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https://www.readbyqxmd.com/read/29144250/case-not-closed-prescription-errors-12-years-after-computerized-physician-order-entry-implementation
#1
Gili Kadmon, Michal Pinchover, Avichai Weissbach, Shirley Kogan Hazan, Elhanan Nahum
OBJECTIVE: To assess the prolonged impact of computerized physician order entry (CPOE) on medication prescription errors in pediatric intensive care patients. STUDY DESIGN: This observational study was conducted at a pediatric intensive care unit in which a CPOE (Metavision, iMDsoft, Israel) with a limited clinical decision support system was implemented between 2004 and 2007. Since then, no changes were made to the systems. We analyzed 2500 electronic prescriptions (1250 prescriptions from 2015 and 1250 prescriptions from 2016)...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29143891/in-search-of-the-ideal-promotility-agent-optimal-use-of-currently-available-promotility-agents-for-nutrition-therapy-of-the-critically-ill-patient
#2
REVIEW
Sarah J Diamond, Endashaw Omer, Laszlo Kiraly
PURPOSE OF REVIEW: Enteral nutrition therapy is essential in the management of critically ill patients. Prokinetic agents have been used successfully to aid in the delivery of nutrition and improve feeding tolerance in patients in the intensive care unit (ICU). The aim of this report is to review the existing promotility agents available for use in the critically ill as well as outline the role of potential investigative drugs in order to provide a guide to the management of this difficult and important clinical dilemma...
November 16, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29143551/independent-validation-of-the-icu-requirement-score-in-a-cohort-of-acutely-poisoned-adults
#3
Regina Böll, Katrin Romanek, Sabrina Schmoll, Raphael Stich, Armin Ott, Jochen Stenzel, Stefanie Geith, Florian Eyer, Christian Rabe
OBJECTIVE: To independently validate the predictive value of the intensive care requirement score (IRS) in unselected poisoned patients. DESIGN: Retrospective chart review. PATIENTS AND METHODS: Five hundred and seventeen out of 585 admissions for acute intoxications could be analyzed. Eleven were excluded for a condition already requiring intensive care unit (ICU) support at admission (e.g., preclinical intubation). A further 57 admissions were excluded due to missing data...
November 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29143503/-lung-and-pleural-space-ultrasonography-for-pulmonologist
#4
Leslie Noirez, Laurent P Nicod
In the past twenty years ultrasound has been the subject of renewed interest in lung exploration in the broad sense. The necessity of accessing a means of rapid exploration at the bed of the patient in a critical situation has led to the development of a pleuro-pulmonary ultrasound semiology to make it a diagnostic tool of choice which exceeds the strict framework intensive care units and emergency services. With the diagnosis of thoracic tumors or the exploration of interstitial syndromes, it tends to integrate more into the daily practice of the pulmonologist...
November 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29142896/sodium-variability-is-associated-with-increased-mortality-in-severe-burn-injury
#5
Soman Sen, Nam Tran, Brian Chan, Tina L Palmieri, David G Greenhalgh, Kiho Cho
Background: Dysnatremias are associated with increased mortality in critically ill patients. Hypernatremia in burn patients is also associated with poor survival. Based on these findings, we hypothesized that high plasma sodium variability is a marker for increased mortality in severely burn-injured patients. Methods: We performed a retrospective review of adult burn patients with a burn injury of 15% total body surface area (TBSA) or greater from 2010 to 2014. All patients included in the study had at least three serum sodium levels checked during admission...
2017: Burns and trauma
https://www.readbyqxmd.com/read/29141664/prevalence-and-prognosis-of-acutely-ill-patients-with-organ-failure-at-arrival-to-hospital-protocol-for-a-systematic-review
#6
Peter Bank Pedersen, Asbjorn Hrobjartsson, Daniel Lykke Nielsen, Daniel Pilsgaard Henriksen, Mikkel Brabrand, Annmarie Touborg Lassen
BACKGROUND: Acutely ill patients are a heterogeneous group, and some of these suffer from organ failure. As the prognosis of organ failure improves with early treatment, it is important to identify these patients as early as possible. Most studies on organ failure have been performed in intensive care settings, or on selected groups of patients, where a high prevalence and mortality have been reported. Before patients arrive to the intensive care unit, or the general ward, most of them have passed through the emergency department (ED), where diagnosis and treatment has been initiated...
