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Physiology critical care

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https://www.readbyqxmd.com/read/29150999/focus-on-focus-lack-of-coherence-between-systemic-and-microvascular-indices-of-edema-formation
#1
Birkitt Ten Tusscher, Corien Gudden, Suus van Vliet, Bob Smit, Can Ince, E Christiaan Boerma, Harm-Jan S de Grooth, Paul W G Elbers
BACKGROUND: Fluid therapy remains a cornerstone of therapy in shock states. However, fluid overloading ultimately results in edema formation which is related to excess morbidity and mortality. Handheld microscopes are now frequently used to study the sublingual microcirculation. As a corollary, these devices measure focal distance, or surface to capillary distance. Physiologically, this could represent a microvascular index of edema formation and could have the potential to guide fluid therapy...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29148046/delirium-and-effect-of-circadian-light-in-the-intensive-care-unit-a-retrospective-cohort-study
#2
S Estrup, C K W Kjer, L M Poulsen, I Gøgenur, O Mathiesen
BACKGROUND: Delirium is a serious condition often experienced by critically ill patients in intensive care units (ICUs). The role of circadian light for this condition is unclear. The aim of this study was to describe incidence of delirium, risk factors for delirium, and the association between delirium and circadian light for patients in the ICU. METHODS: This is a retrospective cohort study of all patients at a Danish ICU from 1 August 2015 to 31 January 2016...
November 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29145755/defining-recognizing-and-reporting-malnutrition
#3
Marinos Elia
Although malnutrition is a common health and social care problem, there is no universal agreement about its definition, prevalence, or method of identification and report. Fifteen definitions of malnutrition were critically examined to assess their variability. They ranged from descriptions of undernutrition alone to under- and overnutrition, with intakes ranging from dietary protein and energy alone to dietary and nondietary sources of all nutrients and energy. Definitions also varied from non-outcome based to those based on functional, physiological, and/or clinical outcomes...
November 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29139014/the-ictal-interictal-continuum-to-treat-or-not-to-treat-and-how
#4
Clio Rubinos, Alexandra S Reynolds, Jan Claassen
Continuous electroencephalography (cEEG) monitoring is becoming increasingly used in neurologic and non-neurologic intensive care units (ICUs). Non-convulsive seizures (NCSz) and periodic discharges (PDs) are commonly seen in critically ill patients. Some of these PD patterns, also known as the ictal-interictal continuum (IIC), are associated with an increased risk of seizures and poor outcome. However, we do not fully understand the significance of these periodic patterns and the decision of how aggressively to treat remains controversial...
November 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#5
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29132516/decompensated-cirrhosis-and-fluid-resuscitation
#6
REVIEW
Erin Maynard
The critically ill patient with decompensated cirrhosis has a unique physiology and alterations in albumin that need to be understood to properly resuscitate them and minimize morbidity and mortality. Little data exist on specific resuscitation of the patient with cirrhosis compared with those patients without liver disease. The effectiveness of albumin administration compared with saline administration in common settings, such as large-volume paracentesis, can be extrapolated to the care of the general surgical patient but further studies in this area are warranted...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29131536/non-invasive-ventilation-use-in-status-asthmaticus-16%C3%A2-years-of-experience-in-a-tertiary-intensive-care
#7
Kirsten Rl Bond, Carl Ae Horsley, Anthony B Williams
OBJECTIVE: To describe the use of non-invasive ventilation (NIV) in adults presenting with status asthmaticus to Middlemore Hospital Critical Care Complex (CCC, South Auckland, New Zealand) from 2000 to 2015. METHOD: Retrospective review of all adult asthma admissions to the Hospital CCC between 2000 and 2015. Demographic, physiological, treatment data and blood gas results were recorded. RESULTS: There were 265 asthma admissions to Middlemore Hospital CCC during the study period...
November 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29129241/zinc-and-selenium-status-in-critically-ill-patients-according-to-severity-stratification
#8
Marina Augusta Cirino Ruocco, Evelin Drociunas Pacheco Cechinatti, Fernando Barbosa, Anderson Marliere Navarro
OBJECTIVE: The aim of this study was to evaluate the concentrations of zinc and selenium in different biological materials and to associate them with the clinical severity score according to the Simplified Acute Physiology Score (SAPS) III. METHODS: The study was conducted in a 10-bed general intensive care unit of the Américo Brasiliense State Hospital/SP, with 95 patients stratified by the SAPS III score cutoff points (63.5 points) as less or more severe and by the diagnosis of sepsis...
