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https://www.readbyqxmd.com/read/27257705/what-is-the-effectiveness-of-the-negative-pressure-wound-therapy-npwt-in-patients-treated-with-open-abdomen-technique-a-systematic-review-and-meta-analysis
#1
Roberto Cirocchi, Arianna Birindelli, Walter L Biffl, Ventsislav Mutafchiyski, Georgi Popivanov, Osvaldo Chiara, Gregorio Tugnoli, Salomone Di Saverio
BACKGROUND: The open abdomen technique may be used in critically ill patients to manage abdominal injury, reduce the septic complications, and prevent the abdominal compartment syndrome. Many different techniques have been proposed and multiple studies have been conducted, but the best method of temporary abdominal closure has not been determined yet. Recently, new randomized and nonrandomized controlled trials have been published on this topic. We aimed to perform an up-to-date systematic review on the management of open abdomen, including the most recent published randomized and nonrandomized controlled trials, to compare negative pressure wound therapy (NPWT) with no NPWT and define if one technique has better outcomes than the other with regard to primary fascial closure, postoperative 30-day mortality and morbidity, enteroatmospheric fistulae, abdominal abscess, bleeding, and length of stay...
September 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27235672/non-diabetic-clinical-applications-of-insulin
#2
Jyoti M Benni, Paragouda A Patil
BACKGROUND: Introducing a new drug to the market is a time-consuming process, is complex, and involves consumption of a lot of resources. Therefore, discovering new uses for the old drugs (i.e. drug repurposing) benefits the patients by providing them time-tested drugs. With developments in insulin therapy still happening, it is worth keeping up to date on trends in the use of this powerful glucose-lowering agent. The aim of this article is to explore the potential non-diabetic clinical applications of insulin...
September 1, 2016: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/27108084/analgosedation-improving-patient-outcomes-in-icu-sedation-and-pain-management
#3
Ryan Wiatrowski, Colleen Norton, David Giffen
Sedation practices in the critical care unit have been trending toward lighter sedation since the start of the new millennium, but patients continue to experience inadequate pain management and excessive sedation. This paper includes a brief examination of the problem of pain management in the ICU; trends in sedation practices, including light sedation and the daily interruption of sedation; and a literature review of analgosedation. While the analgosedation literature is relatively sparse, it offers a promising, patient-centered method for managing the triad of pain, agitation, and delirium, while reducing common complications associated with long-term ventilation...
June 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/26985250/temporal-trends-of-the-clinical-resource-use-and-outcome-attributes-of-icu-managed-candidemia-hospitalizations-a-population-level-analysis
#4
Lavi Oud
BACKGROUND: There are mixed findings on the longitudinal patterns of the incidence of intensive care unit (ICU)-managed candidemia, with scarcity of reports on the corresponding evolving patterns of patients' clinical characteristics and outcomes. No population-level data were reported on the temporal trends of the attributes, care and outcomes of ICU-managed adults with candidemia. METHODS: The Texas Inpatient Public Use Data File was used to identify hospitalizations aged 18 years or older with a diagnosis of candidemia and ICU admission (C-ICU hospitalizations) between 2001 and 2010...
April 2016: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/26941562/evaluation-of-a-practice-guideline-for-the-management-of-respiratory-distress-syndrome-in-preterm-infants-a-quality-improvement-initiative
#5
Brooke Read, David Sc Lee, Debbie Fraser
BACKGROUND: The use of mechanical ventilation to treat respiratory distress syndrome in preterm infants has been associated with the development of bronchopulmonary dysplasia. As part of a quality improvement initiative to reduce the incidence of bronchopulmonary dysplasia in preterm infants, a new practice guideline for the management of respiratory distress syndrome was developed and adopted into practice in a neonatal intensive care unit in February 2012. OBJECTIVE: To evaluate the effects of implementing the new guideline in regard to the use of mechanical ventilation and surfactant, and the incidence of bronchopulmonary dypslasia...
