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https://www.readbyqxmd.com/read/29443814/danger-signals-in-the-icu
#1
Edward J Schenck, Kevin C Ma, Santosh B Murthy, Augustine M K Choi
OBJECTIVES: Sterile and infectious critical illnesses often result in vasoplegic shock and a robust systemic inflammatory response that are similar in presentation. The innate immune system is at the center of the response to both infectious and traumatic insults. Damage-associated molecular patterns are small molecules that are released from stressed or dying cells. Damage-associated molecular patterns activate pattern recognition receptors and coordinate the leading edge of the innate immune response...
February 13, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29434254/implementation-of-a-pilot-program-of-reach-out-and-read%C3%A2-in-the-neonatal-intensive-care-unit-a-quality-improvement-initiative
#2
Bernadette M Levesque, Anh Tran, Emily Levesque, Hira Shrestha, Ramona Silva, Marsha Adams, Marilyn Valles, Judith Burke, Alison Corning-Clarke, Carole Ferguson
OBJECTIVE: Language exposure is important for neurodevelopment, but is sparse in the neonatal intensive care unit (NICU). STUDY DESIGN: We introduced Reach Out and Read (ROR) in the NICU as a quality improvement initiative to increase language exposure. Measures included availability of books, accessibility of parents, and enrollment of infants, percent infants read to by their parents, and data from parental surveys. RESULT: 98 infants were included (40 before, 58 after)...
February 12, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29431872/interventions-to-prevent-hypothermia-at-birth-in-preterm-and-or-low-birth-weight-infants
#3
REVIEW
Emma M McCall, Fiona Alderdice, Henry L Halliday, Sunita Vohra, Linda Johnston
BACKGROUND: Newborn admission temperature is a strong predictor of outcomes across all gestations. Hypothermia immediately after birth remains a worldwide issue and, if prolonged, is associated with harm. Keeping preterm infants warm is difficult even when recommended routine thermal care guidelines are followed in the delivery room. OBJECTIVES: To assess the efficacy and safety of interventions designed for prevention of hypothermia in preterm and/or low birth weight infants applied within 10 minutes after birth in the delivery room, compared with routine thermal care or any other single/combination of intervention(s) also designed for prevention of hypothermia in preterm and/or low birth weight infants applied within 10 minutes after birth in the delivery room...
February 12, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29430883/models-to-predict-length-of-stay-in-the-intensive-care-unit-after-coronary-artery-bypass-grafting-a-systematic-review
#4
Alireza Atashi, Ilona W Verburg, Hesam Karim, Mirmohammad Miri, Ameen Abu-Hanna, Evert de Jonge, Nicolette F de Keizer, Saeid Eslami
INTRODUCTION: ICU Length of stay (LoS) prediction models are used to compare different institutions and surgeons on their performance, and is useful as an efficiency indicator for quality control. There is little consensus about which prediction methods are most suitable to predict (ICU) length of stay. The aim of this study is to systematically review models for predicting ICU LoS after coronary artery bypass grafting and to assess the reporting and methodological quality of these models to apply them for benchmarking...
February 8, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29426704/handover-in-intensive-care
#5
G Sirgo Rodríguez, M Chico Fernández, F Gordo Vidal, M García Arias, M S Holanda Peña, B Azcarate Ayerdi, E Bisbal Andrés, A Ferrándiz Sellés, P J Lorente García, M García García, P Merino de Cos, J M Allegue Gallego, A García de Lorenzo Y Mateos, J Trenado Álvarez, P Rebollo Gómez, M C Martín Delgado
Handover is a frequent and complex task that also implies the transfer of the responsibility of the care. The deficiencies in this process are associated with important gaps in clinical safety and also in patient and professional dissatisfaction, as well as increasing health cost. Efforts to standardize this process have increased in recent years, appearing numerous mnemonic tools. Despite this, local are heterogeneous and the level of training in this area is low. The purpose of this review is to highlight the importance of IT while providing a methodological structure that favors effective IT in ICU, reducing the risk associated with this process...
February 6, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29426688/variation-in-adolescent-idiopathic-scoliosis-surgery-implications-for-improving-healthcare-value
#6
Jennifer K Workman, Jacob Wilkes, Angela P Presson, Yizhe Xu, John A Heflin, John T Smith
OBJECTIVES: To investigate the variation in care and cost of spinal fusion for adolescent idiopathic scoliosis (AIS), and to identify opportunities for improving healthcare value. STUDY DESIGN: Retrospective cohort study from the Pediatric Health Information Systems database, including children 11-18 years of age with AIS who underwent spinal fusion surgery between 2004 and 2015. Multivariable regression was used to evaluate the relationships between hospital cost, patient outcomes, and resource use...
February 6, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29417181/analysis-of-quality-of-life-after-major-trauma-a-spanish-follow-up-cohort-study
#7
Heura Llaquet Bayo, Sandra Montmany, Pere Rebasa, Miriam Secanella, Marta Alberich, Salvador Navarro
PURPOSE: Study objectives are to determine whether quality of life is recovered completely after major injury and to identify determinants associated with a worse quality of life. METHODS: Prospective 12-month follow-up of injured patients admitted to the intensive care unit in a Spanish level 1 trauma centre. The main outcome (quality of life) was measured using the EQ-5D-5L. The relationships between sociodemographic factors, injury severity and location, and quality of life scores were evaluated...
