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https://www.readbyqxmd.com/read/27902412/the-staff-education-to-reducing-ventilator-associated-pneumonia
#1
Gurdal Yilmaz, Hava Aydin, Mustafa Aydin, Sedat Saylan, Hulya Ulusoy, Iftihar Koksal
Mechanical ventilation (MV) is a life-saving invasive procedure performed in intensive care units (ICUs) where critical patients are given advanced support. The purpose of this study was to assess the effect of personnel training on the incidence of ventilator-associated pneumonia (VAP). The study, performed prospectively in the ICU, was planned in two periods. In both periods, patient's characteristics were recorded on patient data forms. In the second period, ICU physicians and assistant health personnel were given regular theoretical and practical training...
October 17, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27889726/prolonged-infusion-of-dexmedetomidine-in-critically-ill-children
#2
Cinara Andreolio, Jefferson Pedro Piva, Elisa Baldasso, Roberta Ferlini, Rafaela Piccoli
OBJECTIVE: To describe main indications, doses, length of infusion and side effects related to dexmedetomidine infusion. METHODS: Observational and retrospective study evaluating dexmedetomidine use in pediatric intensive care unit. RESULTS: 77 children received dexmedetomidine infusion longer than 6 hours for mechanical ventilation weaning (32.5%), post- neurosurgery and post-upper airway surgery (24.7%), non-invasive ventilation (13%), refractory tachycardia (6...
November 15, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27852461/the-development-of-intensive-care-in-the-military-environment
#3
REVIEW
Matthew J Roberts
If the history of critical care is to be addressed, the starting point must be the fundamental and defining qualities of intensive care units. These are the concentration of the sickest patients in a defined area of the hospital, staffed by the personnel most able to care for them (by virtue of specialist training), and the application of the most advanced monitoring or therapeutic techniques available at the time. In the military environment, the ability to provide critical care to ill or injured servicemen has developed in tandem with the civilian experience, but the pressures of the austere environment of the battlefield have, at times, held back military medical services from providing the highest level of care that servicemen might deserve and, indeed, expect in civilian life...
October 2016: Journal of Anesthesia History
https://www.readbyqxmd.com/read/27834763/acquired-von-willebrand-syndrome-an-under-recognized-cause-of-major-bleeding-in-the-cardiac-intensive-care-unit
#4
Melissa B Jones, Karthik Ramakrishnan, Fahad A Alfares, Kendal M Endicott, Gary Oldenburg, John T Berger, Venkat Shankar, Dilip S Nath, Yaser A Diab
BACKGROUND: Acquired von Willebrand syndrome (AvWS) in the setting of congenital heart disease is an under-recognized cause of bleeding in the pediatric cardiac critical care unit. METHODS: Fourteen patients diagnosed with AvWS admitted to the cardiac intensive care unit at the Children's National Health System between December 2009 and September 2015 were identified with subsequent chart review and case analysis. RESULTS: Of the 14 patients included in this study, 4 patients were on ventricular-assist devices, 6 patients were on extracorporeal membrane oxygenation, and 4 were patients with congenital heart disease not receiving any mechanical circulatory support...
November 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27822078/acute-kidney-injury-adjusted-to-volume-status-in-critically-ill-patients-recognition-of-delayed-diagnosis-restaging-and-associated-outcomes
#5
Harout Yacoub, Leen Khoury, Youssef El Douaihy, Chadi Salmane, Jeanne Kamal, Marc Saad, Patricia Nasr, Jared Radbel, Elie El-Charabaty, Suzanne El-Sayegh
Critically ill patients receive a significant amount of fluids leading to a positive fluid balance; this dilutes serum creatinine resulting in an overestimated glomerular filtration rate. The goal of our study is to identify undiagnosed or underestimated acute kidney injury (AKI) in the intensive care unit (ICU). It will also identify the morbidity and mortality associated with an underestimated AKI. We reviewed records of patients admitted to our institution (Staten Island University Hospital) between 2012 and 2013 for more than 2 days...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27816156/cardiac-lesions-in-the-critical-care-setting
#6
REVIEW
Manisha Gandhi, Amir A Shamshirsaz
The long-held belief that pregnancy is absolutely contraindicated in maternal cardiovascular disease is no longer justifiable using evidence-base medicine. There are some conditions in which pregnancy is contraindicated, and high maternal risk and poor fetal outcome can be predicted. However, in many women with heart disease, a more favorable maternal and fetal outcome is expected. This article focusses on the cardiac conditions that require more attention and have the potential to require observation in the intensive care unit setting...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27751799/performance-of-the-obstetric-early-warning-score-in-critically-ill-patients-for-the-prediction-of-maternal-death
#7
Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27722111/predictors-of-dexmedetomidine-associated-hypotension-in-critically-ill-patients
#8
Anthony T Gerlach, Danielle M Blais, G Morgan Jones, Pamela K Burcham, Stanislaw P Stawicki, Charles H Cook, Claire V Murphy
BACKGROUND: Dexmedetomidine is commonly used for sedation in the Intensive Care Unit (ICU), and its use may be associated with hypotension. We sought to determine predictors of dexmedetomidine-associated hypotension. METHODS: Retrospective, single-center study of 283 ICU patients in four adults ICUs over a 12 month period. Univariate analyses were performed to determine factors associated with dexmedetomidine-related hypotension. Risk factors significant at the 0...
