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https://www.readbyqxmd.com/read/28626956/markedly-increased-incidence-of-critical-illness-in-adults-with-type-1-diabetes
#1
R A Marrie, E A C Sellers, H Chen, R Fransoo, C N Bernstein, C A Hitchon, C A Peschken, A Garland
AIMS: To compare the incidence of and mortality after intensive care unit admission in adults with paediatric-onset Type 1 diabetes vs the general population. METHODS: Using population-based administrative data from Manitoba, Canada, we identified 814 cases of paediatric-onset Type 1 diabetes, and 3579 general population controls matched on age, sex and region of residence. We estimated the incidence of intensive care unit admission in adulthood, and compared the findings between populations using incidence rate ratios and multivariable Cox proportional hazards regression, adjusting for age, sex, comorbidity and socio-economic status...
June 19, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28625260/-predictive-value-of-four-different-scoring-systems-for-septic-patient-s-outcome-a-retrospective-analysis-with-311-patients
#2
Shengbiao Wang, Tao Li, Yunfeng Li, Jianwen Zhang, Xingui Dai
OBJECTIVE: To study the predicting value of four different scoring systems such as the acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, quick SOFA (qSOFA) score and systemic inflammatory response syndrome (SIRS) score for the prognosis of septic patients. METHODS: A retrospective analysis were conducted. Septic patients in intensive care unit (ICU) of the First People's Hospital of Chenzhou form July 1st, 2012 to June 30th, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#3
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28618727/analysis-of-epidemiology-and-risk-factors-for-mortality-in-ventilator-associated-pneumonia-attacks-in-intensive-care-unit-patients
#4
Ayşe But, Meltem Arzu Yetkin, Dilek Kanyilmaz, Halide Aslaner, Aliye Baştuğ, Adalet Aypak, Pınar Öngürü, Esragül Akinci, Nevzat Mehmet Mutlu, Hürrem Bodur
BACKGROUND/AIM: The aim of this study was to investigate the epidemiologic characteristics, the causative microorganisms and their antimicrobial susceptibility patterns, and the prognostic risk factors for mortality in critically ill patients with ventilator-associated pneumonia (VAP). MATERIALS AND METHODS: In this retrospective observational study, all the critically ill patients with VAP hospitalized in a medical/surgical intensive care unit (ICU) between January 2010 and June 2015 were evaluated...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28610957/effectiveness-of-heart-rate-control-on-hemodynamics-in-critically-ill-patients-with-atrial-tachyarrhythmias-managed-by-amiodarone
#5
Joe-Elie Salem, Pauline Dureau, Christian Funck-Brentano, Jean-Sébastien Hulot, Maria El-Aissaoui, Nadia Aissaoui, Saik Urien, Christophe Faisy
Atrial tachyarrhythmias (AT) are common in intensive care unit (ICU) patients and might contribute to hemodynamic instability if heart rate (HR) is persistently too rapid. We aimed to assess if HR control below 115 or 130bpm with amiodarone improves hemodynamics in ICU patients with AT. This observational study included 73 ICU patients with disabling AT receiving amiodarone for HR control. A total of 525 changes (mainly within 4-8h) in mean arterial pressure (MAP) and 167 changes in plasma lactate in response to HR variations above 115 or 130bpm were analyzed...
June 10, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28591048/effects-of-dexmedetomidine-on-sleep-quality-of-patients-after-surgery-without-mechanical-ventilation-in-icu
#6
Weina Lu, Qinghui Fu, Xiaoqian Luo, Shuiqiao Fu, Kai Hu
Sleep quality of patients in intensive care unit (ICU) has been recently recognized as an important aspect of the intensive care. Dexmedetomidine is one of the most recently introduced for sedation in the ICU. This study was designed to evaluate the effect of dexmedetomidine on sleep quality of patients without mechanical ventilation in ICU.The patients who were included in this study were divided into two groups. In the sedation group, dexmedetomidine was given by a continuous infusion targeting a sedation level -1 to -2 on the score of RASS (Richmond Agitation-Sedation Scale)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28580340/a-system-for-continuous-estimating-and-monitoring-cardiac-output-via-arterial-waveform-analysis
#7
A Vakily, H Parsaei, M M Movahhedi, M A Sahmeddini
BACKGROUND: Cardiac output (CO) is the total volume of blood pumped by the heart per minute and is a function of heart rate and stroke volume. CO is one of the most important parameters for monitoring cardiac function, estimating global oxygen delivery and understanding the causes of high blood pressure. Hence, measuring CO has always been a matter of interest to researchers and clinicians. Several methods have been developed for this purpose, but a majority of them are either invasive, too expensive or need special expertise and experience...
