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Physiology critical care

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https://www.readbyqxmd.com/read/27910706/intravenous-oxygen-a-novel-method-of-oxygen-delivery-in-hypoxemic-respiratory-failure
#1
Jonathan A Gehlbach, Kyle J Rehder, Michael A Gentile, David A Turner, Daniel J Grady, Ira M Cheifetz
Hypoxemic respiratory failure is a common problem in critical care. Current management strategies, including mechanical ventilation and extracorporeal membranous oxygenation, can be efficacious but these therapies put patients at risk for toxicities associated with invasive forms of support. Areas Covered: In this manuscript, we discuss intravenous oxygen (IVO2), a novel method to improve oxygen delivery that involves intravenous administration of a physiologic solution containing dissolved oxygen at hyperbaric concentrations...
December 2, 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27907961/critical-care-management-of-the-patient-with-traumatic-brain-injury
#2
G Duemani Reddy, Shankar Gopinath, Claudia Robertson
The critical care management of patients with traumatic brain injury is complex. The primary goal is to minimize the effects of secondary injury that would otherwise serve to further worsen neurologic function. This requires an understanding of the abnormal brain physiology that is found in these patients. In this article the authors discuss this physiology and describe suggested treatment strategies for these patients based on evidence-based guidelines.
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27903267/skeletal-muscle-quality-as-assessed-by-ct-derived-skeletal-muscle-density-is-associated-with-6-month-mortality-in-mechanically-ventilated-critically-ill-patients
#3
Wilhelmus G P M Looijaard, Ingeborg M Dekker, Sandra N Stapel, Armand R J Girbes, Jos W R Twisk, Heleen M Oudemans-van Straaten, Peter J M Weijs
BACKGROUND: Muscle quantity at intensive care unit (ICU) admission has been independently associated with mortality. In addition to quantity, muscle quality may be important for survival. Muscle quality is influenced by fatty infiltration or myosteatosis, which can be assessed on computed tomography (CT) scans by analysing skeletal muscle density (SMD) and the amount of intermuscular adipose tissue (IMAT). We investigated whether CT-derived low skeletal muscle quality at ICU admission is independently associated with 6-month mortality and other clinical outcomes...
December 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27902947/what-factors-affect-implementation-of-early-rehabilitation-into-intensive-care-unit-practice-a-qualitative-study-with-clinicians
#4
Selina M Parry, Louisa Remedios, Linda Denehy, Laura D Knight, Lisa Beach, Thomas C Rollinson, Sue Berney, Zudin A Puthucheary, Peter Morris, Catherine L Granger
PURPOSE: To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. MATERIALS AND METHODS: Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. RESULTS: Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork...
November 12, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27899205/development-and-validation-of-the-new-icnarc-model-for-prediction-of-acute-hospital-mortality-in-adult-critical-care
#5
Paloma Ferrando-Vivas, Andrew Jones, Kathryn M Rowan, David A Harrison
PURPOSE: To develop and validate an improved risk model to predict acute hospital mortality for admissions to adult critical care units in the UK. MATERIALS AND METHODS: 155,239 admissions to 232 adult critical care units in England, Wales and Northern Ireland between January and December 2012 were used to develop a risk model from a set of 38 candidate predictors. The model was validated using 90,017 admissions between January and September 2013. RESULTS: The final model incorporated 15 physiological predictors (modelled with continuous nonlinear models), age, dependency prior to hospital admission, chronic liver disease, metastatic disease, haematological malignancy, CPR prior to admission, location prior to admission/urgency of admission, primary reason for admission and interaction terms...
November 21, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27893697/morbidity-and-mortality-predictivity-of-nutritional-assessment-tools-in-the-postoperative-care-unit
#6
Şule Özbilgin, Volkan Hanc, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27890436/respiratory-acid-base-disorders-in-the-critical-care-unit
#7
REVIEW
Kate Hopper
The incidence of respiratory acid-base abnormalities in the critical care unit (CCU) is unknown, although respiratory alkalosis is suspected to be common in this population. Abnormal carbon dioxide tension can have many physiologic effects, and changes in Pco2 may have a significant impact on outcome. Monitoring Pco2 in CCU patients is an important aspect of critical patient assessment, and identification of respiratory acid-base abnormalities can be valuable as a diagnostic tool. Treatment of respiratory acid-base disorders is largely focused on resolution of the primary disease, although mechanical ventilation may be indicated in cases with severe respiratory acidosis...
