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https://www.readbyqxmd.com/read/29791247/a-randomized-trial-of-a-family-support-intervention-in-intensive-care-units
#1
Douglas B White, Derek C Angus, Anne-Marie Shields, Praewpannarai Buddadhumaruk, Caroline Pidro, Cynthia Paner, Elizabeth Chaitin, Chung-Chou H Chang, Francis Pike, Lisa Weissfeld, Jeremy M Kahn, Joseph M Darby, Amy Kowinsky, Susan Martin, Robert M Arnold
Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients' preferences. Methods We conducted a stepped-wedge, cluster-randomized trial involving patients with a high risk of death and their surrogates in five intensive care units (ICUs) to compare a multicomponent family-support intervention delivered by the interprofessional ICU team with usual care...
May 23, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29782357/reversible-microvascular-hyporeactivity-to-acetylcholine-during-diabetic-ketoacidosis
#2
Jérémie Joffre, Simon Bourcier, Geoffroy Hariri, Arnaud-Felix Miailhe, Naike Bigé, Guillaume Dumas, Vincent Dubée, Pierre-Yves Boelle, Idriss Abdallah, Jean-Luc Baudel, Bertrand Guidet, Eric Maury, Hafid Ait-Oufella
OBJECTIVES: Metabolic acidosis is commonly observed in critically ill patients. Experimental studies suggested that acidosis by itself could impair vascular function, but this has been poorly investigated in human. DESIGN: Prospective observational study. SETTING: Medical ICU in a tertiary teaching hospital. PATIENTS: To assess the relationship between metabolic acidosis severity and microvascular reactivity, we included adult diabetic patients admitted in ICU for ketoacidosis...
May 18, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29752016/perioperative-research-into-memory-prime-cognitive-impairment-following-a-severe-burn-injury-and-critical-care-admission-part-1
#3
Edward J R Watson, Klará Nenadlová, Olivia H Clancy, Mena Farag, Naz A Nordin, Agnes Nilsen, Ashley R T Mehmet, Ahmed Al-Hindawi, Sundhiya Mandalia, Lisa M Williams, Trudi L Edginton, Marcela P Vizcaychipi
INTRODUCTION: An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns. METHODS: A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks...
May 8, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29744108/self-reported-fatigue-following-intensive-care-of-chronically-critically-ill-patients-a-prospective-cohort-study
#4
Gloria-Beatrice Wintermann, Jenny Rosendahl, Kerstin Weidner, Bernhard Strauß, Andreas Hinz, Katja Petrowski
Background: Protracted treatment on intensive care unit (ICU) sets the patients at increased risk for the development of chronic critical illness (CCI). Muscular and cardio-respiratory deconditioning are common long-term sequelae, going along with a state of chronic fatigue. At present, findings regarding the frequency, long-term course, and associated factors of self-reported fatigue following ICU treatment of CCI patients are lacking. Methods: CCI patients with the diagnosis of critical illness polyneuropathy/myopathy (CIP/CIM) were assessed at three time points...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29740704/association-of-intensive-care-unit-delirium-with-sleep-disturbance-and-functional-disability-after-critical-illness-an-observational-cohort-study
#5
Marcus T Altman, Melissa P Knauert, Terrence E Murphy, Amy M Ahasic, Zeeshan Chauhan, Margaret A Pisani
BACKGROUND: In medical intensive care unit (MICU) patients, the predictors of post-discharge sleep disturbance and functional disability are poorly understood. ICU delirium is a risk factor with a plausible link to sleep disturbance and disability. This study evaluated the prevalence of self-reported post-ICU sleep disturbance and increased functional disability, and their association with MICU delirium and other ICU factors. METHODS: This was an observational cohort study of MICU patients enrolled in a biorepository and assessed upon MICU admission by demographics, comorbidities, and baseline characteristics...
