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https://www.readbyqxmd.com/read/28916175/early-sepsis-detection-in-critical-care-patients-using-multiscale-blood-pressure-and-heart-rate-dynamics
#1
Supreeth P Shashikumar, Matthew D Stanley, Ismail Sadiq, Qiao Li, Andre Holder, Gari D Clifford, Shamim Nemati
Sepsis remains a leading cause of morbidity and mortality among intensive care unit (ICU) patients. For each hour treatment initiation is delayed after diagnosis, sepsis-related mortality increases by approximately 8%. Therefore, maximizing effective care requires early recognition and initiation of treatment protocols. Antecedent signs and symptoms of sepsis can be subtle and unrecognizable (e.g., loss of autonomic regulation of vital signs), causing treatment delays and harm to the patient. In this work we investigated the utility of high-resolution blood pressure (BP) and heart rate (HR) times series dynamics for the early prediction of sepsis in patients from an urban, academic hospital, meeting the third international consensus definition of sepsis (sepsis-III) during their ICU admission...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28905701/outcomes-of-patients-with-severe-influenza-infection-admitted-to-intensive-care-units-a-retrospective-study-in-a-medical-centre
#2
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Kuo-Shu Yuan, Chin-Ming Chen
PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20...
September 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28900902/derivation-and-validation-of-a-prognostic-model-for-postoperative-risk-stratification-of-critically-ill-patients-with-faecal-peritonitis
#3
Ascanio Tridente, Julian Bion, Gary H Mills, Anthony C Gordon, Geraldine M Clarke, Andrew Walden, Paula Hutton, Paul A H Holloway, Jean-Daniel Chiche, Frank Stuber, Christopher Garrard, Charles Hinds
BACKGROUND: Prognostic scores and models of illness severity are useful both clinically and for research. The aim of this study was to develop two prognostic models for the prediction of long-term (6 months) and 28-day mortality of postoperative critically ill patients with faecal peritonitis (FP). METHODS: Patients admitted to intensive care units with faecal peritonitis and recruited to the European GenOSept study were divided into a derivation and a geographical validation subset; patients subsequently recruited to the UK GAinS study were used for temporal validation...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28895696/b-type-natriuretic-peptide-usefulness-in-the-management-of-critically-ill-neonates
#4
Gisela L Salas, Mariela Jozefkowicz, Gustavo S Goldsmit, Gabriela Disa, Alejandra Rodiño, Susana Rodríguez, Diana Fariña
INTRODUCTION: B-type natriuretic peptide (BNP) is responsible for changes in the heart organogenesis and is associated with transition to extrauterine life. In the first week of life, BNP levels are high and return to normal with the physiological loss in weight. High BNP levels are associated with different conditions. OBJETIVE: To establish the relationship between BNP levels and criticality and the short-term clinical course among patients hospitalized in the neonatal intensive care unit...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28882170/prognostic-value-of-platelet-to-lymphocyte-ratios-among-critically-ill-patients-with-acute-kidney-injury
#5
Chen-Fei Zheng, Wen-Yue Liu, Fang-Fang Zeng, Ming-Hua Zheng, Hong-Ying Shi, Ying Zhou, Jing-Ye Pan
BACKGROUND: Inflammation plays an important role in the initiation and progression of acute kidney injury (AKI). However, evidence regarding the prognostic effect of the platelet-to-lymphocyte ratio (PLR), a novel systemic inflammation marker, among patients with AKI is scarce. In this study, we investigated the value of the PLR in predicting the outcomes of critically ill patients with AKI. METHODS: Patient data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care Database III version 1...
September 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28866320/differences-in-perioperative-femoral-and-radial-arterial-blood-pressure-in-neonates-and-infants-undergoing-pediatric-cardiac-surgery-requiring-cardiopulmonary-bypass
#6
Hwa Jin Cho, Sang Hoon Lee, In Seok Jeong, Nam Sik Yoon, Jae Sook Ma, Byoung Hee Ahn
OBJECTIVE: Several reports claim that blood pressure (BP) in the radial artery may underestimate the accurate BP in critically ill patients. Here, the authors evaluated differences in mean blood pressure (MBP) between the radial and femoral artery during pediatric cardiac surgery to determine the effectiveness of femoral arterial BP monitoring. METHOD: The medical records of children under 1 year of age who underwent open-heart surgery between 2007 and 2013 were retrospectively reviewed...