November 24, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27888542/clinical-outcomes-of-extended-versus-intermittent-infusion-of-piperacillin-tazobactam-in-critically-ill-patients-a-prospective-clinical-trial
#8
Sheung-Yin Fan, Hoi-Ping Shum, Wing-Yee Cheng, Yat-Hei Chan, Sik-Yin McShirley Leung, Wing-Wa Yan
STUDY OBJECTIVE: To determine whether critically ill patients receiving extended-infusion (EI) piperacillin/tazobactam would have improved clinical outcomes compared with patients receiving intermittent infusions. DESIGN: Single-center, open-label, prospective study. SETTING: Twenty-two-bed intensive care unit (ICU) in a regional hospital in Hong Kong. PATIENTS: A total of 367 adults who had a diagnosis of either bacterial infection or neutropenic fever and had received treatment with piperacillin/tazobactam for at least 48 hours between December 1, 2013, and August 31, 2015...
November 26, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27886604/a-low-cost-and-palm-size-analyzer-for-rapid-and-sensitive-protein-detection-by-ac-electrokinetics-capacitive-sensing
#9
Xiaozhu Liu, Cheng Cheng, Jayne Wu, Shigetoshi Eda, Yongcai Guo
Specific detection of protein biomarkers has a wide range of applications in areas such as medical science, diagnostics, and pharmacology. Quantitative detection of protein biomarkers in biological media, such as serum, is critically important in detecting disease or physiological malfunction, or tracking disease progression. Among various detection methods, electrical detection is particularly well suited for point-of-care (POC) specific protein detection, being of low cost, light weight and small form factor...
November 11, 2016: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/27881286/renal-adaptive-changes-and-sodium-handling-in-the-fetal-to-newborn-transition
#10
REVIEW
Jeffrey L Segar
Appropriate fluid and electrolyte management is critical for optimal care of very low birth weight or sick infants. Delivery of such care requires an understanding of developmental changes in renal water and salt handling that occur with advancing gestational age as well as postnatal age. This review focuses on the principles of sodium homeostasis during fetal and postnatal life. The physiology of renal tubular transport mechanisms, as well as neurohumoral factors impacting renal tubular transport are highlighted...
November 20, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27881149/antipsychotic-prescribing-patterns-during-and-after-critical-illness-a-prospective-cohort-study
#11
Jason E Tomichek, Joanna L Stollings, Pratik P Pandharipande, Rameela Chandrasekhar, E Wesley Ely, Timothy D Girard
BACKGROUND: Antipsychotics are used to treat delirium in the intensive care unit (ICU) despite unproven efficacy. We hypothesized that atypical antipsychotic treatment in the ICU is a risk factor for antipsychotic prescription at discharge, a practice that might increase risk since long-term use is associated with increased mortality. METHODS: After excluding patients on antipsychotics prior to admission, we examined antipsychotic use in a prospective cohort of ICU patients with acute respiratory failure and/or shock...
November 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27879534/physician-provided-prehospital-critical-care-effect-on-patient-physiology-dynamics-and-on-scene-time
#12
Bjørn O Reid, Marius Rehn, Oddvar Uleberg, Andreas J Krüger
INTRODUCTION: Improved physiologic status can be seen as a surrogate measure of improved outcome and a field-friendly prognostic model such as the Mainz Emergency Evaluation Score (MEES) could quantify the effect on physiological response. We aim to examine the dynamic physiological profile as measured by this score on patients managed by physician-manned helicopter emergency medical services and how this profile was related to on-scene time expenditure and critical care interventions...
November 22, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27879296/elevated-modified-shock-index-within-24-hours-of-icu-admission-is-an-early-indicator-of-mortality-in-the-critically-ill
#13
Nathan J Smischney, Mohamed O Seisa, Katherine J Heise, Darrell R Schroeder, Timothy J Weister, Daniel A Diedrich
PURPOSE: To assess whether exposure to modified shock index (MSI) in the first 24 hours of intensive care unit (ICU) admission is associated with increased in-hospital mortality. METHODS: Adult critically ill patients were included in a case-control design with 1:2 matching. Cases (death) and controls (alive) were abstracted by a reviewer blinded to exposure status (MSI). Cases were matched to controls on 3 factors-age, end-stage renal disease, and ICU admission diagnosis...
