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https://www.readbyqxmd.com/read/29149864/kinetic-estimated-glomerular-filtration-rate-in-critically-ill-patients-beyond-the-acute-kidney-injury-severity-classification-system
#1
Flávio de Oliveira Marques, Saulo Aires Oliveira, Priscila Ferreira de Lima E Souza, Wandervânia Gomes Nojoza, Maiara da Silva Sena, Taynara Muniz Ferreira, Bruno Gabriele Costa, Alexandre Braga Libório
BACKGROUND: Although significant advances have been achieved in acute kidney injury (AKI) research following its classification, potential pitfalls can be identified in clinical practice. The nonsteady-state (kinetic) estimated glomerular filtration rate (KeGFR) could add clinical and prognostic information in critically ill patients beyond the current AKI classification system. METHODS: This was a retrospective analysis using data from the Multiparameter Intelligent Monitoring in Intensive Care II project...
November 18, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29134245/esophageal-pressure-research-or-clinical-tool
#2
REVIEW
E Baedorf Kassis, S H Loring, D Talmor
Esophageal manometry has traditionally been utilized for respiratory physiology research, but clinicians have recently found numerous applications within the intensive care unit. Esophageal pressure (PEs) is a surrogate for pleural pressures (PPl), and the difference between airway pressure (PAO) and PEs provides a good estimate for the pressure across the lung also known as the transpulmonary pressure (PL). Differentiating the effects of mechanical ventilation and spontaneous breathing on the respiratory system, chest wall, and across the lung allows for improved personalization in clinical decision making...
November 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29127622/the-joint-effects-of-antenatal-steroids-and-gestational-age-on-improved-outcomes-in-neonates
#3
Neal D Goldstein, Kaitlin M Kenaley, Robert Locke, David A Paul
OBJECTIVES: Antenatal corticosteroids are standard of care for women at risk of a preterm birth and demonstrated to be protective against poor outcomes in neonates including respiratory disorders, mortality and intraventricular hemorrhage (IVH). Its benefits may vary by gestational age, and accurate estimation is needed in a single-center population to account for practice variation. METHODS: A retrospective cohort of infants admitted to the hospital's neonatal intensive care unit, 1997-2015...
November 10, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29121480/palliative-care-planner-pcplanner-a-pilot-study-to-evaluate-acceptability-and-usability-of-an-electronic-health-records-system-integrated-needs-targeted-app-platform
#4
Christopher E Cox, Derek M Jones, Wen Reagan, Mary D Key, Vinca Chow, Jessica McFarlin, David Casarett, Claire J Creutzfeldt, Sharron L Docherty
RATIONALE: The quality and patient-centeredness of intensive care unit (ICU)-based palliative care delivery is highly variable. OBJECTIVE: To develop and pilot an app platform for clinicians, ICU patients, and their family members that enhances the delivery of needs-targeted palliative care. METHODS: In the Development Phase of the study, we developed an electronic health record (EHR) system-integrated mobile web app system prototype, PCplanner (Palliative Care Planner)...
November 9, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29111298/improving-neonatal-care-with-the-help-of-veteran-resource-parents-an-overview-of-current-practices
#5
Claude Julie Bourque, Sonia Dahan, Ginette Mantha, Kate Robson, Martin Reichherzer, Annie Janvier
Over the past decade, veteran parents who have lived a neonatal intensive care unit (NICU) experience have become increasingly involved as 'resource parents' to provide peer-to-peer support to "new" NICU parents. These parents can provide a unique form of support to new parents. They can also assume other roles in clinical care, research, administration and/or teaching, but those roles are rarely described in the literature. This article reviews many of the activities performed by resource parents in neonatology...
October 27, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29102443/is-it-my-turn-to-speak-an-analysis-of-the-dialogue-in-the-family-physician-intensive-care-unit-conference
#6
Tessie W October, Zoelle B Dizon, Debra L Roter
OBJECTIVE: Apply turn analysis to family conferences in the pediatric intensive care unit. METHODS: We analyzed 39 audio-recorded family conferences using the Roter Interaction Analysis System. A turn was defined as a continuous block of uninterrupted statements by a speaker. RESULTS: Opening turns by the healthcare team (HCT) averaged 207s, compared to 28s for families. Turn density (number of statements/turn) was 6 for the HCT versus 2 for families (p<0...