January 2018: Nutrition
https://www.readbyqxmd.com/read/29125177/surgical-management-of-impalement-injuries-to-the-trunk-of-dogs-a-multicentre-retrospective-study
#9
M Matiasovic, Z J Halfacree, A Moores, P Nelissen, S Woods, B Dean, G Chanoit, D C Barnes
OBJECTIVES: To review a large series of dogs referred for treatment of traumatic impalement injuries to the thorax and/or abdomen and to report aetiologies, injury characteristics, management and long-term outcomes. MATERIALS AND METHODS: Previously collected data on dogs that were surgically treated for impalement injuries to the trunk at six veterinary specialist referral institutions in the UK over an 11-year period were reviewed. Data included patient signalment, physiological variables, injury-specific variables, diagnostic imaging reports, surgical procedures undertaken, duration of hospitalisation, antibiotic use, complications and outcomes...
November 10, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29121281/epidemiology-of-sepsis-and-septic-shock-in-critical-care-units-comparison-between-sepsis-2-and-sepsis-3-populations-using-a-national-critical-care-database
#10
M Shankar-Hari, D A Harrison, G D Rubenfeld, K Rowan
Background: New sepsis and septic shock definitions could change the epidemiology of sepsis because of differences in criteria. We therefore compared the sepsis populations identified by the old and new definitions. Methods: We used a high-quality, national, intensive care unit (ICU) database of 654 918 consecutive admissions to 189 adult ICUs in England, from January 2011 to December 2015. Primary outcome was acute hospital mortality. We compared old (Sepsis-2) and new (Sepsis-3) incidence, outcomes, trends in outcomes, and predictive validity of sepsis and septic shock populations...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29118899/alterations-in-tendon-microenvironment-in-response-to-mechanical-load-potential-molecular-targets-for-treatment-strategies
#11
REVIEW
Mohamed B Fouda, Finosh G Thankam, Matthew F Dilisio, Devendra K Agrawal
Rotator cuff (RC) tendons could beinflicted in many ways with an eventual outcome of pain, weakness and disability, which represent a large burden on health care cost. However, optimal healing, either conservatively or with surgical intervention, remains an issue that needs further investigation. Disorders of the RC tendons may result from external factors like trauma, or internal factors through physiologic and metabolic derangement. Most RC tendon disorders may be asymptomatic and may result from an over-activity of the inflicted shoulder and its tendons...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/29115861/postnatal-overnutrition-affects-metabolic-and-vascular-function-reflected-by-physiological-and-histological-changes-in-the-aorta-of-adult-wistar-rats
#12
Gerardo Sánchez-García, Laura Del Bosque-Plata, Enrique Hong
Rigorous nutritional care during early life leads to healthy adulthood. Cardiovascular and metabolic disorders, the most prevalent clinical challenges worldwide, are epidemiologically linked to poor nutritional habits throughout life. We aimed to understand whether postnatal overnutrition (PO) initiated during lactation affects metabolic markers and vascular function later in life. To test this hypothetical effect, we studied a PO Wistar rat model based on adjusting litter size at the third day of age to three pups and eight for the control group (C)...
November 8, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29115280/real-time-cerebellar-neuroprosthetic-system-based-on-a-spiking-neural-network-model-of-motor-learning
#13
Tao Xu, Na Xiao, Xiaolong Zhai, Pak Kwan Chan, Chung Tin
Damage to the brain, as a result of various medical conditions, impacts everyday life of patients and there is still no complete cure to neurological disorders. Neuroprostheses that can functionally replace the damaged neural circuit have recently emerged as a possible solution to these problems. Here we describe the development of a real-time cerebellar neuroprosthetic system to substitute neural function in cerebellar circuitry for learning delay eyeblink conditioning (DEC). Approach: The system was empowered by a biologically realistic spiking neural network (SNN) model of the cerebellar neural circuit, which considers the neuronal population and anatomical connectivity of the network...