January 2016: Paediatrics & Child Health
https://www.readbyqxmd.com/read/26855892/neuroprotective-measures-in-children-with-traumatic-brain-injury
#6
REVIEW
Shruti Agrawal, Ricardo Garcia Branco
Traumatic brain injury (TBI) is a major cause of death and disability in children. Severe TBI is a leading cause of death and often leads to life changing disabilities in survivors. The modern management of severe TBI in children on intensive care unit focuses on preventing secondary brain injury to improve outcome. Standard neuroprotective measures are based on management of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) to optimize the cerebral blood flow and oxygenation, with the intention to avoid and minimise secondary brain injury...
February 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26205314/recreational-phenethylamine-poisonings-reported-to-a-french-poison-control-center
#7
Gaël Le Roux, Chloé Bruneau, Bénédicte Lelièvre, Marie Bretaudeau Deguigne, Alain Turcant, Patrick Harry, David Boels
OBJECTIVES: Over the last decade, use of phenethylamines has become increasingly prevalent. This study aimed to describe typical aspects of phenethylamine poisoning in order to better inform patient care. METHODS: Phenethylamine poisoning cases reported to the Poison Control Center of Angers, France, from January, 2007 to December, 2013 were examined. Clinical findings were examined in 105 patients, including phenethylamine used, symptoms and final outcome. Patients were predominantly male (80%), with mean age 26±8 years...
September 1, 2015: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/25922054/surgical-outcome-of-pancreaticoduodenectomy-high-volume-center-or-multidisciplinary-management
#8
Giovanni Alemanno, Carlo Bergamini, Jacopo Martellucci, Riccardo Somigli, Paolo Prosperi, Alessandro Bruscino, Alessandro Sturiale, Andrea Valeri
BACKGROUND: More recently mortality and morbidity related to PD has dramatically dropped, due to the new mini-invasive technology as well as to a trend leading towards centralization. Our hospital can be considered a high-volume center for pancreatic surgery; nevertheless, each of its 5 surgical units taken alone has a low/medium-volume activity. The aim of this study was to evaluate the results of PD in a low-medium volume unit with multidisciplinary support in a major high-volume hospital...
February 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/25255404/a-cost-analysis-of-the-impact-of-a-new-intravenous-antihypertensive-in-managing-perioperative-blood-pressure-during-cardiac-surgery
#9
Solomon Aronson, Joseph F Dasta, Jerrold H Levy, Philip D Lumb, Manuel Fontes, Yamei Wang, Tracy A Crothers, Katherine A Sulham, Marco S Navetta
OBJECTIVE: To examine the impact of intravenous antihypertensive selection on hospital health resource utilization using data from the Evaluation of CLevidipine In the Perioperative Treatment of Hypertension Assessing Safety Events (ECLIPSE) trials. METHODS: Analysis of ECLIPSE trial data comparing clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine and unit costs based on the Premier Hospital database to assess surgery duration, time to extubation, and length of stay (LOS) with the associated cost...
August 2014: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/25147481/is-a-good-death-possible-in-australian-critical-and-acute-settings-physician-experiences-with-end-of-life-care
#10
Steven A Trankle
BACKGROUND: In Australia approximately 70% of all deaths are institutionalised but over 15% of deaths occur in intensive care settings where the ability to provide a "good death" is particularly inhibited. Yet, there is a growing trend for death and dying to be managed in the ICU and physicians are increasingly challenged to meet the new expectations of their specialty. This study examined the unexplored interface between specialised Australian palliative and intensive care and the factors influencing a physician's ability to manage deaths well...