July 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/27722110/the-epidemiology-and-outcome-of-critical-illness-in-mongolia-a-multicenter-prospective-observational-cohort-study
#9
Naranpurev Mendsaikhan, Tsolmon Begzjav, Ganbold Lundeg, Martin W Dünser
CONTEXT: The epidemiology and outcome of critical illness in Mongolia remain undefined. AIM: The aim of this study was to evaluate the epidemiology and outcome of critical illness in Mongolia. SETTINGS AND DESIGN: This is a multicenter, prospective, observational cohort study including 19 Mongolian centers. MATERIALS AND METHODS: Demographic, clinical, and outcome data of patients >15 years admitted to the Intensive Care Units (ICUs) were collected during a 6-month period...
July 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/27716696/early-enteral-nutrition-therapy-in-congenital-cardiac-repair-postoperatively-a-randomized-controlled-pilot-study
#10
Manoj Kumar Sahu, Anuradha Singal, Ramesh Menon, Sarvesh Pal Singh, Alka Mohan, Mala Manral, Divya Singh, V Devagouru, Sachin Talwar, Shiv Kumar Choudhary
BACKGROUND AND OBJECTIVES: Adequate nutritional supplementation in infants with cardiac malformations after surgical repair is a challenge. Critically ill infants in the early postoperative period are in a catabolic stress. The mismatch between estimated energy requirement (EER) and the intake in the postoperative period is multifactorial, predisposing them to complications such as immune deficiency, more infection, and growth failure. This study aimed to assess the feasibility and efficacy of enriched breast milk feed on postoperative recovery and growth of infants after open heart surgery...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27709722/cardiogenic-shock-in-intensive-care-units-evolution-of-prevalence-patient-profile-management-and-outcomes-1997-2012
#11
Etienne Puymirat, Jean Yves Fagon, Philippe Aegerter, Jean Luc Diehl, Alexandra Monnier, Caroline Hauw-Berlemont, Florence Boissier, Gilles Chatellier, Bertrand Guidet, Nicolas Danchin, Nadia Aissaoui
AIM: To address the paucity of data on the characteristics, outcome and temporal trends in mortality of cardiogenic shock (CS) patients admitted to intensive care units (ICUs) we examined key features, variations in mortality from CS, and predictors of death in ICU patients over the past 15 years. METHODS AND RESULTS: From the 1997-2012 database of the Collège des Utilisateurs de Bases de données en Réanimation (CUB-Réa) that prospectively collects data from ICUs in the greater Paris area, we determined temporal trends in the incidence of CS, patient outcomes [Crude and Simplified Acute Physiology Score (SAPS)-II Standardized Mortality] and predictors of in-ICU mortality...
October 6, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27706464/effect-of-postextubation-high-flow-nasal-cannula-vs-noninvasive-ventilation-on-reintubation-and-postextubation-respiratory-failure-in-high-risk-patients-a-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Gonzalo Hernández, Concepción Vaquero, Laura Colinas, Rafael Cuena, Paloma González, Alfonso Canabal, Susana Sanchez, Maria Luisa Rodriguez, Ana Villasclaras, Rafael Fernández
Importance: High-flow conditioned oxygen therapy delivered through nasal cannulae and noninvasive mechanical ventilation (NIV) may reduce the need for reintubation. Among the advantages of high-flow oxygen therapy are comfort, availability, lower costs, and additional physiopathological mechanisms. Objective: To test if high-flow conditioned oxygen therapy is noninferior to NIV for preventing postextubation respiratory failure and reintubation in patients at high risk of reintubation...
October 18, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27699815/impact-of-the-implementation-of-vasoactive-drug-protocols-on-safety-and-efficacy-in-the-treatment-of-critically-ill-patients
#13
I Cuesta López, M Sánchez Cuervo, Á Candela Toha, J Benedí González, T Bermejo Vicedo
WHAT IS KNOWN AND OBJECTIVE: The correct management of high-alert medications is a priority issue in expert recommendations for improving the clinical safety of patients. Objectives were to assess the impact of the implementation of vasoactive drug (VAD) protocols on safety and efficacy in the treatment of critically ill patients. METHODS: A prospective before-and-after study on the implementation of different VAD protocols, comparing medication errors (MEs) rates, mean intensive care unit (ICU) stay, mean blood pressure (MAP), heart rate (HR) and oxygen saturation...