June 2017: Journal of Biomedical Physics & Engineering
https://www.readbyqxmd.com/read/28575484/comprehensive-analysis-of-liberal-and-restrictive-transfusion-strategies-in-pediatric-intensive-care-unit
#8
Basak Akyildiz, Nazan Ulgen Tekerek, Ozge Pamukcu, Adem Dursun, Musa Karakukcu, Nazmi Narin, Mehmet Yay, Ferhan Elmali
Background: We prospectively compared restrictive and liberal transfusion strategies for critically ill children regarding hemodynamic and laboratory parameters. Methods: A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger < 10 g/dL, Group 1) and the restrictive transfusion strategy group (transfusion trigger ≤ 7 g/dL, Group 2). Basal variables including venous/arterial hemoglobin, hematocrit and lactate levels; stroke volume; and cardiac output were recorded at the beginning and end of the transfusion...
May 30, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28570379/promoting-evidence-based-practice-at-a-primary-stroke-center-a-nurse-education-strategy
#9
Christina Anne Case
BACKGROUND: Promoting a culture of evidence-based practice within a health care facility is a priority for health care leaders and nursing professionals; however, tangible methods to promote translation of evidence to bedside practice are lacking. OBJECTIVES: The purpose of this quality improvement project was to design and implement a nursing education intervention demonstrating to the bedside nurse how current evidence-based guidelines are used when creating standardized stroke order sets at a primary stroke center, thereby increasing confidence in the use of standardized order sets at the point of care and supporting evidence-based culture within the health care facility...
July 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28536944/fluid-responsiveness-predicted-by-transcutaneous-partial-pressure-of-oxygen-in-patients-with-circulatory-failure-a-prospective-study
#10
Jingyuan Xu, Xiao Peng, Chun Pan, Shixia Cai, Xiwen Zhang, Ming Xue, Yi Yang, Haibo Qiu
BACKGROUND: Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO2) in the critically ill patients. METHODS: This was a single-center prospective study conducted in the intensive care unit of a tertiary care teaching hospital. Shock patients who presented with at least one clinical sign of inadequate tissue perfusion, defined as systolic blood pressure <90 mmHg or a decrease >40 mmHg in previously hypertensive patients or the need for vasopressive drugs; urine output <0...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28525671/infection-in-critically-ill-pediatric-patients-on-continuous-renal-replacement-therapy
#11
Maria J Santiago, Jesús López-Herce, Eva Vierge, Ana Castillo, Amaya Bustinza, Jose M Bellón, Amelia Sánchez, Sarah Fernández
INTRODUCTION: Continuous renal replacement therapies (CRRT) are frequently used in critically ill children and may increase the risk of infection. However, the incidence, characteristics and prognosis of infection in critically ill children on CRRT have not been studied. METHODS: Data from a prospective, single-center register of critically ill children treated with CRRT was analyzed. RESULTS: 55 children (40% under 1 year of age) were treated with CRRT between June 2008 and January 2012; 43 patients (78...
May 29, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28524035/-comparison-of-risk-of-death-between-older-and-non-older-critical-patients-in-icu-a-retrospective-cohort-study-of-consecutive-3-years
#12
Yeting Zhou, Daoming Tong, Shaodan Wang, Liansong Liu, Song Ye, Benwen Xu
OBJECTIVE: To investigate the risk of death between older and non-older critical patients in intensive care unit (ICU) in Shuyang People's Hospital. METHODS: A retrospective cohort study was conducted. The critical patients who aged 15 or above, and admitted to ICU of Shuyang People's Hospital from January 2014 to December 2016 were enrolled, and all the data was collected from the registration and electronic medical records in the ICU. The prevalence and causes of death in ICU critical patients during the study period were observed...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28495379/transthoracic-echocardiography-for-diagnosing-pulmonary-embolism-a-systematic-review-and-meta-analysis
#13
J Matthew Fields, Joshua Davis, Lily Girson, Arthur Au, Jacqueline Potts, Charity J Morgan, Imelda Vetter, Lee Ann Riesenberg
OBJECTIVE: Pulmonary embolism (PE) is a common diagnosis with significant mortality if not appropriately treated. The use of transthoracic echocardiography in patients with PE is common; however, its diagnostic capabilities in this use are unclear. With the increased use of ultrasonography in medical settings, it is important to understand the strengths and limitations of echocardiography for the diagnosis of PE. METHODS: We conducted a systematic review of PubMed, CINAHL, and EMBASE through 2016 for articles assessing the diagnostic accuracy of transthoracic echocardiography for PE...