November 8, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29109640/obstetric-critical-care-requirements-felt-by-the-obstetricians-an-experience-based-study
#14
Mohan Deep Kaur, Jyoti Sharma, Prasoon Gupta, Tarun Deep Singh, Saurav Mitra Mustafi
Background and Aims: Pregnancy is a state of physiological stress to a woman's health. Concomitant complications and infections during pregnancy may necessitate intensive monitoring and management of such patients in critical care settings. This study aims to determine the perceptions about the requirement of obstetric critical care based on the experience of obstetricians. Material and Methods: An observational, questionnaire-based study was conducted in 200 obstetricians working in various settings, who were approached during obstetric conferences...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29107635/predictors-of-need-for-critical-care-support-adverse-events-and-outcome-after-stroke-thrombolysis
#15
Panagiotis Papamichalis, Spyridon Karagiannis, Efthimios Dardiotis, Achilleas Chovas, Dimitrios Papadopoulos, Tilemachos Zafeiridis, Dimitris Babalis, Georgios Paraforos, Vasiliki Zisopoulou, Apostolia-Lemonia Skoura, Ioannis Staikos, Konstantinos Bouliaris, Michail Papamichalis, Georgios Hadjigeorgiou, Apostolos Komnos
BACKGROUND: Results from trials and international registries exhibit heterogeneity regarding safety, efficacy, markers of prognosis, and markers of the need for critical care support after intravenous thrombolysis (IVT) for strokes. The purpose of our study was to indentify such markers after performance of comparisons among patients who received thrombolysis in our intensive care unit. MATERIALS AND METHODS: Our study included 124 patients who received IVT in accordance with international criteria...
October 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29105064/outcomes-after-cancelled-helicopter-emergency-medical-service-missions-due-to-concurrencies-a-retrospective-cohort-study
#16
Ø Østerås, J-K Heltne, K Tønsager, G Brattebø
BACKGROUND: Appropriate dispatch criteria and helicopter emergency medical service (HEMS) crew decisions are crucial for avoiding over-triage and reducing the number of concurrencies. The aim of the present study was to compare patient outcomes after completed HEMS missions and missions cancelled by the HEMS due to concurrencies. METHODS: Missions cancelled due to concurrencies (AMB group) and completed HEMS missions (HEMS group) in Western Norway from 2004 to 2013 were assessed...
November 3, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29092656/effect-of-anemia-on-mortality-in-mechanically-ventilated-patients-with-chronic-obstructive-pulmonary-disease
#17
Shruti K Gadre, Aravdeep Singh Jhand, Sami Abuqayyas, Xiaofeng Wang, Jorge Guzman, Abhijit Duggal
RATIONALE: The effect of anemia on patients with chronic obstructive pulmonary disease (COPD) requiring invasive mechanical ventilation for acute respiratory failure is unknown. OBJECTIVES: To examine the association between anemia (hemoglobin <12 g/dL) and 90-day and overall mortality in patients with COPD having acute respiratory failure requiring invasive mechanical ventilation. METHODS: Retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between October 2007 and December 2012 with a diagnosis of COPD and requiring invasive mechanical ventilation for acute respiratory failure of any cause...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29073537/diagnostic-accuracy-of-delirium-assessment-methods-in-critical-care-patients
#18
Angkita Barman, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Anirban Bhattacharjee, Sonali Shinde Tesia, Jayanta Kumar Mitra
PURPOSE: Delirium is a disorder of decreased ability to focus, sustain or shift attention, change in cognition and or perception. The main objective was to evaluate the diagnostic accuracy of Confusion Assessment Method for the ICU (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) among the nursing and medical staff in a multidisciplinary ICU. METHODS AND MATERIAL: Three hundred ten verbally communicating and non-communicating patients (mean age in years 47...
October 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29065319/nurses-experiences-of-managing-patient-deterioration-following-a-post-registration-education-programme-a-critical-incident-analysis-study
#19
Clare Butler
The aim of this study was to explore nurses' experiences assessing and managing deteriorating patients in practice following completion of a relevant post-registration education programme. Recognising the increasing acuity of ward patients, nurses are faced with patients who are at an increased risk of deterioration. Patients who are acutely ill or deteriorating often exhibit periods of physiological deterioration; however there is evidence illustrating that these clinical changes are frequently missed, misinterpreted or mismanaged in practice...
October 13, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/29062574/analysis-of-adverse-events-during-intrahospital-transportation-of-critically-ill-patients
#20
Francielli Mary Pereira Gimenez, Wesley Henrique Bueno de Camargo, Ana Clara Beraldo Gomes, Thaylla Sumyre Nihei, Monique Walicheki Maria Andrade, Maria Laura de A F Sé Valverde, Larissa D' Epiro de Souza Campos, Debora Carvalho Grion, Josiane Festti, Cintia Magalhães Carvalho Grion
PURPOSE: To describe adverse events occurring during intrahospital transportation of adult patients hospitalized in an Intensive Care Unit (ICU) and to evaluate the association with morbidity and mortality. METHOD: Prospective cohort study from July 2014 to July 2015. Data collection comprised clinical data, prognostic scores, length of stay, and outcome at hospital discharge. Data was collected on transport and adverse events. Adverse events were classified according to the World Health Organization following the degree of damage...
2017: Critical Care Research and Practice
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