May 8, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29705433/outcomes-of-deviation-from-treatment-guidelines-in-status-epilepticus-a-systematic-review
#6
REVIEW
Preena Uppal, Michael Cardamone, John A Lawson
OBJECTIVE: Due to a gap between published clinical guidelines on status epilepticus SE and clinician management of SE, a systematic review was performed to investigate treatment adherence to SE guidelines and its impact on patient outcomes. METHODS: Medline and Embase searches were conducted for studies appraising adherence to SE guidelines (from 1970 and 1st April 2018). The quality of eligible studies was assessed by QUADAS- 2 criteria. Comparison was made between patients where guidelines were followed and not followed...
April 16, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29642743/initiative-for-burnout-of-icu-caregivers-feasibility-and-preliminary-results-of-a-psychological-support
#7
Bara Ricou, Fabienne Gigon, Edith Durand-Steiner, Maud Liesenberg, Christine Chemin-Renais, Paolo Merlani, Sylvette Delaloye
BACKGROUND: Intensive care unit (ICU) caregivers are at high risk of burnout and the shortage of this highly specialized personal is a problem. The feasibility and impact of a psychological intervention were never assessed in this special context. METHODS: A randomized controlled single-blind study in an ICU. The first intervention consisted in weekly problem-based sessions led by psychologists with small groups of caregivers using a systemic approach over 3 months...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29606480/recovery-programme-for-icu-survivors-has-no-effect-on-relatives-quality-of-life-secondary-analysis-of-the-rapit-study
#8
Søs Bohart, Ingrid Egerod, Morten H Bestle, Dorthe Overgaard, Doris F Christensen, Janet F Jensen
BACKGROUND: Relatives of intensive care patients are at risk of developing symptoms of anxiety, depression and posttraumatic stress resulting in reduced health-related quality of life. Recovery programmes for patients have been implemented, but their effect on relatives is uncertain. AIM: To determine whether relatives benefit from a recovery programme intended for intensive care survivors. RESEARCH DESIGN: A randomised controlled trial of 181 adult relatives: intervention group (n = 87), control group (n = 94)...
March 29, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29580964/obstetric-patients-health-related-quality-of-life-before-and-after-intensive-care
#9
Seppänen Pia, Sund Reijo, Ala-Kokko Tero, Roos Mervi, Uotila Jukka, Helminen Mika, Suominen Tarja
BACKGROUND: Intensive care admissions during pregnancy, childbirth, and postpartum period are relatively well investigated. However, very little is known about these obstetric patients' health-related quality of life (HRQoL) before and after critical care. OBJECTIVE: The objective of this study was to assess obstetric patients' HRQoL before intensive care admission (baseline) and at 6 months after discharge (follow-up) DESIGN: This was a retrospective database study...
March 23, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29553799/grief-symptoms-in-relatives-who-experienced-organ-donation-request-in-the-icu
#10
Nancy Kentish-Barnes, Sylvie Chevret, Gaëlle Cheisson, Liliane Joseph, Laurent Martin-Lefèvre, Anne Gaelle Si Larbi, Gérald Viquesnel, Sophie Marqué, Stéphane Donati, Julien Charpentier, Nicolas Pichon, Benjamin Zuber, Olivier Lesieur, Martial Ouendo, Anne Renault, Pascale Le Maguet, Stanislas Kandelman, Marie Thuong, Bernard Floccard, Chaouki Mezher, Marion Galon, Jacques Duranteau, Elie Azoulay
RATIONALE: In the case of organ donation, the family is highly involved in the decision process. OBJECTIVE: To assess experience of organ donation process and grief symptoms in relatives of brain dead patients who discussed organ donation in the ICU. METHODS: Multicentre cross-sectional study in 28 ICUs in France. Participating subjects were relatives of brain dead patients who were approached to discuss organ donation. Relatives were followed-up by phone at 3 time points: at 1 month to complete a questionnaire describing their experience of organ donation process; At 3 months to complete the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised; At 9 months, to complete the IES-R and the Inventory of Complicated Grief...
