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https://www.readbyqxmd.com/read/28429475/common-carotid-artery-sonography-versus-transthoracic-echocardiography-for-cardiac-output-measurements-in-intensive-care-unit-patients
#1
Qian-Yi Peng, Li-Na Zhang, Mei-Lin Ai, Li Li, Cheng-Huan Hu, Yan-Xin Zhang, Wei Liu, Qing Feng, Yu Zou, Yu-Hang Ai
OBJECTIVES: This study was designed to test the effectiveness of common carotid artery sonography in comparison with transthoracic echocardiography (TTE) for cardiac output measurements to provide an easier alternative for cardiac output monitoring in the intensive care unit. METHODS: This study included 148 patients who had common carotid artery Doppler examinations and TTE performed within 8 hours of each other, and the cardiac output measurement results were compared with each other...
April 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#2
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28424124/acute-respiratory-distress-syndrome-incidence-but-not-mortality-has-decreased-nationwide-a-national-trauma-data-bank-study
#3
Michael Fahr, Glenn Jones, Hollis O'Neal, Juan Duchesne, Danielle Tatum
Acute respiratory distress syndrome (ARDS) incidence is reported to have decreased in recent years. However, no large-scale study to date has exclusively examined ARDS in the critically injured. We sought to examine the national incidence of ARDS and its associated outcomes exclusively in adult trauma patients. The National Trauma Data Bank (NTDB) was queried to evaluate the incidence of ARDS and associated outcomes over a 6-year study period (2007-2012). Included patients were ≥18 years old, with at least one ventilator day, and complications recorded...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422919/the-lung-rescue-unit-lru-does-a-dedicated-intensive-care-unit-for-veno-venous-extra-corporeal-membrane-oxygenation-vv-ecmo-improve-survival-to-discharge
#4
Jay Menaker, Katelyn Dolly, Raymond Rector, Joseph Kufera, Eugenia E Lee, Ali Tabatabai, Ronald P Rabinowitz, Zachary Kon, Pablo Sanchez, Si Pham, Daniel L Herr, James V O'Connor, Deborah M Stein, Thomas M Scalea
BACKGROUND: The use of veno-venous extra corporeal membrane oxygenation (VV ECMO) for acute respiratory failure/distress syndrome (ARF/ARDS) has increased since 2009. Specialized units for patients requiring VV ECMO are not standard and patients are often cohorted with other critically ill patients. The purpose of this study was to report the outcome of adult patients admitted in 2015 to the LRU, which, to our knowledge, is the first intensive care unit in the United States that has been specifically created to provide care for patients requiring VV ECMO...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#5
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#6
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28419061/functional-status-of-neonatal-and-pediatric-patients-after-extracorporeal-membrane-oxygenation
#7
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Tammara Jenkins, Kathleen L Meert
OBJECTIVES: To describe functional status at hospital discharge for neonatal and pediatric patients treated with extracorporeal membrane oxygenation, and identify factors associated with functional status and mortality. DESIGN: Secondary analysis of observational data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. SETTING: Eight hospitals affiliated with the Collaborative Pediatric Critical Care Research Network...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28412028/-effectiveness-of-erlotinib-in-critical-care-unit-in-patients-with-non-small-cell-lung-cancer-with-egfr-mutation
#8
M Dewolf, C Dayen, C Garoute, W Khamis, M Fourrier, F Rousselle, M Sadki, F Le Meunier, R Suguenot, E Lecuyer, H Bentayeb, Y Douadi, P Berna
INTRODUCTION: The search for mutations epidermal growth factor receptor (EGFR) has changed the therapeutic approach and prognosis of non-small cell lung cancer (NSCLC). The effectiveness of tyrosine kinase inhibitors (TKI) has been demonstrated orally in patients with EGFR mutation. We report the case of a patient for whom treatment with TKI was started effectively in a Critical Care Unit. OBSERVATION: A patient of 59 years is followed for a stage IV lung adenocarcinoma with metastases in liver, brain, adrenal, lung and pleura...
April 12, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28411422/ventilation-distribution-and-lung-recruitment-with-speaking-valve-use-in-tracheostomised-patient-weaning-from-mechanical-ventilation-in-intensive-care
#9
Anna-Liisa Sutt, Chris M Anstey, Lawrence R Caruana, Petrea L Cornwell, John F Fraser
PURPOSE: Speaking valves (SV) are used infrequently in tracheostomised ICU patients due to concerns regarding their putative effect on lung recruitment. A recent study in cardio-thoracic population demonstrated increased end-expiratory lung volumes during and post SV use without examining if the increase in end-expiratory lung impedance (EELI) resulted in alveolar recruitment or potential hyperinflation in discrete loci. MATERIALS AND METHODS: A secondary analysis of Electrical Impedance Tomography (EIT) data from a previous study was conducted...