August 30, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28828035/urine-flow-rate-monitoring-in-hypovolemic-multiple-trauma-patients
#7
Evgeni Brotfain, Yoram Klein, Ronen Toledano, Leonid Koyfman, Dmitry Frank, Micha Y Shamir, Moti Klein
BACKGROUND: The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill multiple trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive multiple trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported. METHODS: The study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28822384/clinical-characteristics-of-trauma-patients-requiring-hydrocortisone-treatment-for-refractory-hypotension
#8
Gina Kim, Jeffrey Young
Corticosteroids play an important role in responding to physiologic stress in the human body. However, its application in critical care remains heavily debated. The purpose of this study was to identify patient characteristics associated with receiving stress-dose steroids during the intensive care unit stay after traumatic injury and its effect on in-hospital mortality. Patients admitted to the University of Virginia trauma center between January 1, 2011, and December 31, 2015, were identified using our Trauma Registry...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28807423/coping-with-the-stress-in-the-cardiac-intensive-care-unit-can-mindfulness-be-the-answer
#9
Nadya Golfenshtein, Janet A Deatrick, Amy J Lisanty, Barbara Medoff-Cooper
BACKGROUND: Mothers of infants with complex congenital heart disease are exposed to increased stress which has been associated with numerous adverse health outcomes. The coping mechanisms these mothers use critically effect the familial illness adaptation and most likely infant outcomes. Currently no data-based strategies have been developed for mothers to facilitate their coping, and proactively promote their adaptation in the critical care settings. A potential strategy is mindfulness which is currently used in other clinical settings with stress-reduction effects...
August 11, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28795669/-evaluation-of-volume-overload-in-critical-patients-by-monitoring-change-of-cardiac-output-under-bed-head-raising-combined-with-passive-leg-raising
#10
Long Zhang, Luhao Wang, Weixiong Luo, Meihua Mei, Youjuan Chen, Bin Ouyang
OBJECTIVE: To investigate whether the change of cardiac output (CO) with bed head raising (BHR) combined with passive leg raising (PLR) can be used to assess volume overload in critical patients. METHODS: A prospective observational diagnostic trial was designed. The patients who underwent fluid resuscitation 6 hours or more, and admitted to intensive care unit (ICU) of Meizhou People's Hospital in Guangdong Province from January to December in 2016 were enrolled...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28794122/organizational-structure-staffing-resources-and-educational-initiatives-in-cardiac-intensive-care-units-in-the-united-states-an-american-heart-association-acute-cardiac-care-committee-and-american-college-of-cardiology-critical-care-cardiology-working-group
#11
Sean van Diepen, Christopher B Fordyce, Zachary K Wegermann, Christopher B Granger, Amanda Stebbins, David A Morrow, Michael A Solomon, Jeffrey Soble, Timothy D Henry, Ian C Gilchrist, Jason N Katz, Mauricio G Cohen, L Kristin Newby
No abstract text is available yet for this article.
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28794121/changes-in-primary-noncardiac-diagnoses-over-time-among-elderly-cardiac-intensive-care-unit-patients-in-the-united-states
#12
Shashank S Sinha, Michael W Sjoding, Devraj Sukul, Hallie C Prescott, Theodore J Iwashyna, Hitinder S Gurm, Colin R Cooke, Brahmajee K Nallamothu
BACKGROUND: Early reports suggest the number of cardiac intensive care unit (CICU) patients with primary noncardiac diagnoses is rising in the United States, but no national data currently exist. We examined changes in primary noncardiac diagnoses among elderly patients admitted to a CICU during the past decade. METHODS AND RESULTS: Using 2003 to 2013 Medicare data, we grouped elderly patients admitted to CICUs into 2 categories based on principal diagnosis at discharge: (1) primary noncardiac diagnoses and (2) primary cardiac diagnoses...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28768288/reliability-and-validity-of-a-smartphone-paired-pulse-oximeter-for-screening-of-critical-congenital-heart-defects-in-newborns
#13
Maurice J Huizing, Eduardo Villamor-Martínez, Ingrid A Chavagne, Ward Y Vanagt, Marc A E Spaanderman, Eduardo Villamor
BACKGROUND: Barriers to widespread implementation of pulse oximetry screening of critical congenital heart defects (CCHD) in newborns include increasing trends of out-of-hospital births and cost of equipment. In recent years, smartphone-compatible pulse oximeters have appeared on the market, but the validity of such devices in the setting of CCHD screening has not been evaluated. OBJECTIVES: To compare the performance in CCHD screening of a smartphone-paired pulse oximeter (Masimo iSpO2-Rx™) and a hospital-grade pulse oximeter (Masimo Radical-7™)...
