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https://www.readbyqxmd.com/read/28640785/physiologic-considerations-in-trauma-patients-undergoing-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#1
Zaffer A Qasim, Robert A Sikorski
Resuscitative endovascular balloon occlusion of the aorta is a new procedure for adjunctive management of critically injured patients with noncompressible torso or pelvic hemorrhage who are in refractory hemorrhagic shock, ie, bleeding to death. The anesthesiologist plays a critical role in management of these patients, from initial evaluation in the trauma bay to definitive care in the operating room and the critical care unit. A comprehensive understanding of the effects of resuscitative endovascular balloon occlusion of the aorta is essential to making it an effective component of hemostatic resuscitation...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28625266/-risk-factors-of-deep-venous-thrombosis-associated-with-peripherally-inserted-central-venous-catheter-in-upper-extremity-in-icu
#2
Ning Zhao, Jiale Zhang, Ting Jiang, Xia Chen, Jianning Wang, Chengzhi Ding, Fen Liu, Kejian Qian, Rong Jiang
OBJECTIVE: To analyze the incidence and its risk factors of peripherally inserted central venous catheter related upper extremity deep venous thrombosis (PICC-UEDVT) in intensive care unit (ICU). METHODS: Clinical data of the patients received PICCs in ICU of the First Affiliated Hospital of Nanchang University from August 2013 to August 2016 were retrospectively analysed. The inclusion criteria in the study included: the age > 18 years old, catheter indwelling time > 1 week and the complete relevant information...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625262/-predictive-value-of-sofa-score-combined-agi-grading-system-in-elderly-patients-with-sepsis-a-retrospective-analysis-with-91-patients
#3
Lingling Wang, Rui Chen, Zexun Mo, Jiahui Dong, Zhaokun Sun, Fei Xiao, Shaoting Hu, Richeng Xiong, Jie Sun, Zhou Yu, Zhenhui Guo
OBJECTIVE: To explore the predictive value of sequential organ failure assessment (SOFA) score combined the acute gastrointestinal injury (AGI) grading system in critical elderly patients with sepsis. METHODS: A retrospective analysis was conducted. Elderly patients with sepsis aged > 60 years admitted to medical intensive care unit (MICU) of General Hospital of Guangzhou Military Command from March 2014 to December 2015 and experiencing critical care over 48 hours were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625261/-formulation-of-combined-predictive-indicators-using-logistic-regression-model-in-predicting-sepsis-and-prognosis
#4
Liwei Duan, Sheng Zhang, Zhaofen Lin
OBJECTIVE: To explore the method and performance of using multiple indices to diagnose sepsis and to predict the prognosis of severe ill patients. METHODS: Critically ill patients at first admission to intensive care unit (ICU) of Changzheng Hospital, Second Military Medical University, from January 2014 to September 2015 were enrolled if the following conditions were satisfied: (1) patients were 18-75 years old; (2) the length of ICU stay was more than 24 hours; (3) All records of the patients were available...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625260/-predictive-value-of-four-different-scoring-systems-for-septic-patient-s-outcome-a-retrospective-analysis-with-311-patients
#5
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/28615274/detecting-organisational-innovations-leading-to-improved-icu-outcomes-a-protocol-for-a-double-blinded-national-positive-deviance-study-of-critical-care-delivery
#6
Howard Chiou, Jeffrey K Jopling, Jennifer Yang Scott, Meghan Ramsey, Kelly Vranas, Todd H Wagner, Arnold Milstein
INTRODUCTION: There is substantial variability in intensive care unit (ICU) utilisation and quality of care. However, the factors that drive this variation are poorly understood. This study uses a novel adaptation of positive deviance approach-a methodology used in public health that assumes solutions to challenges already exist within the system to detect innovations that are likely to improve intensive care. METHODS AND ANALYSIS: We used the Philips eICU Research Institute database, containing 3...
June 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28599662/a-randomized-controlled-pilot-study-to-evaluate-the-effect-of-an-enteral-formulation-designed-to-improve-gastrointestinal-tolerance-in-the-critically-ill-patient-the-spirit-trial
#7
Stephan M Jakob, Lukas Bütikofer, David Berger, Michael Coslovsky, Jukka Takala
BACKGROUND: Diarrhea is frequent in patients in intensive care units (ICU) and is associated with discomfort and complications and may increase the length of stay and nursing workload. METHODS: This was a prospective, double-blind, randomized, controlled single-center pilot study to assess the incidence and frequency of diarrhea and the respective effects of a modified enteral diet (intervention: Peptamen® AF, rich in proteins, medium chain triglycerides and fish oil) compared to a standard diet (control: Isosource® Energy) in 90 randomized adult patients (intervention, n = 46; control, n = 44) with an ICU stay ≥5 days and tube feeding ≥3 days...
