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Critical care review

Thomas W L Scheeren, Jannis N Wicke, Jean-Louis Teboul
PURPOSE OF REVIEW: The current review attempts to demonstrate the value of several forms of carbon dioxide (CO2) gaps in resuscitation of the critically ill patient as monitor for the adequacy of the circulation, as target for fluid resuscitation and also as predictor for outcome. RECENT FINDINGS: Fluid resuscitation is one of the key treatments in many intensive care patients. It remains a challenge in daily practice as both a shortage and an overload in intravascular volume are potentially harmful...
March 20, 2018: Current Opinion in Critical Care
R Dumont, F Puleo, J Collignon, N Meurisse, M Chavez, L Seidel, P Gast, M Polus, C Loly, Ph Delvenne, P Meunier, R Hustinx, A Deroover, O Detry, E Louis, Ph Martinive, D Van Daele
BACKGROUND AND STUDY AIMS: The current standard of care for resectable pancreatic ductal adenocarcinoma (PDAC) is surgery-first followed by adjuvant chemotherapy. We review our single center experience in a PDAC cohort managed by the surgery-first strategy. We then compare our data to those of Belgian and international literature. PATIENTS METHODS: We reviewed a series of 83 consecutive resectable patients with PDAC, treated by the surgery-first approach in a Belgian Academic Hospital between 2007 and 2013...
October 2017: Acta Gastro-enterologica Belgica
Jennifer L Walton, Diane K Dunn, Nhi Y Haines, Ilana Heisler, Michael T Bigham, Teresa A Volsko
BACKGROUND: The American Academy of Pediatrics Section on Transport recommends the use of portable ventilators during the transport of patients with advanced airways. We sought to identify knowledge gaps and evaluate the effectiveness of a transport ventilator competency boot camp. METHODS: Electronic health records of children requiring ventilatory support during air and ground interfacility transport from January 1 through December 31, 2015, were reviewed to determine when manual ventilation was used in lieu of a portable ventilator, and simulations were constructed from commonly occurring scenarios...
March 20, 2018: Respiratory Care
Dawn Perez, Kath Peters, Lesley Wilkes, Gillian Murphy
BACKGROUND: Physical restraints (PRs) are commonly used in intensive care units (ICUs) worldwide for the prevention of treatment interference. While PRs are fundamentally used to maintain patient safety, they can negatively impact the experiences of patients and their families and cause moral and ethical dilemmas for ICU nurses. OBJECTIVES: The aim of this integrative review was to explore the current literature on the use of PR in intensive care. METHODS: This article used an integrative review framework to explore the current literature available on the experiences of PR in ICU...
March 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Anna Hall, Laurence W Busse, Marlies Ostermann
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2018. Other selected articles can be found online at . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from .
March 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
Salil Sidharthan Karipott, Bradley D Nelson, Robert E Guldberg, Keat Ghee Ong
Implantable wireless sensors have been used for real-time monitoring of chemicals and physical conditions of bones, tendons and muscles to diagnose and study orthopedic diseases and injuries. Due to the importance of these sensors in orthopedic care, a critical review, which not only analyzes the underlying technologies but also their clinical implementations and challenges, will provide a landscape view on their current state and their future clinical role. Areas covered: By conducting an extensive literature search and following the leaders of orthopedic implantable wireless sensors, this review covers the battery-powered and battery-free wireless implantable sensor technologies, and describes their implementation for hips, knees, spine, and shoulder stress/strain monitoring...
March 21, 2018: Expert Review of Medical Devices
Daniel K Ting, Eddy S Lang
Clinical question Should I use apneic oxygenation when intubating patients in the emergency department to increase peri-intubation oxygen saturation and first-pass success? Article chosen Oliveira JE, Silva L, Cabrera D, Barrionuevo P, et al. Effectiveness of apneic oxygenation during intubation: a systematic review and meta-analysis. Ann Emerg Med 2017;70(4):483-94. OBJECTIVE: The purpose of this study was to synthesize and appraise the apneic oxygenation literature for its effect on peri-intubation outcomes...