April 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28410318/characteristics-and-outcome-of-patients-after-allogeneic-hematopoietic-stem-cell-transplantation-treated-with-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#10
Philipp Wohlfarth, Gernot Beutel, Pia Lebiedz, Hans-Joachim Stemmler, Thomas Staudinger, Matthieu Schmidt, Matthias Kochanek, Tobias Liebregts, Fabio Silvio Taccone, Elie Azoulay, Alexandre Demoule, Stefan Kluge, Morten Svalebjørg, Catherina Lueck, Johanna Tischer, Alain Combes, Boris Böll, Werner Rabitsch, Peter Schellongowski
OBJECTIVES: The acute respiratory distress syndrome is a frequent condition following allogeneic hematopoietic stem cell transplantation. Extracorporeal membrane oxygenation may serve as rescue therapy in refractory acute respiratory distress syndrome but has not been assessed in allogeneic hematopoietic stem cell transplantation recipients. DESIGN: Multicenter, retrospective, observational study. SETTING: ICUs in 12 European tertiary care centers (Austria, Germany, France, and Belgium)...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28410274/three-hypothetical-inflammation-pathobiology-phenotypes-and-pediatric-sepsis-induced-multiple-organ-failure-outcome
#11
Joseph A Carcillo, E Scott Halstead, Mark W Hall, Trung C Nguyen, Ron Reeder, Rajesh Aneja, Bita Shakoory, Dennis Simon
OBJECTIVES: We hypothesize that three inflammation pathobiology phenotypes are associated with increased inflammation, proclivity to develop features of macrophage activation syndrome, and multiple organ failure-related death in pediatric severe sepsis. DESIGN: Prospective cohort study comparing children with severe sepsis and any of three phenotypes: 1) immunoparalysis-associated multiple organ failure (whole blood ex vivo tumor necrosis factor response to endotoxin < 200 pg/mL), 2) thrombocytopenia-associated multiple organ failure (new onset thrombocytopenia with acute kidney injury and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 activity < 57%), and/or 3) sequential multiple organ failure with hepatobiliary dysfunction (respiratory distress followed by liver dysfunction with soluble Fas ligand > 200 pg/mL), to those without any of these phenotypes...
April 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28410087/racial-and-ethnic-disparities-in-parental-refusal-of-consent-in-a-large-multisite-pediatric-critical-care-clinical-trial
#12
Joanne E Natale, Ruth Lebet, Jill G Joseph, Christine Ulysse, Judith Ascenzi, David Wypij, Martha A Q Curley
OBJECTIVE: To evaluate whether race or ethnicity was independently associated with parental refusal of consent for their child's participation in a multisite pediatric critical care clinical trial. STUDY DESIGN: We performed a secondary analyses of data from Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE), a 31-center cluster randomized trial of sedation management in critically ill children with acute respiratory failure supported on mechanical ventilation...
March 2, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28408242/intravenous-immunoglobulin-protects-against-severe-pandemic-influenza-infection
#13
Steven Rockman, Sue Lowther, Sarina Camuglia, Kirsten Vandenberg, Shirley Taylor, Lou Fabri, Sylvia Miescher, Martin Pearse, Deborah Middleton, Stephen J Kent, Darryl Maher
Influenza is a highly contagious, acute, febrile respiratory infection that can have fatal consequences particularly in individuals with chronic illnesses. Sporadic reports suggest that intravenous immunoglobulin (IVIg) may be efficacious in the influenza setting. We investigated the potential of human IVIg to ameliorate influenza infection in ferrets exposed to either the pandemic H1N1/09 virus (pH1N1) or highly pathogenic avian influenza (H5N1). IVIg administered at the time of influenza virus exposure led to a significant reduction in lung viral load following pH1N1 challenge...