June 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28594976/patient-reported-outcome-measures-in-upper-airway-related-dyspnea-a-systematic-review
#8
Meaghan Noud, Kristen Hovis, Alexander Gelbard, Nila A Sathe, David F Penson, Irene D Feurer, Melissa L McPheeters, David O Francis
Importance: Patient-reported outcome (PRO) measures address the need for patient-centered data and are now used in diverse clinical, research, and policy pursuits. They are important in conditions causing upper airway-related dyspnea in which the patient's reported experience and physiological data can be discrepant. Objectives: To perform a systematic review of the literature on upper airway dyspnea-related PRO measures and to rigorously evaluate each measure's developmental properties, validation, and applicability...
June 8, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28592473/implementing-the-sccm-family-centered-care-guidelines-in-critical-care-nursing-practice
#9
Maureen Coombs, Kathleen A Puntillo, Linda S Franck, Elizabeth A Scruth, Maurene A Harvey, Sandra M Swoboda, Judy E Davidson
Family-centered care is an important component of holistic nursing practice, particularly in critical care, where the impact on families of admitted patients can be physiologically and psychologically burdensome. Family-centered care guidelines, developed by an international group of nursing, medical, and academic experts for the American College of Critical Care Medicine/Society of Critical Care Medicine, explore the evidence base in 5 key areas of family-centered care. Evidence in each of the guideline areas is outlined and recommendations are made about how critical care nurses can use this information in family-centered care practice...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28580719/platelets-stored-at-4%C3%A2-c-contribute-to-superior-clot-properties-compared-to-current-standard-of-care-through-fibrin-crosslinking
#10
Prajeeda M Nair, Shaunak G Pandya, Shatha F Dallo, Kristin M Reddoch, Robbie K Montgomery, Heather F Pidcoke, Andrew P Cap, Anand K Ramasubramanian
Currently, platelets for transfusion are stored at room temperature (RT) for 5-7 days with gentle agitation, but this is less than optimal because of loss of function and risk of bacterial contamination. We have previously demonstrated that cold (4°C) storage is an attractive alternative because it preserves platelet metabolic reserves, in vitro responses to agonists of activation, aggregation and physiological inhibitors, as well as adhesion to thrombogenic surfaces better than RT storage. Recently, the US Food and Drug Administration clarified that apheresis platelets stored at 4°C for up to 72 h may be used for treating active haemorrhage...
June 4, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28580508/economics-of-early-warning-scores-for-identifying-clinical-deterioration-a-systematic-review
#11
A Murphy, J Cronin, R Whelan, F J Drummond, E Savage, J Hegarty
AIM: In 2013, a National Early Warning System (EWS) was implemented in Ireland. Whilst evidence exists to support the clinical effectiveness of EWS in the acute health care setting, there is a paucity of information on their cost and cost effectiveness. The objective of this systematic literature review was to critically evaluate the economic literature on the use of EWS in adult patients in acute health care settings for the timely detection of physiological deterioration. METHODS: A systematic literature review was conducted to accumulate the economic evidence on the use of EWS in adult patients in acute health care settings...
June 3, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28577477/is-gut-feeling-by-medical-staff-better-than-validated-scores-in-estimation-of-mortality-in-a-medical-intensive-care-unit-the-prospective-feeling-on-icu-study
#12
Anne Radtke, Roman Pfister, Kathrin Kuhr, Matthias Kochanek, Guido Michels
PURPOSE: The aim of the FEELING-ON-ICU study was to compare mortality estimations of critically ill patients based on 'gut feeling' of medical staff and by Acute Physiology And Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA). MATERIALS AND METHODS: Medical staff estimated patients' mortality risks via questionnaires. APACHE II, SAPS II and SOFA were calculated retrospectively from records...
May 25, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28570377/part-i-the-effects-of-music-for-the-symptom-management-of-anxiety-pain-and-insomnia-in-critically-ill-patients-an-integrative-review-of-current-literature
#13
Naheed Meghani, Mary Fran Tracy, Niloufar Niakosari Hadidi, Ruth Lindquist
Critical care environments are known for provoking anxiety, pain, and sleeplessness. Often, these symptoms are attributed to patients' underlying physiological conditions; life-sustaining or life-prolonging treatments such as ventilators, invasive procedures, tubes, and monitoring lines; and noise and the fast-paced technological nature of the critical care environment. This, in turn, possibly increases length of stay and morbidity and challenges the recovery and healing of critically ill patients. Complementary therapies can be used as adjunctive therapies alongside pharmacological interventions and modalities...
July 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28562489/a-theory-of-eu-estrogenemia-a-unifying-concept
#14
Ralph J Turner, Irwin J Kerber
OBJECTIVE: The aim of the study was to propose a unifying theory for the role of estrogen in postmenopausal women through examples in basic science, randomized controlled trials, observational studies, and clinical practice. METHODS: Review and evaluation of the literature relating to estrogen. DISCUSSION: The role of hormone therapy and ubiquitous estrogen receptors after reproductive senescence gains insight from basic science models. Observational studies and individualized patient care in clinical practice may show outcomes that are not reproduced in randomized clinical trials...