2014: BMC Palliative Care
https://www.readbyqxmd.com/read/24820463/gram-negative-bacilli-causing-infections-in-an-intensive-care-unit-of-a-tertiary-care-hospital-in-istanbul-turkey
#11
Seniha Senbayrak Akcay, Asuman Inan, Simin Cevan, Ayse Nilufer Ozaydın, Naz Cobanoglu, Seyfi Celik Ozyurek, Sebahat Aksaray
INTRODUCTION: This study aimed to demonstrate the changing epidemiology of infecting microorganisms and their long-term resistance profiles and to describe the microbiological point of view in anti-infective management of intensive care unit (ICU) patients. METHODOLOGY: A total of 5,690 isolates of Gram-negative bacilli were included in this study. Antibiotic susceptibility was tested using the disk diffusion method and Vitek 2 system. Chi-square tests were used for hypothesis testing...
May 2014: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/24739335/reducing-the-impact-of-insulin-sensitivity-variability-on-glycaemic-outcomes-using-separate-stochastic-models-within-the-star-glycaemic-protocol
#12
Felicity Thomas, Christopher G Pretty, Liam Fisk, Geoffrey M Shaw, J Geoffrey Chase, Thomas Desaive
BACKGROUND: The metabolism of critically ill patients evolves dynamically over time. Post critical insult, levels of counter-regulatory hormones are significantly elevated, but decrease rapidly over the first 12-48 hours in the intensive care unit (ICU). These hormones have a direct physiological impact on insulin sensitivity (SI). Understanding the variability of SI is important for safely managing glycaemic levels and understanding the evolution of patient condition. The objective of this study is to assess the evolution of SI over the first two days of ICU stay, and using this data, propose a separate stochastic model to reduce the impact of SI variability during glycaemic control using the STAR glycaemic control protocol...
2014: Biomedical Engineering Online
https://www.readbyqxmd.com/read/24292078/changes-in-the-outcomes-of-severe-trauma-patients-from-15-year-experience-in-a-western-european-trauma-icu-of-emilia-romagna-region-1996-2010-a-population-cross-sectional-survey-study
#13
Salomone Di Saverio, Giorgio Gambale, Federico Coccolini, Fausto Catena, Eleonora Giorgini, Luca Ansaloni, Niki Amadori, Carlo Coniglio, Aimone Giugni, Andrea Biscardi, Stefano Magnone, Filippo Filicori, Piergiorgio Cavallo, Silvia Villani, Francesco Cinquantini, Massimo Annicchiarico, Giovanni Gordini, Gregorio Tugnoli
BACKGROUND: Our experience in trauma center management increased over time and improved with development of better logistics, optimization of structural and technical resources. In addition recent Government policy in safety regulations for road traffic accident (RTA) prevention, such compulsory helmet use (2000) and seatbelt restraint (2003) were issued with aim of decreasing mortality rate for trauma. INTRODUCTION: The evaluation of their influence on mortality during the last 15 years can lead to further improvements...
January 2014: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/23524477/hospital-acquired-pneumonia-and-ventilator-associated-pneumonia-recent-advances-in-epidemiology-and-management
#14
REVIEW
François Barbier, Antoine Andremont, Michel Wolff, Lila Bouadma
PURPOSE OF REVIEW: The recent evidence is reviewed on clinical epidemiology, trends in bacterial resistance, diagnostic tools and therapeutic options in hospital-acquired pneumonia (HAP), with a special focus on ventilator-associated pneumonia (VAP). RECENT FINDINGS: The current incidence of VAP ranges from two to 16 episodes for 1000 ventilator-days, with an attributable mortality of 3-17%. Staphylococcus aureus (with 50-80% of methicillin-resistant strains), Pseudomonas aeruginosa and Enterobacteriaceae represent the most frequent pathogens in HAP/VAP...
May 2013: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/22459726/aspects-of-survival-from-colorectal-cancer-in-denmark
#15
Lene Hjerrild Iversen
This thesis has reported survival among Danish colorectal cancer patients over the past decades and it has explored different aspects of the inferior short-term and long-term survival of Danish patients in relation to (i) patient factors: old age and comorbidity; (ii) disease factors: prognostic factors for early death after emergency surgery; (iii) diagnostic factors: impact of diagnostic delay; (iv) treatment factors: seasonal variation in postoperative mortality and the benefit of a new approach for management of obstructive cancer; and (v) structural factors: hospital volume and surgeon characteristics...