October 28, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29092867/subsyndromal-delirium-and-institutionalization-among-patients-with-critical-illness
#7
Nathan E Brummel, Leanne M Boehm, Timothy D Girard, Pratik P Pandharipande, James C Jackson, Christopher G Hughes, Mayur B Patel, Jin H Han, Eduard E Vasilevskis, Jennifer L Thompson, Rameela Chandrasekhar, Gordon R Bernard, Robert S Dittus, E Wesley Ely
BACKGROUND: The prognostic importance of subsyndromal delirium is unknown. OBJECTIVE: To test whether duration of subsyndromal delirium is independently associated with institutionalization. METHODS: The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was used twice daily to assess for subsyndromal delirium in patients with respiratory failure or shock. Delirium was considered present if the assessment was positive. Subsyndromal delirium was considered present if the assessment was negative but the patient exhibited any CAM-ICU features...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29077619/perceptions-of-risk-and-safety-in-the-icu-a-qualitative-study-of-cognitive-processes-relating-to-staffing
#8
Danielle M D'Lima, Eleanor J Murray, Stephen J Brett
OBJECTIVES: The aims of this study were to 1) examine individual professionals' perceptions of staffing risks and safe staffing in intensive care and 2) identify and examine the cognitive processes that underlie these perceptions. DESIGN: Qualitative case study methodology with nurses, doctors, and physiotherapists. SETTING: Three mixed medical and surgical adult ICUs, each on a separate hospital site within a 1,200-bed academic, tertiary London hospital group...
October 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29067568/anemia-at-pediatric-intensive-care-unit-discharge-prevalence-and-risk-markers
#9
Pierre Demaret, Oliver Karam, Marisa Tucci, Jacques Lacroix, Hélène Behal, Alain Duhamel, Frédéric Lebrun, André Mulder, Stéphane Leteurtre
BACKGROUND: Anemia is prevalent at pediatric intensive care unit (PICU) admission and incident during PICU stay, but little is known about anemia at PICU discharge . Anemia after critical illness is an important issue because it could impact post-PICU outcome. We aimed to estimate the prevalence of anemia at PICU discharge and to determine its risk markers. METHODS: This is an ancillary study of a prospective observational study on transfusion practices conducted in the PICU of a tertiary care children's hospital...
October 24, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29029802/early-life-environmental-exposures-interact-with-genetic-susceptibility-variants-in-pediatric-patients-with-eosinophilic-esophagitis
#10
Elizabeth T Jensen, Jonathan T Kuhl, Lisa J Martin, Carl D Langefeld, Evan S Dellon, Marc E Rothenberg
BACKGROUND: Although eosinophilic esophagitis (EoE) is associated with certain gene variants, the rapidly increasing incidence of EoE suggests that environmental factors contribute to disease development. OBJECTIVE: We tested for gene-environment interaction between EoE-predisposing polymorphisms (within TSLP, LOC283710/KLF13, CAPN14, CCL26, and TGFB) and implicated early-life factors (antibiotic use in infancy, cesarean delivery, breast-feeding, neonatal intensive care unit [NICU] admission, and absence of pets in the home)...
September 12, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29027654/pharmacokinetic-drug-drug-interactions-in-the-intensive-care-unit-single-centre-experience-and-literature-review
#11
Piotr Łój, Aleksanda Olender, Weronika Ślęzak, Łukasz J Krzych
BACKGROUND: Drug-drug interactions constitute a serious health hazard in everyday clinical practice in critically ill patients. Drug-drug interactions may be pharmacokinetic or pharmacodynamic in their nature. We aimed to investigate the quantity and quality of possible drug-drug interactions, and their possible side effects in intensive care unit patients in a 12-month period. METHODS: This retrospective study covered data on pharmacological treatment of 43 consecutive patients (11 females, 32 males) aged 62 ± 15 years, hospitalized between January 2015 and February 2016...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29025194/procalcitonin-to-initiate-or-discontinue-antibiotics-in-acute-respiratory-tract-infections
#12
REVIEW
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Neera Bhatnagar, Djillali Annane, Konrad Reinhart, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Stella Ss Lima, Vera Maravić-Stojković, Alessia Verduri, Bin Cao, Yahya Shehabi, Albertus Beishuizen, Jens-Ulrik S Jensen, Caspar Corti, Jos A Van Oers, Ann R Falsey, Evelien de Jong, Carolina F Oliveira, Bianca Beghe, Matthias Briel, Beat Mueller
BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with ARIs and different settings ranging from primary care settings to emergency departments, hospital wards, and intensive care units...
October 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29017336/increase-in-oxytocin-from-skin-to-skin-contact-enhances-development-of-parent-infant-relationship
#13
Dorothy Vittner, Jacqueline McGrath, JoAnn Robinson, Gretchen Lawhon, Regina Cusson, Leonard Eisenfeld, Stephen Walsh, Erin Young, Xiaomei Cong
OBJECTIVE: To examine changes that occur in infant and parent salivary oxytocin (OT) and salivary cortisol (SC) levels during skin-to-skin contact (SSC) and whether SSC alleviates parental stress and anxiety while also supporting mother-father-infant relationships. METHODS: This randomized crossover study was conducted in the neonatal intensive care unit (NICU) with a sample of 28 stable preterm infants and their parents. Saliva samples were collected from infants, mothers, and fathers on Days 1 and 2 (1/parent) for OT and cortisol measurement pre-SSC, during a 60-min SSC session, and a 45-min post-SSC...
