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https://www.readbyqxmd.com/read/29321041/effects-of-stress-ulcer-prophylaxis-in-adult-icu-patients-receiving-renal-replacement-therapy-sup-icu-renal-siren-study-protocol-for-a-pre-planned-observational-study
#1
Joerg C Schefold, Anders Perner, Theis Lange, Jørn Wetterslev, Matt P Wise, Mark Borthwick, Stepani Bendel, Frederik Keus, Anne Berit Guttormsen, Søren Marker, Mette Krag, Morten Hylander Møller
BACKGROUND: Proton pump inhibitors are often used in critically ill patients to prevent gastrointestinal bleeding despite limited evidence for benefit. Patients with acute kidney injury requiring renal replacement therapy (RRT) are at high risk of gastrointestinal bleeding as (pre-)uremia induces coagulopathy through effects on platelets and coagulation cascades. No high-quality randomized clinical trials have previously assessed the benefits and harms of prophylactic proton pump inhibitor use in this high-risk population of adult critically ill patients...
January 10, 2018: Trials
https://www.readbyqxmd.com/read/29300197/effectiveness-of-sucrose-used-routinely-for-pain-relief-and-neonatal-clinical-risk-in-preterm-infants-a-nonrandomized-study
#2
Beatriz Oliveira Valeri, Cláudia Maria Gaspardo, Francisco Eulógio Martinez, Maria Beatriz Martins Linhares
BACKGROUND: Preterm infants (PI) requiring the Neonatal Intensive Care Unit (NICU) are exposed to early repetitive pain/distress. Little is known about how pain relief strategies interact with infants'clinical health status, such as severity of illness with pain responses. This study aimed to examine main and interactive effects of routine sucrose intervention and neonatal clinical risk (NCR) on biobehavioral pain reactivity-recovery in PI during painful blood collection procedures. METHODS: Very-low birthweight PI (n=104) were assigned to Low and High Clinical Risk Groups, according to the Clinical Risk Index for Babies...
January 3, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29283920/does-lactate-affect-the-association-of-early-hyperglycemia-and-multiple-organ-failure-in-severely-injured-blunt-trauma-patients
#3
Justin E Richards, Thomas M Scalea, Michael A Mazzeffi, Peter Rock, Samuel M Galvagno
BACKGROUND: Early hyperglycemia is associated with multiple organ failure (MOF) after traumatic injury; however, few studies have considered the contribution of depth of clinical shock. We hypothesize that when considered simultaneously, glucose and lactate are associated with MOF in severely injured blunt trauma patients. METHODS: We performed a retrospective investigation at a single tertiary care trauma center. Inclusion criteria were patient age ≥18 years, injury severity score (ISS) >15, blunt mechanism of injury, and an intensive care unit length of stay >48 hours...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29276432/animal-assisted-interactions-to-alleviate-psychological-symptoms-in-patients-on-mechanical-ventilation
#4
Breanna Hetland, Tanya Bailey, Maryjo Prince-Paul
Mechanical ventilation is a common life support intervention for critically ill patients that can cause stressful psychological symptoms. Animal assisted interactions have been used in variety of inpatient settings to reduce symptom burden and promote overall well-being. Due to the severity of illness associated with critical care, use of highly technological equipment, and heightened concern for infection control and patient safety, animal-assisted interaction has not been widely adopted in the intensive care unit...
December 2017: Journal of Hospice and Palliative Nursing: JHPN
https://www.readbyqxmd.com/read/29261091/association-of-enterococcus-spp-with-severe-combat-extremity-injury-intensive-care-and-polymicrobial-wound-infection
#5
Rae A Heitkamp, Ping Li, Katrin Mende, Samandra T Demons, David R Tribble, Stuart D Tyner
BACKGROUND: Combat-related extremity wound infections can complicate the recovery of injured military personnel. The Enterococcus genus contains both commensal and pathogenic bacteria found in many combat wounds. We describe the patient population susceptible to Enterococcus infection, the characteristics of Enterococcus spp. isolated from combat-related wounds, and the microbiological profile of Enterococcus-positive wounds. METHODS: Patient and culture data were obtained from the Trauma Infectious Disease Outcomes Study...