August 3, 2017: Neonatology
https://www.readbyqxmd.com/read/28765741/experience-with-mechanical-circulatory-support-for-medically-intractable-low-cardiac-output-in-a-pediatric-intensive-care-unit
#14
Jung Bin Park, Jae Gun Kwak, Hong-Gook Lim, Woong-Han Kim, Jeong Ryul Lee, Yong Jin Kim
BACKGROUND AND OBJECTIVES: Mechanical circulatory support with extracorporeal membrane oxygenation (ECMO) and ventricular assist device has always been the optimal choice for treating the majority of medically intractable low cardiac output case. We retrospectively investigated our institution's outcomes and variables associated with a high risk of mortality. SUBJECTS AND METHODS: From 1999 to 2014, 86 patients who were of pediatric age or had grown-up congenital heart disease underwent mechanical circulatory support for medically intractable low cardiac output in our pediatric intensive care unit...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28761452/comparison-of-manual-versus-automated-blood-pressure-measurement-in-intensive-care-unit-coronary-care-unit-and-emergency-room
#15
Ahmad Mirdamadi, Mostafa Etebari
BACKGROUND: Accuracy of blood pressure (BP) measurement in clinical settings is one of the most concerns despite of promotion in techniques for the measurement of BP. Our aim was to compare automated versus manual BP measurement in intensive care unit (ICU), coronary care unit (CCU), and emergency room patients. METHODS: Totally, 117 patients in ICU, CCU, and emergency department were registered in the study. Demographic information was recorded. The cardioset heart monitoring device was used for measuring BP and mercury sphygmomanometer with appropriate cuffs was used for manual method...
January 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28752835/advanced-competencies-mapping-of-critical-care-nursing-a-qualitative-research-in-two-intensive-care-units
#16
Emanuela Alfieri, Marina Mori, Valentina Barbui, Leopoldo Sarli
BACKGROUND AND AIM: Nowadays, in Italy, the nursing profession has suffered important changes in response to the needs of citizens' health and to improve the quality of the health service in the country.  At the basis of this development there is an increase of the nurses' knowledge, competencies and responsibilities. Currently, the presence of nurses who have followed post-basic training paths, and the subsequent acquisition of advanced clinical knowledge and specializations, has made it essential for the presence of competencies mappings for each specialty, also to differentiate them from general care nurses...
July 18, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28749481/evaluation-of-critical-congenital-heart-defects-screening-using-pulse-oximetry-in-the-neonatal-intensive-care-unit
#17
K Van Naarden Braun, R Grazel, R Koppel, S Lakshminrusimha, J Lohr, P Kumar, B Govindaswami, M Giuliano, M Cohen, N Spillane, P Jegatheesan, D McClure, D Hassinger, O Fofah, S Chandra, D Allen, R Axelrod, J Blau, S Hudome, E Assing, L F Garg
OBJECTIVE: To evaluate the implementation of early screening for critical congenital heart defects (CCHDs) in the neonatal intensive care unit (NICU) and potential exclusion of sub-populations from universal screening. STUDY DESIGN: Prospective evaluation of CCHD screening at multiple time intervals was conducted in 21 NICUs across five states (n=4556 infants). RESULTS: Of the 4120 infants with complete screens, 92% did not have prenatal CHD diagnosis or echocardiography before screening, 72% were not receiving oxygen at 24 to 48 h and 56% were born ⩾2500 g...
July 27, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28739066/a-turkish-version-of-the-critical-care-pain-observation-tool-reliability-and-validity-assessment
#18
Yeşim Yaman Aktaş, Neziha Karabulut
PURPOSE: The study aim was to evaluate the validity and reliability of the Critical-Care Pain Observation Tool in critically ill patients. DESIGN: A repeated measures design was used for the study. METHODS: A convenience sample of 66 patients who had undergone open-heart surgery in the cardiovascular surgery intensive care unit in Ordu, Turkey, was recruited for the study. The patients were evaluated by using the Critical-Care Pain Observation Tool at rest, during a nociceptive procedure (suctioning), and 20 minutes after the procedure while they were conscious and intubated after surgery...
August 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28730329/an-evaluation-of-the-addition-of-critical-congenital-heart-defect-screening-in-georgia-newborn-screening-procedures
#19
Shelby T Rentmeester, Johanna Pringle, Carol R Hogue
Objectives Each year in the U.S., approximately 7200 infants are born with a critical congenital heart defect (CCHD). The Georgia Department of Public Health (DPH) mandated routine screening for CCHD starting January 2015. The current study evaluated hospital performance of the mandated CCHD screenings in Georgia. Methods Utilizing the DPH newborn screening surveillance system, data from 6 months before and after the mandate were analyzed for reports submitted and positive CCHD screening results. Chi square tests of independence were performed to examine the association between reporting of results for CCHD screening after the mandate and hospital nursery level [level I (well-baby/newborn); level II (special care); level III (neonatal intensive care unit-NICU)] and NICU submissions...
July 20, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28697154/interfacility-transport-shock-index-is-associated-with-decreased-survival-in-children
#20
Ryan M Jennings, Bradley A Kuch, Kathryn A Felmet, Richard A Orr, Joseph A Carcillo, Ericka L Fink
BACKGROUND: Shock index, the ratio of heart rate to systolic blood pressure that changes with age, is associated with mortality in adults after trauma and in children with sepsis. We assessed the utility of shock index to predict sepsis diagnosis and survival in children requiring interfacility transport to a tertiary care center. METHODS: We studied children aged 1 month to 21 years who had at least 2 sets of vital signs recorded during interfacility transport to the Children's Hospital of Pittsburgh by our critical care transport team...
July 11, 2017: Pediatric Emergency Care
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