March 19, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29549820/resiliency-is-independently-associated-with-greater-quality-of-life-among-informal-caregivers-to-neuroscience-intensive-care-unit-patients
#11
Emily L Zale, Tessa J Heinhuis, Tara Tehan, Danielle Salgueiro, Jonathan Rosand, Ana-Maria Vranceanu
OBJECTIVE: Every year, millions of Americans become informal caregivers to loved ones admitted to Neuroscience Intensive Care Units (Neuro-ICU), and face challenges to Quality of Life (QoL). This study sought to identify associations between resiliency, distress, and caregiver QoL at time of Neuro-ICU admission. METHODS: Informal caregivers (N = 79, Mage  = 53, 64% female) of Neuro-ICU patients were recruited and completed self-report questionnaires during the hospitalization...
May 2018: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29525234/syndrome-of-inappropriate-antidiuretic-hormone-secretion-in-a-mini-breed-puppy-associated-with-aspiration-pneumonia
#12
Rocío Martínez, Carlos Torrente
A 3-month-old intact male Prague ratter was presented to the emergency service for evaluation of progressive lethargy, weakness, coughing and labour breathing after an episode of resistance to oral deworming. The patient exhibited depression, increased respiratory effort and cyanosis at initial presentation. Results of first diagnostic work-up (complete blood cell count, biochemistry panel and thoracic x-rays) were all consistent with aspiration pneumonia. The puppy was initially treated with balanced isotonic crystalloids, broad spectrum antibiotics, nebulization with thoracic coupage and was transferred to an infant incubator with a sustained FiO2 of 40-50%...
December 2017: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/29494374/stress-reduction-in-postcardiac-surgery-family-members-implementation-of-a-postcardiac-surgery-tool-kit
#13
Lauren Breisinger, Angela Macci Bires, Thomas W Cline
The intensive care unit (ICU) can be a place of stress, anxiety, and emotional instability for both patients and families. Medical and nursing care during this acute time is patient focused, and family members are often left in the dark. Unintentional exclusion from information results in high levels of stress, anxiety, and uncertainty for families. Due to the acuity of illness, family members of cardiac surgery patients experience the highest levels of stress. Spouses may experience intense psychosomatic symptoms such as depression, anxiety, and fear for several months after the surgery...
April 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29463245/fatigue-in-chronically-critically-ill-patients-following-intensive-care-reliability-and-validity-of-the-multidimensional-fatigue-inventory-mfi-20
#14
Gloria-Beatrice Wintermann, Jenny Rosendahl, Kerstin Weidner, Bernhard Strauß, Andreas Hinz, Katja Petrowski
BACKGROUND: Fatigue often occurs as long-term complication in chronically critically ill (CCI) patients after prolonged intensive care treatment. The Multidimensional Fatigue Inventory (MFI-20) has been established as valid instrument to measure fatigue in a wide range of medical illnesses. Regarding the measurement of fatigue in CCI patients, the psychometric properties of the MFI-20 have not been investigated so far. Thus, the present study examines reliability and validity of the MFI-20 in CCI patients...
February 20, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29446987/dexmedetomidine-decreases-postoperative-pain-and-narcotic-use-in-children-undergoing-alveolar-bone-graft-surgery
#15
Mariela M Lopez, Derrick Zech, Judith L Linton, Steven J Blackwell
OBJECTIVE: Dexmedetomidine is a parenteral agent that combines the benefits of cooperative sedation, anxiolysis, and analgesia without the risks of respiratory depression. Off-label use has been reported in children. We have introduced dexmedetomidine for use in patients having undergone alveolar bone graft (ABG). The objective is to demonstrate the value and safety of postoperative dexmedetomidine infusion in a non-ICU setting following ABG. DESIGN: A retrospective review was performed on patients who underwent ABG by the senior author...