November 21, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27873009/systematic-review-and-need-assessment-of-pediatric-trauma-outcome-benchmarking-tools-for-low-resource-settings
#14
REVIEW
Etienne St-Louis, Jade Séguin, Daniel Roizblatt, Dan Leon Deckelbaum, Robert Baird, Tarek Razek
INTRODUCTION: Trauma is a leading cause of mortality and disability in children worldwide. The World Health Organization reports that 95% of all childhood injury deaths occur in Low-Middle-Income Countries (LMIC). Injury scores have been developed to facilitate risk stratification, clinical decision making, and research. Trauma registries in LMIC depend on adapted trauma scores that do not rely on investigations that require unavailable material or human resources. We sought to review and assess the existing trauma scores used in pediatric patients...
November 21, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27872033/a-review-of-visual-representations-of-physiologic-data
#15
REVIEW
Rishikesan Kamaleswaran, Carolyn McGregor
BACKGROUND: Physiological data is derived from electrodes attached directly to patients. Modern patient monitors are capable of sampling data at frequencies in the range of several million bits every hour. Hence the potential for cognitive threat arising from information overload and diminished situational awareness becomes increasingly relevant. A systematic review was conducted to identify novel visual representations of physiologic data that address cognitive, analytic, and monitoring requirements in critical care environments...
November 21, 2016: JMIR Medical Informatics
https://www.readbyqxmd.com/read/27868444/-plant-based-diets-a-review
#16
Zoltán Szabó, Attila Erdélyi, Andrea Gubicskóné Kisbenedek, Tamás Ungár, Éva Lászlóné Polyák, Szilvia Szekeresné Szabó, Réka Erika Kovács, László Bence Raposa, Mária Figler
Plant-based diet is an old-new trend in nutrition. In this review based on a historical context, we wish to introduce this popular nutritional trend. Our aim is to present plant-based diet as a primary measure for prevention. We intend to critically analyse some past stereotypes related to plant-based diet - whose main components include fruits, vegetables, whole grains, legumes, nuts and seeds - according to the literature (e.g. protein, vitamin B12, folic acid, and iron intake) by doing so we wish to create an adequate conceptual basis for its interpretation...
November 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27866108/clinical-characteristics-of-critically-ill-patients-with-suspected-influenza-during-the-2009-10-and-2013-14-outbreaks
#17
Miguel J Franquiz, Paul G Saleeb, Carl B Shanholtz, Jeffrey P Gonzales
PURPOSE: Pandemic influenza A pdm09 (pH1N1) virus was the predominant isolate identified during the 2009-10 and 2013-14 influenza outbreaks, causing significant morbidity and mortality. We describe clinical characteristics of critically ill patients during 2 pH1N1 outbreaks. METHODS: Single-center, retrospective cohort study of patients admitted to the intensive care unit receiving oseltamivir for suspected influenza during 2 outbreak periods. Demographics and comorbidities were collected from the medical record...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27865497/invited-review-abomasal-emptying-in-calves-and-its-potential-influence-on-gastrointestinal-disease
#18
Johann Burgstaller, Thomas Wittek, Geof W Smith
Creating the ideal nutrition program for calves is a demanding task that has undergone tremendous change in recent years. Products and technologies including novel milk replacers and automated calf feeding systems have been developed to facilitate the ability of dairy producers to feed for higher growth rates before weaning. The creation of new feeding programs and milk replacers has to be looked at carefully, not only from a nutrition point of view but also from the perspective of a potential effect on physiologic digestion and calf health...
November 16, 2016: Journal of Dairy Science
https://www.readbyqxmd.com/read/27862249/a-critical-caring-theory-of-protection-for-migrants-and-seasonal-farmworkers
#19
Jennifer E Shearer
Pesticide exposures represent inequities among a vulnerable population of migrant and seasonal farmworkers. A social justice theory synthesized from an environmental health research framework, a middle range theory of critical caring, and literature on pesticide exposure is presented as a situation-specific public health practice theory. Concepts from the physiological, epistemological, vulnerability, and health protection domains are related to concepts of critical caring revealing protective strategies for vulnerable populations exposed to pesticides...
November 14, 2016: Public Health Nursing
https://www.readbyqxmd.com/read/27857912/biomarkers-of-physiological-disturbances-for-predicting-mortality-in-decompressive-craniectomy
#20
Young Ha Jeong, So Hyun Kim, Eun Hee Choi, Kum Whang
OBJECTIVE: Of many critical care regimens, the management of physiological disturbances in serum is particularly drawing an attention in conjunction with patient outcome. The aim of this study was to assess the association of serum biochemical markers with mortality in head trauma patients with decompressive craniotomy. METHODS: Ninety six patients with acute subdural hematoma underwent decompressive craniectomy between January 2014 and December 2015. The clinical data and laboratory variables of these patients were recorded and analyzed retrospectively...
October 2016: Korean Journal of Neurotrauma
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