December 20, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29243506/macrocognition-in-the-healthcare-built-environment-mhcbe-a-focused-ethnographic-study-of-neighborhoods-in-a-pediatric-intensive-care-unit
#6
Susan O'Hara, Robin Toft Klar, Emily S Patterson, Nancy Morris, Judy Ascenzi, James C Fackler, Donna J Perry
OBJECTIVES: The objectives of this research were to describe the interactions (formal and informal), in which macrocognitive functions occur and their location on a pediatric intensive care unit, to describe challenges and facilitators of macrocognition using space syntax constructs (openness, connectivity, and visibility), and to analyze the healthcare built environment (HCBE) using those constructs to explicate influences on macrocognition. BACKGROUND: In high reliability, complex industries, macrocognition is an approach to develop new knowledge among interprofessional team members...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/29242652/the-effect-of-intravenous-dextrose-administration-for-prevention-of-post-operative-nausea-and-vomiting-after-laparoscopic-cholecystectomy-a-double-blind-randomised-controlled-trial
#7
Abolfazl Firouzian, Alieh Zamani Kiasari, Gholamali Godazandeh, Afshin Gholipour Baradari, Abbas Alipour, Arman Taheri, Amir Emami Zeydi, Maryam Montazemi
Background and Aims: Post-operative nausea and vomiting (PONV) is a common and distressing complication after laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the effect of intravenous (IV) dextrose administration for the prophylaxis of PONV after LC. Methods: In a double-blind, randomised controlled trial, a total of 150 female patients who were scheduled for elective LC were randomly assigned into two groups (A and B). Thirty minutes before induction of anaesthesia, patients received an infusion of 500 cc lactated Ringer's solution (Group A) and 5% dextrose in lactated Ringer's solution (Group B) and over a period of 30 min...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29219875/ehealth-interventions-for-parents-in-neonatal-intensive-care-units-a-systematic-review
#8
Justine Dol, Alannah Delahunty-Pike, Sheren Anwar Siani, Marsha Campbell-Yeo
BACKGROUND: As technology becomes increasingly more advanced, particularly video technology and interactive learning platforms, some neonatal intensive care units are embracing electronic health (eHealth) technologies to enhance and expand their family-centered care environments. Despite the emergence of eHealth, there has been a lack of systematic evaluation of its effectiveness thus far. OBJECTIVES: To examine the effect of eHealth interventions used in neonatal intensive care units on parent-related and infant outcomes...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29208756/neurally-adjusted-ventilatory-assist-after-pediatric-cardiac-surgery-clinical-experience-and-impact-on-ventilation-pressures
#9
Benjamin Crulli, Mariam Khebir, Baruch Toledano, Suzanne Vobecky, Nancy Poirier, Guillaume Emeriaud
INTRODUCTION: After pediatric cardiac surgery, ventilation with high airway pressures can be detrimental to right ventricular function and pulmonary blood flow. Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interactions, helping maintain spontaneous ventilation. This study reports our experience with the use of NAVA in children after a cardiac surgery. We hypothesize that using NAVA in this population is feasible and allows for lower ventilation pressures. METHODS: We retrospectively studied all children ventilated with NAVA (invasively or noninvasively) after undergoing cardiac surgery between January 2013 and May 2015 in our pediatric intensive care unit...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29206071/multivariable-analysis-of-the-association-between-electrolyte-disturbances-and-mortality-in-cats
#10
Robert Goggs, Sage De Rosa, Daniel J Fletcher
Objectives Electrolyte disorders have been individually associated with mortality in small populations of cats with specific conditions, but the associations and interactions between electrolyte disturbances and outcome have not been evaluated in a large, heterogeneous population. It was hypothesized that abnormalities of sodium, chloride, potassium and calcium concentrations would be independently and proportionately associated with death from natural causes and with all-cause mortality in cats. Methods An electronic database containing 7064 electrolyte profiles was constructed to assess the association between disorders of sodium, potassium, corrected-chloride and ionized calcium concentrations with non-survival by multivariable modelling...
December 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#11
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29203503/multicentre-prospective-randomised-single-blind-controlled-study-protocol-of-the-effect-of-an-additional-parent-administered-sensorimotor-stimulation-on-neurological-development-of-preterm-infants-primebrain
#12
Karine Pelc, Irit Daniel, Bernard Wenderickx, Bernard Dan
INTRODUCTION: Preterm and very low birthweight infants are at increased risk for neurodevelopmental disorders, including cerebral palsy, sensory impairment and intellectual disability. Several early intervention approaches have been designed in the hope of optimising neurological development in this context. It seems important that the intervention takes into account parental mental health, focuses on parent-child interactions and lasts sufficiently long. This study aims to evaluate the effects of a stimulation programme administered by parents until 6 months post-term on motor and neurophysiological development of infants born preterm...