February 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29415760/mobile-critical-care-recovery-program-m-ccrp-for-acute-respiratory-failure-survivors-study-protocol-for-a-randomized-controlled-trial
#8
Sikandar Khan, Ashok Biju, Sophia Wang, Sujuan Gao, Omar Irfan, Amanda Harrawood, Stephanie Martinez, Emily Brewer, Anthony Perkins, Frederick W Unverzagt, Sue Lasiter, Ben Zarzaur, Omar Rahman, Malaz Boustani, Babar Khan
BACKGROUND: Patients admitted to intensive care units (ICU) with acute respiratory failure (ARF) face chronic complications that can impede return to normal daily function. A mobile, collaborative critical care model may enhance the recovery of ARF survivors. METHODS: The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. We will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation in a 1:1 ratio to one of two arms (310 patients per arm) - m-CCRP intervention versus attention control...
February 7, 2018: Trials
https://www.readbyqxmd.com/read/29411632/video-assisted-thoracoscopic-thymectomy-for-thymoma-a-single-center-experience
#9
Giang Truong Nguyen, Trung Ngoc Nguyen, Nam Van Nguyen, Kien Trung Nguyen, Anh Viet Le
Background Thymoma is a primary tumor derived from the epithelial cells of the thymus, which is commonly seen in the mediastinum. Surgical thymectomy is the radical treatment for thymoma. The recent introduction of video-assisted thoracoscopic surgery has improved the quality of thymectomy surgery. The clinical characteristics of thymoma and the outcomes of video-assisted thoracoscopic thymectomy in Vietnamese patients are still lacking. The objectives of this study were to investigate the clinical and laboratory characteristics of thymoma and to evaluate the early results of video-assisted thoracoscopic thymectomy for thymoma in Vietnamese patients...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29409085/-point-of-care-sonography-in-emergency-and-intensive-care-medicine
#10
Caroline Busche, Hans-Jörg Busch, Guido Michels
The use of Point-of-care ultrasonography (POC Ultrasonography) is getting more and more important in the bedside care of patients, especially in emergency- and intensive care units. In addition to the focused sonography of the heart, lungs and abdomen, the POC Ultrasonography recently includes also cases in prehospital care. Increasingly special applications in intensive care, e.g. the assessment of weaning from mechanical ventilation or evaluation of the hemodynamics of a patient by means of sonographic control, gain meaning...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29407008/cardiac-intensive-care-unit-management-of-patients-after-cardiac-arrest-now-the-real-work-begins
#11
REVIEW
Varinder K Randhawa, Brian E Grunau, Derek B Debicki, Jian Zhou, Ahmed F Hegazy, Terry McPherson, A Dave Nagpal
Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)-in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post-cardiac arrest syndrome also require diligent observation and management, including post-cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29406472/novel-approach-to-emergency-departments-pediatric-readiness-across-a-health-system
#12
Isabel A Barata, Joriane M Stadnyck, Meredith Akerman, Kate OʼNeill, Jill Castaneda, Anupama Subramony, Paula Fessler, Charles Schleien, John DʼAngelo
STUDY OBJECTIVE: A gap analysis of emergency departments' (EDs') pediatric readiness across a health system was performed after the appointment of a service line health system pediatric emergency medicine (PEM) quality director. METHODS: A 55-question survey was completed by each eligible ED to generate a weighted pediatric readiness score (WPRS). The survey included questions regarding volume, ED configuration, presence of a pediatric emergency care coordinator (PECC), quality initiatives, policies and procedures, and equipment...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29404987/enhanced-recovery-via-peripheral-nerve-block-for-open-hepatectomy
#13
Lucas W Thornblade, Yongwoo D Seo, Tracy Kwan, Jane H Cardoso, Eric Pan, Gregory Dembo, Raymond S W Yeung, James O Park
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now commonplace in many fields of surgery, but only limited data exists for their use in hepatobiliary surgery. We implemented standardized ERAS protocols for all open hepatectomies and replaced thoracic epidurals with a transversus abdominis plane (TAP) block. METHODS: We performed a retrospective cohort study of all patients undergoing open hepatectomy during the 14 months before and 19 months after implementation of an ERAS protocol at our institution (January 2014-September 2016)...
February 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29404599/association-of-rooming-in-with-outcomes-for-neonatal-abstinence-syndrome-a-systematic-review-and-meta-analysis
#14
Kathryn Dee L MacMillan, Cassandra P Rendon, Kanak Verma, Natalie Riblet, David B Washer, Alison Volpe Holmes
Importance: Rising incidence of neonatal abstinence syndrome (NAS) is straining perinatal care systems. Newborns with NAS traditionally receive care in neonatal intensive care units (NICUs), but rooming-in with mother and family has been proposed to reduce the use of pharmacotherapy, length of stay (LOS), and cost. Objective: To systematically review and meta-analyze if rooming-in is associated with improved outcomes for newborns with NAS. Data Sources: MEDLINE, CINAHL, The Cochrane Library, and clinicaltrials...