November 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#7
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29138955/the-impact-of-palliative-care-training-for-oncologists-and-integrative-palliative-service-in-a-public-funded-hospital-cluster-a-retrospective-cohort-study
#8
Pak-Lun Lam, Tai-Chung Lam, Cheuk-Wai Choi, Anne Wing-Mui Lee, Kwok-Keung Yuen, To-Wai Leung
PURPOSE: Oncological care of advanced cancer patients was provided by multiple departments in Hong Kong. One of these departments, the clinical oncology department (COD), introduced systematic palliative care training for its oncologists since 2002. The COD was recognized as a European Society for Medical Oncology (ESMO) Designated Centre of Integrated Oncology and Palliative Care since 2009. This retrospective cohort study aims to review the impact of integrative training and service on palliative care coverage and outcome...
November 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29138878/higher-cost-of-hospitalizations-for-non-cardiac-diagnoses-in-adults-with-congenital-heart-disease
#9
Michael D Seckeler, Ian D Thomas, Jennifer Andrews, Omar Meziab, Tabitha Moe, Elissa Heller, Scott E Klewer
Adults with congenital heart disease (CHD) are a rapidly increasing population and their impact on healthcare resources is not fully understood. The purpose of this study was to describe the costs of hospitalizations for non-cardiac disease for adults with CHD. We conducted a retrospective review of hospital discharge data from the University HealthSystem Consortium Clinical Data Base/Resource Manager from January 2011 through December 2013. Patients were ≥ 18 years old at admission with any ICD-9 code for moderate or high severity CHD; cardiac surgical admissions were excluded...
November 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#10
Lauren E Payne, David J Gagnon, Richard R Riker, David B Seder, Elizabeth K Glisic, Jane G Morris, Gilles L Fraser
BACKGROUND: Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the blood-brain barrier and exhibit concentration-dependent ϒ-aminobutyric acid (GABA) antagonism. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Data suggest that up to 15% of ICU patients treated with cefepime may experience these adverse effects. Risk factors include renal dysfunction, excessive dosing, preexisting brain injury, and elevated serum cefepime concentrations...
November 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29135521/the-effect-of-icu-out-of-hours-admission-on-mortality-a-systematic-review-and-meta-analysis
#11
Megan Galloway, Aoife Hegarty, Sarah McGill, Nishkantha Arulkumaran, Stephen J Brett, David Harrison
OBJECTIVES: Organizational factors are associated with outcome of critically ill patients and may vary by time of day and day of week. We aimed to identify the association between out-of-hours admission to critical care and mortality. DATA SOURCES: MEDLINE (via Ovid) and EMBASE (via Ovid). STUDY SELECTION: We performed a systematic search of the literature for studies on out-of-hours adult general ICU admission on patient mortality. DATA EXTRACTION: Meta-analyses were performed and Forest plots drawn using RevMan software...
November 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29135100/safety-and-efficacy-of-liver-resections-in-elderly-patients
#12
Georgios C Sotiropoulos, Ioannis D Kostakis, Nikolaos Machairas, Stylianos Kykalos, Gregory Kouraklis
PURPOSE: Elderly patients constitute a special group of surgical candidates due to the frequent coexistence of major comorbidities. We report our experience in performing liver resections in patients aged 75 years or older. METHODS: During a period of 62 months, 154 patients underwent liver resections, out of which 20 were 75 years old or older. Our prospectively maintained database was reviewed regarding patient and tumor characteristics, intraoperative and postoperative data...
September 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29133291/watcher-initiative-associated-with-decrease-in-failure-to-rescue-events-in-pediatric-population
#13
Melanie McClain Smith, Maryanne Chumpia, Lindsey Wargo, Julie Nicol, Mark Bugnitz
BACKGROUND AND OBJECTIVES: Improved situation awareness may prevent unplanned ICU transfers. Transfers with serious safety issues may be classified as unrecognized situation awareness failure events (UNSAFE) and are associated with intubation, vasopressors, or >3 fluid boluses within 1 hour before or after ICU arrival. Our aim was to decrease the proportion of unplanned ICU transfers that met UNSAFE criteria by 50% in 1 year. METHODS: We adapted a previously described huddle-based intervention...
