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https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#1
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28074985/-characteristics-and-evolution-of-patients-admitted-to-a-public-hospital-intensive-care-unit
#2
Carolina Ruiz, Miguel Ángel Díaz, Juan Marcelo Zapata, Sebastián Bravo, Sergio Panay, Cristina Escobar, Jorge Godoy, Max Andresen, Ricardo Castro
BACKGROUND: The epidemiology of critical patients in Chile could differ from that reported in international studies. AIM: To describe the causes of admission and evolution of patients who were admitted to the ICU (Intensive Care Unit) of a general hospital in Chile in a two-year period (2012-2013). PATIENTS AND METHODS: A retrospective study was carried out using the ICU database. The following variables were registered: admission diagnosis, APACHE II (Acute Physiology and Chronic Health Evaluation), days of mechanical ventilation (MV), ICU length of stay and ICU and hospital survival...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28066607/risk-factors-and-outcome-of-primary-graft-dysfunction-after-lung-transplantation-in-korea
#3
Sungwoo Moon, Moo Suk Park, Jin Gu Lee, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Se Kyu Kim, Joon Chang, Hyo Chae Paik, Song Yee Kim
BACKGROUND: Primary graft dysfunction (PGD) is a severe, acute and post-transplantation lung injury associated with early morbidity and mortality. We aimed to identify clinical risk factors for PGD, as well as the outcome of PGD after lung transplantation in Korea. METHODS: We retrospectively analyzed lung transplant patients in a South Korean Hospital. The primary outcome was grade 3 PGD, defined according to the International Society for Heart and Lung Transplantation criteria...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065635/meals-enhancing-nutrition-after-discharge-findings-from-a-pilot-randomized-controlled%C3%A2-trial
#4
David R Buys, Anthony D Campbell, Alice Godfryd, Kellie Flood, Elizabeth Kitchin, Meredith L Kilgore, Sally Allocca, Julie L Locher
BACKGROUND: After older adults experience episodes of poor health or are hospitalized, they may not return to premorbid or prehospitalization eating behaviors. Furthermore, poor nutrition increases hospital readmission risk, but evidence-based interventions addressing these risks are limited. OBJECTIVE: This pilot study's objective was to evaluate the feasibility of conducting a randomized controlled trial assessing a post-discharge home-delivered meal program's impact on older adults' nutritional intake and hospital readmissions and to assess patient acceptability and satisfaction with the program...
January 5, 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28057455/comparison-of-botulinum-toxin-with-surgery-for-the-treatment-of-acute-onset-comitant-esotropia-in-children
#5
Michael J Wan, Iason S Mantagos, Ankoor S Shah, Melanie Kazlas, David G Hunter
PURPOSE: To determine whether botulinum toxin is as effective as strabismus surgery in the treatment of acute-onset, comitant esotropia in children. DESIGN: Retrospective, non-randomized, comparative clinical study. METHODS: Setting: Tertiary care pediatric hospital. STUDY POPULATION: 49 children with acute-onset, comitant esotropia. INTERVENTION: Treatment with either botulinum toxin ("chemodenervation group") or standard incisional strabismus surgery ("surgery group")...
January 2, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28056115/a-tiered-approach-to-retinopathy-of-prematurity-screening-tarp-using-a-weight-gain-predictive-model-and-a-telemedicine-system
#6
Jaclyn Gurwin, Lauren A Tomlinson, Graham E Quinn, Gui-Shuang Ying, Agnieshka Baumritter, Gil Binenbaum
Importance: The Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study telemedicine system of remote fundus image grading and The Children's Hospital of Philadelphia Retinopathy of Prematurity (CHOP-ROP) postnatal weight gain predictive model are 2 approaches for improving ROP screening efficiency. Current screening has low specificity for severe ROP. Objective: To describe a tiered approach to ROP screening (TARP) for identifying children who develop severe ROP using telemedicine and a predictive model synergistically...
January 5, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28042016/spontaneous-intraventricular-hemorrhage-a-rare-presentation-of-a-skull-base-mesenchymal-chondrosarcoma
#7
Altaf Ali Laghari, Gohar Javed, Muhammad Faheem Khan, Syed Ijlal Ahmed, Karim Rizwan Nathani, Riyasat Ahmed
INTRODUCTION: Chondrosarcomas (CSA) are very rare malignant slow growing tumors which develop in or near the petroclival region of the brain. We report our experience of a very rare case in which the tumor originated from left petrous bone and induced intraventricular hemorrhage (IVH) leading to an acute comatose presentation. CASE DESCRIPTION: A 28 year old male initially presented in outpatient department (OPD) with a 1 month history of headache, vomiting, vertigo and left facial numbness...
