a-systematic-review-and-network-meta-analysis
#16
Alexander C Fanaroff, Vic Hasselblad, Matthew T Roe, Deepak L Bhatt, Stefan K James, Ph Gabriel Steg, C Michael Gibson, E Magnus Ohman
BACKGROUND: Nine oral antithrombotic medications currently available in the United States and Europe have been studied in clinical trials for secondary prevention of cardiac events following acute coronary syndrome (ACS). Few combinations of these medications have been directly compared, and studies have used multiple different comparator regimens. METHODS: We performed a systematic review and network meta-analysis of randomized controlled trials evaluating one or more available oral antithrombotic therapies in patients with ACS or prior myocardial infarction (MI)...
March 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28318891/lessons-from-a-national-audit-of-acute-pancreatitis-a-summary-of-the-ncepod-report-treat-the-cause
#17
REVIEW
D A O'Reilly, S J McPherson, M T Sinclair, N Smith
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is an independent organisation whose remit is to review the quality of medical and surgical care provided in the United Kingdom. We undertook a review into the care provided to patients treated for acute pancreatitis during a 6 month study period between 1st January and 30th June 2014. This included assessment of care at an organisational level, clinical level within hospitals and external peer review. From a random sample, 712 patients underwent hospital clinician review and 418 patients had external peer review...
February 17, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28318620/factors-associated-with-mortality-risk-in-critical-care-patients-treated-with-veno-arterial-extracorporeal-membrane-oxygenation
#18
Sun Hee Lee, Dong-Soo Shin, Jong Ran Kim, Hyunjung Kim
OBJECTIVES: To identify factors associated with mortality in patients treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and to validate the discrimination of the risk assessment tools to predict mortality. BACKGROUND: VA-ECMO is a rescue therapy for patients with life-threatening cardiac failure, but mortality remains high. METHODS: In this retrospective study, we reviewed the medical records of adult patients who underwent VA-ECMO in an intensive care unit of a university hospital, between 2009 and 2013...
March 16, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28316318/synchronous-open-heart-surgery-and-laparoscopic-cholecystectomy-an-observational-case-study-with-28-patients
#19
Mustafa Bilge Erdogan, Mehmet Kaplan, Hakki Kazaz, Bulent Salman
Acute cholecystitis (AC) may be a severe problem and may increase the mortality rate and hospital stay in patients who undergo open heart surgery (OHS), due to its aggressive course; therefore, AC should be treated as soon as possible. We aimed to present data on our synchronous cardiac and laparoscopic cholecystectomy (LC) operations performed for AC complicating patients with cardiac disease and who were waiting to undergo OHS. Between January 2008 and September 2014, we performed 2773 OHSs in Medical Park Gaziantep Hospital...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28304263/battling-a-tangled-web-the-lived-experience-of-nurses-providing-end-of-life-care-on-an-acute-medical-unit
#20
Irene Oliveira, Frances Fothergill-Bourbonnais, Christine McPherson, Brandi Vanderspank-Wright
Meeting the heath care needs of patients at the end of life is becoming more complex. In Canada, most patients with life-limiting illness will die in hospitals, many on medical units. Yet, few studies have qualitatively investigated end-of-life care (EOLC) in this context, or from the perspectives of nurses providing EOLC. The purpose of this study was to seek to understand the lived experience of nurses on a medical unit providing EOLC to patients. Interpretive phenomenology guided the method and analysis...
November 1, 2016: Research and Theory for Nursing Practice
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