March 20, 2018: CJEM
Nikos Ulrich, Petra Gastmeier, Ralf-Peter Vonberg
Background: Identifying the source of an outbreak is the most crucial aspect of any outbreak investigation. In this review, we address the frequently discussed question of whether (rectal) screening of health care workers (HCWs) should be carried out when dealing with outbreaks caused by gram negative bacteria (GNB).A systematic search of the medical literature was performed, including the Worldwide Outbreak Database and PubMed. Outbreaks got included if a HCW was the source of the outbreak and the causative pathogen was an Escherichia coli , Klebsiella spp ...
2018: Antimicrobial Resistance and Infection Control
Tiffany A Moore Simas, Michael P Flynn, Aimee R Kroll-Desrosiers, Stephanie M Carvalho, Leonard L Levin, Kathleen Biebel, Nancy Byatt
This systematic review searched 4 databases (PubMed/MEDLINE, Scopus, CINAHL, and PsychINFO) and identified 21 articles eligible to evaluate the extent to which interventions that integrate depression care into outpatient obstetric practice are feasible, effective, acceptable, and sustainable. Despite limitations among the available studies including marked heterogeneity, there is evidence supporting feasibility, effectiveness, and acceptability. In general, this is an emerging field with promise that requires additional research...
March 16, 2018: Clinical Obstetrics and Gynecology
Ron J Smith
BACKGROUND: Siege, a process of political domination aimed at isolating an entire population, is a unique threat to health-care provision. The aim of this study was to qualitatively examine the effects of the Israeli siege on the practices and systems that underlie health in the Gaza Strip. METHODS: Data were from participant observation between 2009 and 2017, including 20 interviews with doctors and health administrators in non-governmental organisations (NGO), government, and UN sectors...
February 21, 2018: Lancet
Victoria E Jackson, Helen Hurst, Sandip Mitra
INTRODUCTION: Arteriovenous fistulae remain the gold standard of vascular access in haemodialysis. There is currently no consensus on standardised methods of monitoring arteriovenous fistulae. Assessment techniques and practice remain widely variable. The purpose of this study is to determine whether existing evidence supports physical assessment as an effective tool and a good predictor of arteriovenous fistulae dysfunction to allow for timely intervention and improve outcomes. METHODS: A literature search was performed using CINAHL, PubMed, Medline and BNI databases and relevant search terms...
March 1, 2018: Journal of Vascular Access
Joshua T Eggold, Erinn B Rankin
The regulation of erythropoiesis in the bone marrow microenvironment is a carefully orchestrated process that is dependent upon both systemic and local cues. Systemic erythropoietin (EPO) production by renal interstitial cells plays a critical role in maintaining erythropoietic homeostasis. In addition, there is increasing clinical and preclinical data linking changes in EPO and erythropoiesis to altered skeletal homeostasis, suggesting a functional relationship between the regulation of erythropoiesis and bone homeostasis...
March 15, 2018: Bone
D Díaz-Díaz, M Villanova Martínez, E Palencia Herrejón
OBJECTIVE: To analyze the factors influencing in-hospital mortality among cancer patients admitted to an Intensive Care Unit (ICU). DESIGN: A retrospective observational study was carried out. SETTING: The ICU of a community hospital. PATIENTS: Adults diagnosed with solid or hematological malignancies admitted to the ICU, excluding those admitted after scheduled surgery and those with an ICU stay of under 24h. INTERVENTIONS: Review of clinical data...
March 15, 2018: Medicina Intensiva
Sophia Merisier, Caroline Larue, Louise Boyer
BACKGROUND: Problem-based learning is an educational method promoting clinical reasoning that has been implemented in many fields of health education. Questioning is a learning strategy often employed in problem-based learning sessions. AIM: To explore what is known about the influence of questioning on the promotion of clinical reasoning of students in health care education, specifically in the field of nursing and using the educational method of problem-based learning...