December 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28028819/a-pilot-randomized-controlled-trial-comparing-effectiveness-of-prism-glasses-visual-search-training-and-standard-care-in-hemianopia
#8
F J Rowe, E J Conroy, E Bedson, E Cwiklinski, A Drummond, M García-Fiñana, C Howard, A Pollock, T Shipman, C Dodridge, C MacIntosh, S Johnson, C Noonan, G Barton, C Sackley
OBJECTIVE: Pilot trial to compare prism therapy and visual search training, for homonymous hemianopia, to standard care (information only). METHODS: Prospective, multicentre, parallel, single-blind, three-arm RCT across fifteen UK acute stroke units. PARTICIPANTS: Stroke survivors with homonymous hemianopia. INTERVENTIONS: Arm a (Fresnel prisms) for minimum 2 hours, 5 days per week over 6 weeks. Arm b (visual search training) for minimum 30 minutes, 5 days per week over 6 weeks...
December 27, 2016: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28027819/mortality-and-readmission-of-outcomes-after-discharge-from-the-surgical-intensive-care-unit-to-long-term-acute-care-hospitals
#9
Michelle C Nguyen, David S Strosberg, Teresa S Jones, Ankur Bhakta, Edward L Jones, Michael R Lyaker, Cindy A Byrd, Carly Sobol, Daniel S Eiferman
BACKGROUND: Patients with prolonged hospitalizations in the surgical intensive care unit often have ongoing medical needs that require further care at long-term, acute-care hospitals upon discharge. Setting expectations for patients and families after protracted operative intensive care unit hospitalization is challenging, and there are limited data to guide these conversations. The purpose of this study was to determine patient survival and readmission rates after discharge from the surgical intensive care unit directly to a long-term, acute-care hospital...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/28024441/the-effects-of-telehealth-use-for-post-acute-rehabilitation-patient-outcomes
#10
Stephanie A Hicks, Verena R Cimarolli
Introduction Previous research has shown that home telehealth services can reduce hospitalisations and emergency department visits and improve clinical outcomes among older adults with chronic conditions. However, there is a lack of research on the impact of telehealth (TH) use on patient outcomes in post-acute rehabilitation settings. The current study examined the effects of TH for post-acute rehabilitation patient outcomes (i.e. discharge setting and change in functional independence) when controlling for other factors (e...
January 1, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28017276/patient-journey-in-decompensated-heart-failure-an-analysis-in-departments-of-cardiology-and-geriatrics-in-the-greater-paris-university-hospitals
#11
Florent Laveau, Nadjib Hammoudi, Emmanuelle Berthelot, Joël Belmin, Patrick Assayag, Ariel Cohen, Thibaud Damy, Denis Duboc, Olivier Dubourg, Albert Hagege, Olivier Hanon, Richard Isnard, Guillaume Jondeau, Florian Labouree, Damien Logeart, Nicolas Mansencal, Christophe Meune, Eric Pautas, Yves Wolmark, Michel Komajda
BACKGROUND: Hospitalization for worsening/acute heart failure is increasing in France, and limited data are available on referral/discharge modalities. AIM: To evaluate patients' journeys before and after hospitalization for this condition. METHODS: On 1 day per week, between October 2014 and February 2015, this observational study enrolled 260 consecutive patients with acute/worsening heart failure in all 10 departments of cardiology and four of the departments of geriatrics in the Greater Paris University Hospitals...
December 21, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28006826/predictive-performance-of-the-simplified-acute-physiology-score-saps-ii-and-the-initial-sequential-organ-failure-assessment-sofa-score-in-acutely-ill-intensive-care-patients-post-hoc-analyses-of-the-sup-icu-inception-cohort-study
#12
Anders Granholm, Morten Hylander Møller, Mette Krag, Anders Perner, Peter Buhl Hjortrup
PURPOSE: Severity scores including the Simplified Acute Physiology Score (SAPS) II and the Sequential Organ Failure Assessment (SOFA) score are used in intensive care units (ICUs) to assess disease severity, predict mortality and in research. We aimed to assess the predictive performance of SAPS II and the initial SOFA score for in-hospital and 90-day mortality in a contemporary international cohort. METHODS: This was a post-hoc study of the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) inception cohort study, which included acutely ill adults from ICUs across 11 countries (n = 1034)...
2016: PloS One
https://www.readbyqxmd.com/read/28005410/results-of-a-medicare-bundled-payments-for-care-improvement-initiative-for-copd-readmissions
#13
Surya P Bhatt, J Michael Wells, Anand S Iyer, deNay P Kirkpatrick, Trisha M Parekh, Lauren T Leach, Erica M Anderson, J Greg Sanders, Jessica K Nichols, Cindy C Blackburn, Mark T Dransfield
RATIONALE: Approximately 20% of Medicare beneficiaries hospitalized for acute exacerbations of COPD are readmitted within 30 days of discharge. In addition to implementing penalties for excess readmissions, the United States Centers for Medicare & Medicaid Services (CMS) has developed Bundled Payments for Care Improvement (BPCI) initiatives to improve outcomes and control costs. OBJECTIVES: To evaluate whether a comprehensive COPD multidisciplinary intervention focusing on inpatient, transitional and outpatient care as part of our institution's BPCI participation initiative would reduce 30-day all-cause readmission rates for COPD exacerbations and reduce overall costs...