April 2012: Danish Medical Journal
https://www.readbyqxmd.com/read/21991199/a-new-era-in-the-management-of-burns-trauma-in-kumasi-ghana
#16
P Agbenorku, J Akpaloo, D Yalley, A Appiah
The aim of the study was to investigate the factors affecting the outcome of treatment of burns patients admitted to the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Information on patients admitted to the BICU from February 2001 to January 2006 was recorded. Parameters recorded included: admission record and demographics, causes of the injury, burned surface area, laboratory investigations, treatment regime, and record of discharge/death. The data were analysed with SPSS version 12...
June 30, 2010: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/21944682/mechanical-ventilation-of-the-premature-neonate
#17
REVIEW
Melissa K Brown, Robert M DiBlasi
Although the trend in the neonatal intensive care unit is to use noninvasive ventilation whenever possible, invasive ventilation is still often necessary for supporting pre-term neonates with lung disease. Many different ventilation modes and ventilation strategies are available to assist with the optimization of mechanical ventilation and prevention of ventilator-induced lung injury. Patient-triggered ventilation is favored over machine-triggered forms of invasive ventilation for improving gas exchange and patient-ventilator interaction...
September 2011: Respiratory Care
https://www.readbyqxmd.com/read/21257156/outcomes-of-a-protocol-based-management-for-zone-1-retinopathy-of-prematurity-the-indian-twin-cities-rop-screening-program-report-number-2
#18
MULTICENTER STUDY
Subhadra Jalali, Siddharth Kesarwani, Anjli Hussain
PURPOSE: To report the outcomes of zone 1 aggressive posterior retinopathy of prematurity (ROP) treated with aggressive laser photocoagulation by a protocol-based approach over a 10-year period. DESIGN: Prospective, interventional case series. METHODS: HASH(0x380e670) SETTING: Tertiary eye institute and neonatal intensive care units in the twin cities of Hyderabad and Secunderabad in South India. STUDY POPULATION: Babies screened under the Indian Twin Cities Retinopathy of Prematurity Screening (ITCROPS) program between January 1, 1997 and March 31, 2007...
April 2011: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/21122176/a-low-sodium-solution-for-airway-care-results-of-a-multicenter-trial
#19
MULTICENTER STUDY
Robert D Christensen, Erick Henry, Vickie L Baer, Nhan Hoang, Gregory L Snow, Gorgi Rigby, Jill Burnett, Susan E Wiedmeier, Roger G Faix, Larry D Eggert
BACKGROUND: Normal saline is sometimes instilled into the endotracheal tube preparatory to airway suctioning, to assist in removing thick secretions. However, saline can damage the antimicrobial properties of airway secretions. We previously described a low-sodium physiologically based solution for airway care and reported a small (n = 60) randomized trial in neonates, which showed trends toward less ventilator-associated pneumonia (VAP) and less chronic lung disease with the new solution...
December 2010: Respiratory Care
https://www.readbyqxmd.com/read/20876177/trends-in-admissions-for-pediatric-status-asthmaticus-in-new-jersey-over-a-15-year-period
#20
Mary E Hartman, Walter T Linde-Zwirble, Derek C Angus, R Scott Watson
OBJECTIVE: Status asthmaticus accounts for a large portion of the morbidity and mortality associated with asthma, but we know little about its epidemiology. We describe here the hospitalization characteristics of children with status asthmaticus, how they changed over time, and how they differed between hospitals with and without PICUs. PATIENTS AND METHODS: We used administrative data from New Jersey that included all hospitalizations in the state from 1992, 1995, and 1999-2006...
October 2010: Pediatrics
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