December 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27668696/corrective-effect-of-norepinephrine-on-hypotension-induced-by-dexmedetomidine-in-critically-ill-patients
#14
Donghao Wang, Yongmei Cao, Yi Lyu, Yingchuan Li, Tao Han
PURPOSE: To evaluate the corrective effect of norepinephrine on hypotension induced by dexmedetomidine through monitoring sedation status, hemodynamics as well as oxygen metabolism. METHODS: 100 patients administered standard-dose dexmedetomidine therapy with RASS between -2 and 0 in the intensive care unit (ICU) were included in the study. According to the application of norepinephrine to correct hypotension after dexmedetomidine therapy, the patients were divided into two groups: group A and group B...
December 2016: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27665572/evaluation-of-perfusion-index-as-a-tool-for-pain-assessment-in-critically-ill-patients
#15
Ahmed Hasanin, Sabah Abdel Raouf Mohamed, Akram El-Adawy
Pain is a common and undertreated problem in critically ill patients. Pain assessment in critically ill patients is challenging and relies on complex scoring systems. The aim of this work was to find out the possible role of the perfusion index (PI) measured by a pulse oximeter (Masimo Radical 7; Masimo Corp., Irvine, CA, USA) in pain assessment in critically ill patients. A prospective observational study was carried out on 87 sedated non-intubated patients in a surgical intensive care unit. In addition to routine monitoring, a Masimo pulse oximeter probe was used for PI measurement...
September 24, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27606159/pleth-variability-index-and-respiratory-system-compliance-to-direct-peep-settings-in-mechanically-ventilated-patients-an-exploratory-study
#16
Jing Zhou, Yi Han
OBJECTIVES: To analyze the ability of pleth variability index (PVI) and respiratory system compliance (RSC) on evaluating the hemodynamic and respiratory effects of positive end expiratory pressure (PEEP), then to direct PEEP settings in mechanically ventilated critical patients. METHODS: We studied 22 mechanically ventilated critical patients in the intensive care unit. Patients were monitored with classical monitor and a pulse co-oximeter, with pulse sensors attached to patients' index fingers...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27605484/utility-of-genetic-evaluation-in-infants-with-congenital-heart-defects-admitted-to-the-cardiac-intensive-care-unit
#17
Rebecca C Ahrens-Nicklas, Shama Khan, Jennifer Garbarini, Stacy Woyciechowski, Lisa D'Alessandro, Elaine H Zackai, Matthew A Deardorff, Elizabeth Goldmuntz
Congenital heart defects (CHDs) are heterogeneous and present with a spectrum of severity, with roughly 25% of patients requiring intervention before age 1. The etiology of disease is unknown in many individuals; however, there is a rapidly expanding understanding of genetic risk factors that may contribute to pathogenesis. Through this work, we sought to evaluate the diagnostic yield of a clinical genetics evaluation and associated genetic testing among infants with critical CHDs. Furthermore, we aimed to both determine the utility of microarray and establish a strong baseline that can be used in future studies of the impact of exome sequencing in this population...
September 8, 2016: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/27604617/12th-winfocus-world-congress-on-ultrasound-in-emergency-and-critical-care
#18
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27587426/symptoms-of-cardiac-anxiety-in-family-members-of-intensive-care-unit-patients
#19
Zoe Konstanti, Mary Gouva, Elena Dragioti, Georgios Nakos, Vasilios Koulouras
BACKGROUND: Studies have shown an association between intensive care unit environments and symptoms of psychological distress in family members of critically ill patients. OBJECTIVE: To investigate levels of cardiac anxiety in family members of intensive care unit patients. METHODS: From March 2012 to July 2013, on the third day after the patient's admission, 223 family members of 147 patients completed the Cardiac Anxiety Questionnaire. A total score was calculated from 3 subscales: fear and worry about heart sensations, avoidance of activities reproducing cardiac symptoms, and heart-focused attention and monitoring of cardiac activity...
September 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27573571/device-and-medication-preferences-of-canadian-physicians-for-emergent-endotracheal-intubation-in-critically-ill-patients
#20
Robert S Green, Dean A Fergusson, Alexis F Turgeon, Lauralyn A McIntyre, George J Kovacs, Donald E Griesdale, Ryan Zarychanski, Michael B Butler, Nelofar Kureshi, Mete Erdogan
OBJECTIVES: Various medications and devices are available for facilitation of emergent endotracheal intubations (EETIs). The objective of this study was to survey which medications and devices are being utilized for intubation by Canadian physicians. METHODS: A clinical scenario-based survey was developed to determine which medications physicians would administer to facilitate EETI, their first choice of intubation device, and backup strategy should their first choice fail...
August 30, 2016: CJEM
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