April 6, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28401600/involvement-of-patients-perspectives-on-treatment-with-non-invasive-ventilation-in-patients-with-copd-a-qualitative-study
#14
Helle Marie Christensen, Lotte Huniche, Ingrid L Titlestad
AIMS AND OBJECTIVES: To clarify COPD patients' perspectives on treatment with non-invasive ventilation and develop management strategies for the treatment based on these perspectives. BACKGROUND: The effect of treating COPD patients with non-invasive ventilation is well documented, as is the problem of patient difficulties in tolerating the treatment. Knowledge of how patients with COPD experience and evaluate treatment with non-invasive ventilation is limited; therefore, more information of patient perspectives is needed to develop treatment practices in respiratory medicine...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#15
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28398076/refining-low-physical-activity-measurement-improves-frailty-assessment-in-advanced-lung-disease-and-survivors-of-critical-illness
#16
Matthew R Baldwin, Jonathan P Singer, Debbie Huang, Jessica Sell, Wendy C Gonzalez, Lauren Pollack, Mathew S Maurer, Frank F D'Ovidio, Matthew Bacchetta, Joshua R Sonett, Selim M Arcasoy, Lori Shah, Hilary Robbins, Steven R Hays, Jasleen Kukreja, John R Greenland, Rupal J Shah, Lorriana Leard, Matthew Morrell, Cynthia Gries, Patricia P Katz, Jason D Christie, Joshua M Diamond, David J Lederer
RATIONALE: The frail phenotype has gained popularity as a clinically relevant measure in adults with advanced lung disease and critical illness survivors. Since respiratory disease and chronic illness can greatly limit physical activity, the measurement of participation in traditional leisure-time activities as a frailty component may lead to substantial misclassification of frailty in pulmonary and critical care patients. OBJECTIVES: To test and validate replacing the Duke Activities Scale Index (DASI), a simple 12-item questionnaire, for the Minnesota Leisure Time Activities (MLTA), a detailed questionnaire covering 18 leisure time activities, as the measure of low activity in the Fried frailty phenotype instrument (FFP)...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28391305/the-effectiveness-of-singing-or-playing-a-wind-instrument-in-improving-respiratory-function-in-patients-with-long-term-neurological-conditions-a-systematic-review
#17
Kexin Ang, Matthew Maddocks, Huiying Xu, Irene J Higginson
Background: Many long-term neurological conditions adversely affect respiratory function. Singing and playing wind instruments are relatively inexpensive interventions with potential for improving respiratory function; however, synthesis of current evidence is needed to inform research and clinical use of music in respiratory care. Objective: To critically appraise, analyze, and synthesize published evidence on the effectiveness of singing or playing a wind instrument to improve respiratory function in people with long-term neurological conditions...
March 1, 2017: Journal of Music Therapy
https://www.readbyqxmd.com/read/28390605/association-of-sleep-disordered-breathing-symptoms-with-early-postoperative-analgesic-requirement-in-pediatric-ambulatory-surgical-patients
#18
Kamie Yang, Anne Baetzel, Wilson T Chimbira, Yuliya Yermolina, Paul I Reynolds, Olubukola O Nafiu
INTRODUCTION: Sleep disordered breathing (SDB) symptoms are associated with increased rates of opioid-induced respiratory depression as well as enhanced nociception. Consequently, practitioners often withhold or administer lower intraoperative doses of opioids out of concern for postoperative respiratory depression. Therefore, SDB may be a critical determinant of analgesic requirement in the post-anesthesia care unit (PACU). We investigated whether preoperative SDB classification was independently associated with need for PACU analgesic intervention in a cross-sectional sample of 985 children who underwent elective, painful ambulatory surgical procedures...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28388376/how-much-and-what-type-of-protein-should-a-critically-ill-patient-receive
#19
Juan B Ochoa Gautier, Robert G Martindale, Saúl J Rugeles, Ryan T Hurt, Beth Taylor, Daren K Heyland, Stephen A McClave
Protein loss, manifested as loss of muscle mass, is observed universally in all critically ill patients. Depletion of muscle mass is associated with impaired function and poor outcomes. In extreme cases, protein malnutrition is manifested by respiratory failure, lack of wound healing, and immune dysfunction. Protecting muscle loss focused initially on meeting energy requirements. The assumption was that protein was being used (through oxidation) as an energy source. In healthy individuals, small amounts of glucose (approximately 400 calories) protect muscle loss and decrease amino acid oxidation (protein-sparing effect of glucose)...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28375991/implementing-family-meetings-into-a-respiratory-care-unit-a-care-and-communication-quality-improvement-project
#20
Vicki Loeslie, Ma Sunnimpha Abcejo, Claudia Anderson, Emily Leibenguth, Cathy Mielke, Jeffrey Rabatin
BACKGROUND: Substantial evidence in critical care literature identifies a lack of quality and quantity of communication between patients, families, and clinicians while in the intensive care unit. Barriers include time, multiple caregivers, communication skills, culture, language, stress, and optimal meeting space. For patients who are chronically critically ill, the need for a structured method of communication is paramount for discussion of goals of care. OBJECTIVE: The objective of this quality improvement project was to identify barriers to communication, then develop, implement, and evaluate a process for semistructured family meetings in a 9-bed respiratory care unit...
May 2017: Dimensions of Critical Care Nursing: DCCN
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