March 10, 2018: Nurse Education Today
Carolien J Aantjes, Andrew Gilmoor, Elena V Syurina, Tamaryn L Crankshaw
OBJECTIVE: To conduct a systematic review of the status of post-abortion care (PAC) provision in Eastern and Southern Africa with particular reference to reach, quality and costs of these services. STUDY DESIGN: We searched Pubmed, EMBASE, Science Direct, POPLINE and Web of Science for articles published between 2000 and October 2017 presenting primary or secondary data from one or more countries in the region. RESULTS: Seventy articles representing data from fourteen countries were abstracted and included in the review...
March 14, 2018: Contraception
Carol L Wagner, John E Baatz, Danforth Newton, Bruce W Hollis
In this review, we will discuss the changes that occur in the mammary gland from pregnancy to lactation and the issues surrounding the analysis of circulating and milk hormones during the stages of lactogenesis. There is a cascade of events that must occur to achieve milk synthesis, milk ejection, and successful transfer to the breastfeeding infant. The adequacy and success of this process is no small measure and the assessment of milk production, the hormones involved in this process and the ability to properly diagnose conditions and causes of low milk supply are critical for the health and well-being of the mother-infant breastfeeding dyad...
January 2018: Best Practice & Research. Clinical Endocrinology & Metabolism
Tsz Yeung Kam, Melpomeni Kountouri, Arnaud Roth, Frossard Jean-Loui, Olivier Huber, Stefan Mönig, Thomas Zilli
Radical esophagectomy with extended lymph node dissection is considered the standard of care in treatment of squamous cell carcinoma of esophagus with deep mucosal invasion (pT1a m3) or submucosal involvement (pT1b). However, despite the increasing use of minimally invasive approaches, it remains a major surgery associated with significant morbidities and even mortality risk. Endoscopic resection (ER) results in excellent local control in early superficial mucosal (pT1a) disease yet there is substantial risk of lymph node metastases in T1b disease...
April 2018: Critical Reviews in Oncology/hematology
Kurt F Heiss, Mehul V Raval
For over 20 years enhanced recovery protocols (ERPs) have been used to decrease the physiologic stress and inflammation of surgery using evidence-based principles. ERPs include optimizing patient preparation, creating less trauma using minimally invasive anesthetic and surgical techniques, and regular audit of outcomes. A critical aspect of ERPs is patient engagement in all phases of care, which facilitates effective team function and focused oversight of patient flow through the system. Counseling extends beyond traditional review of surgical risks and benefits, by creating clear daily patient goals, establishing pain management plans, optimizing nutrition, and defining criteria for discharge...
April 2018: Seminars in Pediatric Surgery
Kofi Boamah Mensah, Frasia Oosthuizen, Adwoa Bemah Bonsu
BACKGROUND: The WHO recognises that community pharmacists are the most accessible healthcare professionals to the general public. Most patients regularly visit community pharmacies for health information and also seek advice from pharmacists with respect to signs and symptoms of cancer. As readily accessible health care professionals, community pharmacists are also in the best position to include cancer-screening initiatives into their practice. Pharmacists are therefore in a good position to raise awareness when they counsel people who buy over-the-counter medication for the control of possible cancer-related symptoms...
March 16, 2018: BMC Cancer
Ashley Gionfriddo, Mika L Nonoyama, Peter C Laussen, Peter N Cox, Megan Clarke, Alejandro A Floh
OBJECTIVES: To promote standardization, the Centers for Disease Control and Prevention introduced a new ventilator-associated pneumonia classification, which was modified for pediatrics (pediatric ventilator-associated pneumonia according to proposed criteria [PVAP]). We evaluated the frequency of PVAP in a cohort of children diagnosed with ventilator-associated pneumonia according to traditional criteria and compared their strength of association with clinically relevant outcomes. DESIGN: Retrospective cohort study...
March 15, 2018: Pediatric Critical Care Medicine
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