December 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29198543/exposure-to-gastric-acid-inhibitors-increases-the-risk-of-infection-in-preterm-very-low-birth-weight-infants-but-concomitant-administration-of-lactoferrin-counteracts-this-effect
#13
Paolo Manzoni, Ruben García Sánchez, Michael Meyer, Ilaria Stolfi, Lorenza Pugni, Hubert Messner, Silvia Cattani, Pasqua Maria Betta, Luigi Memo, Lidia Decembrino, Lina Bollani, Matteo Rinaldi, Maria Fioretti, Michele Quercia, Milena Maule, Elena Tavella, Alessandro Mussa, Chryssoula Tzialla, Nicola Laforgia, Fabio Mosca, Rosario Magaldi, Michael Mostert, Daniele Farina
OBJECTIVE: To investigate whether exposure to inhibitors of gastric acidity, such as H2 blockers or proton pump inhibitors, can independently increase the risk of infections in very low birth weight (VLBW) preterm infants in the neonatal intensive care unit. STUDY DESIGN: This is a secondary analysis of prospectively collected data from a multicenter, randomized controlled trial of bovine lactoferrin (BLF) supplementation (with or without the probiotic Lactobacillus rhamnosus GG) vs placebo in prevention of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29196594/perceptions-of-families-of-intensive-care-unit-patients-regarding-involvement-in-delirium-prevention-activities-a-qualitative-study
#14
Pamela L Smithburger, Amanda S Korenoski, Sheila A Alexander, Sandra L Kane-Gill
BACKGROUND: Nonpharmacologic delirium-prevention strategies are commonly used in the intensive care unit by bedside nurses. With up to 80% of intensive care unit patients becoming delirious, and lacking treatment options, prevention is key. However, with increasing nurse workloads, innovative delirium-prevention strategies such as involving the patient's family are needed. OBJECTIVE: To gain insight into opinions of patients' families regarding active participation in delirium-prevention activities to inform specific recommendations for involving patients' families in such activities...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29191797/web-based-intervention-to-teach-developmentally-supportive-care-to-parents-of-preterm-infants-feasibility-and-acceptability-study
#15
Thuy Mai Luu, Li Feng Xie, Perrine Peckre, Sylvana Cote, Thierry Karsenti, Claire-Dominique Walker, Julie Gosselin
BACKGROUND: Preterm birth affects 8% to 11% of the population and conveys a significant risk of developmental delays. Intervention programs that support child development have been shown to have a positive impact on early motor and cognitive development and on parental well-being. However, these programs are often difficult to implement in a real-life setting due to lack of resources. Hence, our multidisciplinary team developed Mieux Agir au Quotidien (MAQ) to teach developmentally supportive care to parents of preterm infants with the goal of improving child development and parental outcomes...
November 30, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29180214/thioredoxin-1-attenuates-sepsis-induced-cardiomyopathy-after-cecal-ligation-and-puncture-in-mice
#16
Rickesha L Wilson, Vaithinathan Selvaraju, Rajesh Lakshmanan, Mahesh Thirunavukkarasu, Jacob Campbell, David W McFadden, Nilanjana Maulik
BACKGROUND: Sepsis is a leading cause of mortality among patients in intensive care units across the USA. Thioredoxin-1 (Trx-1) is an essential 12 kDa cytosolic protein that, apart from maintaining the cellular redox state, possesses multifunctional properties. In this study, we explored the possibility of controlling adverse myocardial depression by overexpression of Trx-1 in a mouse model of severe sepsis. METHODS: Adult C57BL/6J and Trx-1Tg/+ mice were divided into wild-type sham (WTS), wild-type cecal ligation and puncture (WTCLP), Trx-1Tg/+sham (Trx-1Tg/+S), and Trx-1Tg/+CLP groups...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29161170/examining-the-implementation-of-collaborative-competencies-in-a-critical-care-setting-key-challenges-for-enacting-competency-based-education
#17
Joanne Goldman, Simon Kitto, Scott Reeves
Interprofessional collaboration is recognised as an important factor in improving patient care in intensive care units (ICUs). Competency frameworks, and more specifically interprofessional competency frameworks, are a key strategy being used to support the development of attitudes, knowledge, skills, and behaviours needed for an interprofessional approach to care. However, evidence for the application of competencies is limited. This study aimed to extend our empirically based understanding of the significance of interprofessional competencies to actual clinical practice in an ICU...
November 21, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29158089/opportunities-and-difficulties-for-counseling-at-the-margins-of-viability
#18
REVIEW
Patrick Myers, Bree Andrews, William Meadow
At the margins of viability, the interaction between physicians and families presents challenges but also opportunities for success. The counseling team often focuses on data: morbidity and mortality statistics and the course of a typical infant in the neonatal intensive care unit. Data that are generated on the population level can be difficult to align with the multiple facets of an individual infant's trajectory. It is also information that can be difficult to present because of framing biases and the complexities of intuiting statistical information on a personal level...
November 17, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29156253/exploring-the-impact-of-using-measured-or-estimated-values-for-height-and-weight-on-the-relationship-between-bmi-and-acute-hospital-mortality
#19
Anne P Toft-Petersen, Jerome Wulff, David A Harrison, Marlies Ostermann, Mike Margarson, Kathryn M Rowan, Deborah Dawson
PURPOSE: Studies have demonstrated an association between height and weight and mortality among patients in the Intensive Care Unit (ICU) and the optimal body mass index (BMI) might be well above the optimal values in the general population. Most of these studies have relied on estimated values, the validity of which is not known. MATERIAL AND METHODS: Admissions to adult general ICUs from 1 April 2009 to 31 March 2016 in the Case Mix Programme (CMP) Database were described by height and weight assessment methods (measured or estimated)...
November 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29149864/kinetic-estimated-glomerular-filtration-rate-in-critically-ill-patients-beyond-the-acute-kidney-injury-severity-classification-system
#20
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
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