December 22, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28002651/a-test-of-the-arcc%C3%A2-model-improves-implementation-of-evidence-based-practice-healthcare-culture-and-patient-outcomes
#14
Bernadette Mazurek Melnyk, Ellen Fineout-Overholt, Martha Giggleman, Katie Choy
BACKGROUND: Although several models of evidence-based practice (EBP) exist, there is a paucity of studies that have been conducted to evaluate their implementation in healthcare settings. AIM: The purpose of this study was to examine the impact of the Advancing Research and Clinical practice through close Collaboration (ARCC) Model on organizational culture, clinicians' EBP beliefs and EBP implementation, and patient outcomes at one healthcare system in the western United States...
December 21, 2016: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/27997877/effects-of-low-dose-atrial-natriuretic-peptide-infusion-on-cardiac-surgery-associated-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#15
Chieko Mitaka, Tetsu Ohnuma, Takanori Murayama, Fumio Kunimoto, Michio Nagashima, Tetsuhiro Takei, Naoya Iguchi, Makoto Tomita
PURPOSE: To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. MATERIALS AND METHODS: The Japanese trial for AKI in Post-cardiovascular surgery patients by ANP (JAPAN) was a prospective, multicenter, randomized, double-blind, placebo-controlled study conducted in 11 hospitals in Japan. Acute kidney injury was defined as an increase in serum creatinine of at least 0...
December 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27973930/comorbidities-and-subgroups-of-patients-surviving-severe-acute-hypercapnic-respiratory-failure-in-the-icu
#16
Dan Adler, Jean-Louis Pépin, Elise Dupuis-Lozeron, Katerina Espa-Cervena, Roselyne Merlet-Violet, Hajo Muller, Jean-Paul Janssens, Laurent Brochard
RATIONALE: No methodical assessment of the lung, cardiac and sleep function of patients surviving an acute hypercapnic respiratory failure episode requiring admission to the intensive care unit (ICU) has been reported in the literature. OBJECTIVES: To prospectively investigate the prevalence and impact of comorbidities in patients treated by mechanical ventilator support (invasive or non-invasive) for acute hypercapnic respiratory failure in the ICU. METHODS: Seventy-eight consecutive patients admitted for an episode of acute hypercapnic respiratory failure underwent an assessment of lung, cardiac and sleep function by pulmonary function tests, transthoracic echocardiography and polysomnography 3 months after ICU discharge...
December 14, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27942344/acute-care-trauma-surgeon-s-role-in-obstetrical-gynecologic-emergencies-the-obcat-alert
#17
Seong K Lee, Eddy H Carrillo, Andrew Rosenthal, Rafael Sanchez, Chauniqua Kiffin, Dafney L Davare
BACKGROUND: Overwhelming hemorrhage or other intra-abdominal complications may be associated with obstetrical or gynecologic (OB/GYN) procedures and may require the surgical training of an Acute Care/Trauma Surgeon. The OB Critical Assessment Team (OBCAT Alert) was developed at our institution to facilitate a multidisciplinary response to complex OB/GYN cases. We sought to review and characterize the Acute Care/Trauma Surgeon's role in these cases. METHODS: We conducted a retrospective review of all emergency consults during an OB/GYN case at our institution from 2008 to 2015...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27942052/critical-incidents-in-paediatric-anaesthesia-a-prospective-analysis-over-a-1-year-period
#18
Raylene Dias, Nandini Dave, Swapna Chiluveru, Madhu Garasia
BACKGROUND AND AIMS: Critical incident reporting helps to identify errors and formulate preventive strategies. Many countries have existing national reporting systems. Such a system is yet to be established in India. We aimed to study the incidence of critical events in the paediatric operation theatre (OT) of our institute. METHODS: We conducted a prospective observational study of all children receiving anaesthesia in paediatric OT over a period of 1 year. They were monitored intraoperatively as well as postoperatively, and critical incidents were noted in terms of date and time of incident, location (OT/post-anaesthesia care unit, clinical category, age of patient, degree of patient harm resulting from the incident, description of what happened and duration of surgery...
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27942002/the-impact-of-adding-a-physician-assistant-to-a-critical-care-outreach-team
#19
Hayley B Gershengorn, Yunchao Xu, Carri W Chan, Mor Armony, Michelle N Gong
RATIONALE: Hospitals are increasingly using critical care outreach teams (CCOTs) to respond to patients deteriorating outside intensive care units (ICUs). CCOT staffing is variable across hospitals and optimal team composition is unknown. OBJECTIVES: To assess whether adding a critical care medicine trained physician assistant (CCM-PA) to a critical care outreach team (CCOT) impacts clinical and process outcomes. METHODS: We performed a retrospective study of two cohorts-one with a CCM-PA added to the CCOT (intervention hospital) and one with no staffing change (control hospital)-at two facilities in the same system...
2016: PloS One
https://www.readbyqxmd.com/read/27929206/acute-bronchitis
#20
Scott Kinkade, Natalie A Long
Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. Pneumonia should be suspected in patients with tachypnea, tachycardia, dyspnea, or lung findings suggestive of pneumonia, and radiography is warranted. Pertussis should be suspected in patients with cough persisting for more than two weeks that is accompanied by symptoms such as paroxysmal cough, whooping cough, and post-tussive emesis, or recent pertussis exposure...
October 1, 2016: American Family Physician
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