May 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29434802/an-investigation-of-the-mechanism-of-dexmedetomidine-in-improving-postoperative-cognitive-dysfunction-from-the-perspectives-of-alleviating-neuronal-mitochondrial-membrane-oxidative-stress-and-electrophysiological-dysfunction
#16
Jie Chen, Na Shen, Xiaohui Duan, Yaning Guo
The aim of this study was to investigate the mechanism of dexmedetomidine in improving postoperative cognitive dysfunction from the perspectives of alleviating neuronal mitochondrial membrane oxidative stress and electrophysiological dysfunction. A total of 120 patients undergoing elective surgery under general anesthesia from June 2013 to May, 2016 were selected as the subjects of the study and randomly divided into the propofol + remifentanil and dexmedetomidine groups. The Rey Auditory Verbal Learning Test (AVLT) and Beck Depression Inventory (BDI) were performed at day 1 before operation and at day 1, 3, 5 and 15 after operation...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29422179/depressive-symptoms-are-associated-with-in-hospital-complications-following-acute-myocardial-infarction
#17
Mohannad Eid AbuRuz, Fawwaz Alaloul, Ghadeer Al-Dweik
AIM: To examine the effect of depressive symptoms on in-hospital complication rates after Acute Myocardial Infarction (AMI). BACKGROUND: Coronary Heart Disease (CHD) is the primary cause of death worldwide. AMI is the most common consequence of CHD. Depressive symptoms are an important risk factor for CHD and increased risk of AMI. Understanding the relationship between depressive symptoms and short term complications for patients with AMI is important for determining their needs, developing interventions, and evaluating the outcomes of interventions...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29340154/the-impact-of-sepsis-delirium-and-psychological-distress-on-self-rated-cognitive-function-in-icu-survivors-a-prospective-cohort-study
#18
Emily Brück, Anna Schandl, Matteo Bottai, Peter Sackey
Background: Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU survivors. The primary aim of this study was to examine the relationship between sepsis, ICU delirium, and later self-rated cognitive function. A second aim was to investigate the association between psychological problems and self-rated cognitive function 3 months after the ICU stay...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29338144/mortality-and-long-term-quality-of-life-after-percutaneous-tracheotomy-in-intensive-care-unit-a-prospective-observational-study
#19
Maria Vargas, Yuda Sutherasan, Iole Brunetti, Camilla Micalizzi, Angelo Insorsi, Lorenzo Ball, Marta Folentino, Rosanna Sileo, Arduino DE Lucia, Manuela Cerana, Alessandro Accattatis, Domenico DE Lisi, Angelo Gratarola, Francesco Mora, Giorgio Peretti, Giuseppe Servillo, Paolo Pelosi
BACKGROUND: Quality of life and mortality after percutaneous dilatational tracheotomy (PDT) has been poorly investigated. The aims of this study were to evaluate the independent risk factors for Intensive Care Unit (ICU) mortality and investigate quality of life over the first year after PDT in critically ill patients. METHODS: This was a prospective, single-center, cohort study performed in a tertiary care University Hospital, enrolling consecutive ICU patients requiring elective PDT, collecting data during the tracheotomy procedure and the ICU stay...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29324947/cognitive-changes-in-nurses-working-in-intensive-care-units
#20
Daniel Aragão Machado, Nébia Maria Almeida de Figueiredo, Luciane de Souza Velasques, Cleonice Alves de Melo Bento, Wiliam César Alves Machado, Lúcia Alves Marques Vianna
OBJECTIVE: To measure the levels of stress, anxiety, and depression of nurses working in ICUs, relating them to levels of attention before and after 24 hours. METHOD: An observational, quantitative, analytical study with 18 nurses undergoing an inventory of stress, anxiety, and depression, as well as assessment of attention levels and psychomotor functioning. RESULTS: Sixty-one percent showed positive for stress. Depression was observed in 33%; and anxiety in 99...
January 2018: Revista Brasileira de Enfermagem
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