May 29, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28561253/obstetric-disorders-in-the-icu
#15
Daniela N Vasquez, Lauren Plante, María N Basualdo, Gustavo G Plotnikow
Pregnant and postpartum patients represent a challenge to critical care physicians, as two patients in one have to be cared for and because specific obstetric disorders, not universally covered in formal critical care training, need to be managed. Pregnancy also alters physiologic norms, so that the critical care physician may either fail to recognize a value as abnormal in pregnancy or mistakenly identify as abnormal a value within the normal range for a pregnant woman. In this article, we will review the most frequent obstetric causes of admission of pregnant/postpartum patients to the intensive care unit (hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric sepsis) along with their diagnostic criteria, clinical presentation, and recommended treatment...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28557559/aggressive-antimicrobial-initiation-for-suspected-intensive-care-unit-acquired-infection-is-associated-with-decreased-long-term-survival-after-critical-illness
#16
Christopher A Guidry, Tjasa Hranjec, Puja M Shah, Zachary C Dietch, Taryn E Hassinger, Nathan R Elwood, Robert G Sawyer
BACKGROUND: The long-term significance of early and prolonged antibiotic use in critically ill patients is yet to be described. Several studies suggest that antimicrobial exposure may have as yet unrecognized long-term effects on clinically meaningful outcomes. Our group previously conducted a quasi-experimental, before and after observational cohort study of hemodynamically stable surgical patients suspected of having an intensive care unit-acquired infection. This study demonstrated that aggressive initiation of antimicrobial therapy was associated with increased 30-day deaths...
May 30, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28553262/differing-complex-microbiota-alter-disease-severity-of-the-il-10-mouse-model-of-inflammatory-bowel-disease
#17
Marcia L Hart, Aaron C Ericsson, Craig L Franklin
It is estimated that 1.4 million people in the United States suffer from Inflammatory Bowel Disease (IBD), with an overall annual health care cost of more than $1.7 billion. Although the exact etiology of this disease remains unknown, research suggests that it is a multifactorial disease associated with aberrant gastrointestinal microbial populations (dysbiosis). The C57BL/6 and C3H/HeJBir mouse strains with targeted mutations in the IL-10 gene are commonly used models to study IBD. However, anecdotally, disease phenotype can vary in severity from lab to lab...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28552079/clinical-epidemiology-and-centre-variation-in-chylothorax-rates-after-cardiac-surgery-in-children-a-report-from-the-pediatric-cardiac-critical-care-consortium
#18
Jason R Buckley, Eric M Graham, Michael Gaies, Jeffrey A Alten, David S Cooper, John M Costello, Yuliya Domnina, Darren Klugman, Sara K Pasquali, Janet E Donohue, Wenying Zhang, Mark A Scheurer
Introduction Chylothorax after paediatric cardiac surgery incurs significant morbidity; however, a detailed understanding that does not rely on single-centre or administrative data is lacking. We described the present clinical epidemiology of postoperative chylothorax and evaluated variation in rates among centres with a multicentre cohort of patients treated in cardiac ICU. METHODS: This was a retrospective cohort study using prospectively collected clinical data from the Pediatric Cardiac Critical Care Consortium registry...
May 29, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28548951/development-of-a-novel-score-for-the-prediction-of-hospital-mortality-in-patients-with-severe-sepsis-the-use-of-electronic-healthcare-records-with-lasso-regression
#19
Zhongheng Zhang, Yucai Hong
BACKGROUND AND OBJECTIVE: There are several disease severity scores being used for the prediction of mortality in critically ill patients. However, none of them was developed and validated specifically for patients with severe sepsis. The present study aimed to develop a novel prediction score for severe sepsis. RESULTS: A total of 3206 patients with severe sepsis were enrolled, including 1054 non-survivors and 2152 survivors. The LASSO score showed the best discrimination (area under curve: 0...
May 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28548479/insular-gliomas-a-surgical-reappraisal-based-on-a-systematic-review-of-the-literature
#20
Domenico Murrone, Rodolfo Maduri, Afif Afif, Domenico Chirchiglia, Isabelle Pelissou-Guyotat, Jacques Guyotat, Francesco Signorelli
INTRODUCTION: Insular gliomas are heterogeneous lesions whose management presents multiple challenges for their tendency to affect young patients in good neurological and cognitive conditions, their deep anatomic location and proximity with critical functional and vascular structures. The appropriate management of insular gliomas requires a multidisciplinary evidence-centred teamwork grounded on the best anatomic, neurophysiological and oncological knowledge. The present study provides a reappraisal of the management of insular gliomas based on a systematic review of the literature with the aim of guiding clinicians in the management of such tumors...
May 25, 2017: Journal of Neurosurgical Sciences
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