November 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29133019/frequency-and-significance-of-qsofa-criteria-during-adult-rapid-response-team-reviews-a-prospective-cohort-study
#14
Maurice Le Guen, Yvonne Ballueer, Richard McKay, Glenn Eastwood, Rinaldo Bellomo, Daryl Jones
AIM: A new definition of sepsis released by an international task-force has introduced the concept of quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA). This study aimed to measure the proportion of patients who fulfilled qSOFA criteria during a Rapid Response Team (RRT) review and to assess their associated outcomes. METHODS: We conducted a prospective study of adult RRT reviews over a one month period between 6th June and 10th July 2016 in a large tertiary hospital in Melbourne Australia RESULTS: Over a one-month period, there were 282 RRT reviews, 258 of which were included...
November 10, 2017: Resuscitation
https://www.readbyqxmd.com/read/29132597/retrospective-review-of-pediatric-transport-where-do-our-patients-go-after-transport
#15
REVIEW
Emily Krennerich, Curtis G Sitler, Manish Shah, Fong Lam, Jeanine Graf
OBJECTIVE: This review describes disposition of transported children and identifies contributing factors affecting optimal patient placement. The study describes timing and patient placement indicators in transport patients to identify areas of improvement, re-education, and training. METHODS: A retrospective chart review for transports via our pediatric specialty transport team from January 1, 2012, to December 31, 2014, was performed. Patients were identified by the transport quality assurance performance improvement database, hospital electronic medical records, and transport medical records...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29132321/the-role-of-the-specialized-team-in-the-operation-of-continuous-renal-replacement-therapy-a-single-center-experience
#16
Harin Rhee, Gum Sook Jang, Miyeun Han, In Seong Park, Il Young Kim, Sang Heon Song, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak
BACKGROUND: The requirement of continuous renal replacement therapy (CRRT) is increasing with the growing incidence of acute kidney injury (AKI). The decision to initiate CRRT is not difficult if an adequate medical history is obtained. However, the handling and maintenance of CRRT constitute a labor-intensive intervention that requires specialized skills. For these reasons, our center organized a specialized CRRT team in March 2013. The aim of this study is to report on the role of a specialized CRRT team and to evaluate the team's outcome...
November 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29131536/non-invasive-ventilation-use-in-status-asthmaticus-16%C3%A2-years-of-experience-in-a-tertiary-intensive-care
#17
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/29131465/psychometric-analysis-of-subjective-sedation-scales-used-for-critically-ill-paediatric-patients
#18
Xiaohua Ge, Tingting Zhang, Lingling Zhou
AIMS: This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice. BACKGROUND: A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over- or undersedation. However, there has been no systematic review of these scales...
November 12, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29131450/potential-for-health-care-cost-savings-with-preoperative-gastrostomy-tube-placement-in-the-head-and-neck-cancer-population
#19
Ashley C Mays, Harrison G Bartels, Paul R Wistermayer, Matt L Rohlfing, Christopher M Gentile, Ralph D'Agostino, Joshua D Waltonen
BACKGROUND: The purpose of this study was to examine the cost differences between preoperative and postoperative placement of gastrostomy tubes (G-tubes) in patients with head and neck cancer. METHODS: We conducted a retrospective chart review of patients with aerodigestive tract cancers from 2010 to 2015. Data included inpatient and postdischarge costs, demographics, tumor characteristics, surgical treatment, length of stay (LOS), time spent in the intensive care unit (ICU), and readmissions...
November 13, 2017: Head & Neck
https://www.readbyqxmd.com/read/29130675/-severe-adverse-pregnancy-outcomes-in-placenta-previa-and-prior-cesarean-delivery
#20
Mi Zhou, Meng Chen, Li Zhang, Guo-Lin He, Lei He, Qiang Wei, Tao Li, Xing-Hui Liu
OBJECTIVE: To investigate the severe adverse pregnancy outcomes in pregnancies with placenta previa and prior cesarean delivery and its risk factors. METHODS: This retrospective casecontrol study reviewed all pregnancies with placenta previa and prior cesarean delivery delivered by repeat cesarean section in our institution between January 2005 and June 2015,and investigated the incidence of severe adverse pregnancy outcome. A composite of severe adverse pregnancy outcomes (including transfusion of 10 units or more red blood cells,maternal ICU admission,unanticipated injuries,repeat operation,hysterectomy,and maternal death) and other maternal and neonatal outcomes were described...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
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