January 1, 2017: Biological Research for Nursing
https://www.readbyqxmd.com/read/28991764/hypoglycaemia-in-the-newborn
#14
Orhideja Stomnaroska, Elizabeta Petkovska, Sanja Ivanovska, Snezana Jancevska, Dragan Danilovski
AIM: Severe neonatal hypoglycaemia (HG) leads to neurologic damage, mental retardation, epilepsy, impaired cardiac performance and muscle weakness. The aim was to assess the frequency and severity of HG in a population of newborns. PATIENTS AND METHODS: We investigated 739 patients with neonatal hypoglycaemia (HG) (M:F=370:369) born at the University Clinic for Gynaecology and Obstetritics in Skopje in the period 2014-2016 and treated at the neonatal intensive care unit (NICU)...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28987982/a-qualitative-study-of-speaking-out-about-patient-safety-concerns-in-intensive-care-units
#15
Carolyn Tarrant, Myles Leslie, Julian Bion, Mary Dixon-Woods
Much policy focus has been afforded to the role of "whistleblowers" in raising concerns about quality and safety of patient care in healthcare settings. However, most opportunities for personnel to identify and act on these concerns are likely to occur much further upstream, in the day-to-day mundane interactions of everyday work. Using qualitative data from over 900 h of ethnographic observation and 98 interviews across 19 English intensive care units (ICUs), we studied how personnel gave voice to concerns about patient safety or poor practice...
November 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28982349/critical-care-rotation-impact-on-pediatric-resident-mental-health-and-burnout
#16
Katie K Wolfe, Sharon M Unti
BACKGROUND: Burnout and depression are common among medical trainees and intensive care unit providers, negatively impacting both providers and patients. We hypothesized that at the end of the pediatric intensive care unit (PICU) rotation, there would be an increased prevalence of depression and burnout in pediatric residents when compared to the beginning. METHODS: Pediatric residents were assessed prior to and following their PICU rotation using the Maslach Burnout Inventory, the Center for Epidemiologic Studies Depression Screen and a survey assessing positive and negative aspects of the rotation...
October 5, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28982305/advanced-modes-of-mechanical-ventilation-introduction-for-the-critical-care-pharmacist
#17
Michael J Cawley
Mechanical ventilation continues to be an evolving modality in the critical care environment. Technological advances in microprocessor-controlled ventilation integrated with the complexity of new ventilator modes has provided the multidisciplinary team opportunities to further improve the care of the critically ill ventilator patients. As members of the critical care multidisciplinary team, pharmacists require a basic understanding of both conventional and advanced modes of mechanical ventilation in order to assist in optimizing medication use and ultimately patient health-care outcomes...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28976482/it-s-in-your-hands-an-educational-initiative-to-improve-parent-family-hand-hygiene-compliance
#18
Celeste J Chandonnet, Kristan M Boutwell, Nadine Spigel, Judith Carter, Michele DeGrazia, Al Ozonoff, Kathleen Flaherty
BACKGROUND: Health care-associated infections contribute to increased morbidity and mortality, increased resource use, higher costs, and extended hospitalizations. Proper hand hygiene (HH) is essential to health care-associated infection prevention. Low compliance among parents in our neonatal intensive care unit (NICU) was identified and prompted development of an HH initiative. OBJECTIVE: The objective of this quality improvement project was to improve parent HH practices with the ultimate goal of achieving 100% compliance with parent HH...
November 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28970318/parental-experience-of-interaction-with-healthcare-professionals-during-their-infant-s-stay-in-the-neonatal-intensive-care-unit
#19
Katie Gallagher, Chloe Shaw, Narendra Aladangady, Neil Marlow
OBJECTIVE: To explore the experiences of parents of infants admitted to the neonatal intensive care unit towards interaction with healthcare professionals during their infants critical care. DESIGN: Semi-structured interviews were conducted with parents of critically ill infants admitted to neonatal intensive care and prospectively enrolled in a study of communication in critical care decision making. Interviews were transcribed verbatim and uploaded into NVivo V...
September 29, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28959218/maternal-sensitivity-buffers-the-association-between-slc6a4-methylation-and-socio-emotional-stress-response-in-3-month-old-full-term-but-not-very-preterm-infants
#20
Livio Provenzi, Monica Fumagalli, Roberto Giorda, Francesco Morandi, Ida Sirgiovanni, Uberto Pozzoli, Fabio Mosca, Renato Borgatti, Rosario Montirosso
BACKGROUND: Very preterm (VPT) infants are hospitalized in Neonatal Intensive Care Units (NICUs) and are exposed to life-saving procedures eliciting pain-related stress. Recent research documented that pain-related stress might result in birth-to-discharge increased methylation of serotonin transporter gene (SLC6A4) in VPT infants, leading to poorer stress regulation at 3 months of age in VPT infants compared to their full-term (FT) counterparts. Maternal sensitivity is thought to support infants' stress response, but its role in moderating the effects of altered SLC6A4 methylation is unknown...
2017: Frontiers in Psychiatry
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