February 5, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29404578/quality-of-care-for-veterans-with-transient-ischemic-attack-and-minor-stroke
#15
Dawn M Bravata, Laura J Myers, Greg Arling, Edward J Miech, Teresa Damush, Jason J Sico, Michael S Phipps, Alan J Zillich, Zhangsheng Yu, Mathew Reeves, Linda S Williams, Jason Johanning, Seemant Chaturvedi, Fitsum Baye, Susan Ofner, Curt Austin, Jared Ferguson, Glenn D Graham, Rachel Rhude, Chad S Kessler, Donald S Higgins, Eric Cheng
Importance: The timely delivery of guideline-concordant care may reduce the risk of recurrent vascular events for patients with transient ischemic attack (TIA) and minor stroke. Although many health care organizations measure stroke care quality, few evaluate performance for patients with TIA or minor stroke, and most include only a limited subset of guideline-recommended processes. Objective: To assess the quality of guideline-recommended TIA and minor stroke care across the Veterans Health Administration (VHA) system nationwide...
February 5, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29396929/is-less-noise-light-and-parental-caregiver-stress-in-the-neonatal-intensive-care-unit-better-for-neonates
#16
Rohini Venkataraman, Majeeda Kamaluddeen, Harish Amin, Abhay Lodha
In utero sensory stimuli and interaction with the environment strongly influence early phases of fetal and infant development. Extremely premature infants are subjected to noxious procedures and routine monitoring, in addition to exposure to excessive light and noise, which disturb the natural sleep cycle and induce stress. Non-invasive ventilation, measures to prevent sepsis, and human milk feeding improve short-term and long-term neurodevelopmental outcomes in premature infants. To preserve brain function, and to improve quality of life and long-term neurodevelopmental outcomes, the focus now is on the neonatal intensive care unit (NICU) environment and its impact on the infant during hospital stay...
January 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29396165/sustainability-of-a-nurse-driven-early-progressive-mobility-protocol-and-patient-clinical-and-psychological-health-outcomes-and-in-a-neurological-intensive-care-unit
#17
Kate E Klein, James F Bena, Malissa Mulkey, Nancy M Albert
OBJECTIVES: To determine sustainable impact of an early progressive mobility protocol on mobility level and clinical outcomes. DESIGN/METHODS: Prospective, longitudinal, comparative study using three time points (pre-, immediate post-intervention and 12-month post-intervention sustainability). Analyses included comparative statistics and multivariable modelling. Data were collected by clinical nurses, from administrative databases. Psychological health data were collected using a valid, reliable tool...
January 31, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29394221/functional-recovery-in-critically-ill-children-the-weecover-multicenter-study
#18
Karen Choong, Douglas Fraser, Samah Al-Harbi, Asm Borham, Jill Cameron, Saoirse Cameron, Ji Cheng, Heather Clark, Tim Doherty, Nora Fayed, Jan-Willem Gorter, Margaret Herridge, Mary Khetani, Kusum Menon, Jamie Seabrook, Racquel Simpson, Lehana Thabane
OBJECTIVES: To evaluate functional outcomes and evaluate predictors of an unfavorable functional outcome in children following a critical illness. DESIGN: Prospective observational longitudinal cohort study. SETTING: Two tertiary care, Canadian PICUs: McMaster Children's Hospital and London Health Sciences. PATIENTS: Children 12 months to 17 years old, admitted to PICU for at least 48 hours with one or more organ dysfunction, were eligible...
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29393277/variation-in-the-phototherapy-practices-and-irradiance-of-devices-in-a-major-metropolitan-area
#19
Amy R Borden, Katie M Satrom, Paul Wratkowski, Thomas N George, Constance A Adkisson, Hendrik J Vreman, Austin P Johnson, Kent J Nichols, Tina M Slusher
BACKGROUND: Phototherapy (PT) is widely used to prevent and treat severe hyperbilirubinemia and its associated risks for both acute and chronic bilirubin encephalopathy. Intensive PT, recommended for inpatient treatment of hyperbilirubinemia in term and near-term infants, is defined as having a spectral irradiance of ≥30 μW/cm2/nm. OBJECTIVES: We aimed to assess local PT practices by measuring the irradiance of PT devices in local neonatal intensive care units and newborn nurseries...
January 31, 2018: Neonatology
https://www.readbyqxmd.com/read/29390515/application-of-failure-mode-and-effect-analysis-in-managing-catheter-related-blood-stream-infection-in-intensive-care-unit
#20
Xixi Li, Mei He, Haiyan Wang
In this study, failure mode and effect analysis (FMEA), a proactive tool, was applied to reduce errors associated with the process which begins with assessment of patient and ends with treatment of complications. The aim of this study is to assess whether FMEA implementation will significantly reduce the incidence of catheter-related bloodstream infections (CRBSIs) in intensive care unit.The FMEA team was constructed. A team of 15 medical staff from different departments were recruited and trained. Their main responsibility was to analyze and score all possible processes of central venous catheterization failures...
December 2017: Medicine (Baltimore)
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