May 9, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28492084/prehospital-triage-of-patients-suffering-severe-dyspnoea-using-n-terminal-pro-brain-natriuretic-peptide-the-prebnp-trial-a-randomised-controlled-clinical-trial
#14
Morten T Bøtker, Maren T Jørgensen, Carsten Stengaard, Sophie-Charlott Seidenfaden, Mona Tarpgaard, Asger Granfeldt, Tanja Ø Mortensen, Thorbjørn Grøfte, Kristian D Friesgaard, Rikke Mærkedahl, Anette B Pedersen, Simon Lundorff, Troels Martin Hansen, Hans Kirkegaard, Erika F Christensen, Christian J Terkelsen
PURPOSE: The purpose of this study was to examine whether the addition of brain natriuretic peptide measurement to the routine diagnostic work-up by prehospital critical care team physicians improves triage in patients with severe dyspnoea. METHODS: Prehospital critical care team physicians randomly assigned patients older than 18 years with severe dyspnoea to routine diagnostic work-up or diagnostic work-up with incorporated point-of-care N-terminal pro-brain natriuretic peptide (NT-proBNP) measurement...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28485316/left-ventricular-longitudinal-systolic-function-in-septic-shock-patients-with-normal-ejection-fraction-a-case-control-study
#15
Hong-Min Zhang, Xiao-Ting Wang, Li-Na Zhang, Wei He, Qing Zhang, Da-Wei Liu
BACKGROUND: Septic cardiomyopathy is a common finding in septic shock patients. The accepted definition of septic cardiomyopathy is often based on the left ventricular ejection fraction (LVEF). The aim of this study was to determine whether the left ventricular longitudinal systolic function was more sensitive than the LVEF in heart function appraisal of septic shock patients. METHODS: This was a case-control study conducted at a 40-bed Intensive Care Unit (ICU) of Peking Union Medical College Hospital...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28482805/management-of-potentially-life-threatening-emergencies-at-74-primary-level-hospitals-in-mongolia-results-of-a-prospective-observational-multicenter-study
#16
Naranpurev Mendsaikhan, Davaa Gombo, Ganbold Lundeg, Christian Schmittinger, Martin W Dünser
BACKGROUND: While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals. METHODS: In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Furthermore, characteristics of patients presenting with potentially life-threatening emergencies to these hospitals were evaluated during a 6 month period...
May 8, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28468613/low-mean-perfusion-pressure-is-a-risk-factor-for-progression-of-acute-kidney-injury-in-critically-ill-patients-a-retrospective-analysis
#17
Marlies Ostermann, Anna Hall, Siobhan Crichton
BACKGROUND: The aim was to investigate whether mean perfusion pressure (MPP) calculated as the difference between mean arterial pressure (MAP) and central venous pressure (CVP) was associated with risk of progression from AKI I to AKI III in critically ill patients. METHODS: Retrospective analysis of adult patients admitted to a multi-disciplinary adult intensive care unit (ICU) between July 2007 and June 2009 who developed AKI I and in whom advanced haemodynamic monitoring was initiated within 12 h of diagnosis of AKI I...
May 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28460704/continuous-capnography-in-pediatric-intensive-care
#18
REVIEW
Christine M Riley
Capnography or end-tidal carbon dioxide (Etco2) monitoring has a variety of uses in the pediatric intensive care setting. The ability to continuously measure exhaled carbon dioxide can provide vital information about airway, breathing, and circulation in critically ill pediatric patients. Capnography has diagnosis-specific applications for pediatric patients with congenital heart disease, reactive airway disease, neurologic emergencies, and metabolic derangement. This modality allows for noninvasive monitoring and has become the standard of care...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28454562/diagnosis-and-outcomes-of-acute-kidney-injury-using-surrogate-and-imputation-methods-for-missing-preadmission-creatinine-values
#19
Amélie Bernier-Jean, William Beaubien-Souligny, Rémi Goupil, François Madore, François Paquette, Stéphan Troyanov, Josée Bouchard
BACKGROUND: Missing preadmission serum creatinine (SCr) values are a common obstacle to assess acute kidney injury (AKI) diagnosis and outcomes. The Kidney Disease Improving Global Outcomes (KDIGO) guidelines suggest using a SCr computed from the Modification of Diet in Renal Disease (MDRD) with an estimated glomerular filtration rate of 75 ml/min/1.73 m(2). We aimed to identify the best surrogate method for baseline SCr to assess AKI diagnosis and outcomes. METHODS: We compared the use of 1) first SCr at hospital admission 2) minimal SCr over 2 weeks after intensive care unit admission 3) MDRD computed SCr and 4) Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) computed SCr to assess AKI diagnosis and outcomes...
April 28, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28441153/discharge-criteria-for-the-late-preterm-infant-a-review-of-the-literature
#20
Jenny M Quinn, Marteen Sparks, Sheila M Gephart
BACKGROUND: Standardized late preterm infant (LPI) discharge criteria ensure best practice and help guide the neonatal provider to determine the appropriate level of care following birth. However, the location can vary from the well newborn setting to the neonatal intensive care unit (NICU). PURPOSE: The purpose of this review is to examine differences in LPI discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?" SEARCH STRATEGY: Databases searched include CINAHL, TRIP, PubMed, and the Cochrane Library...
April 24, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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