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https://www.readbyqxmd.com/read/29779827/zika-virus-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#1
Gisele Sampaio Silva, Guy A Richards, Tim Baker, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Pravin Amin
Zika fever is an acute infectious disease caused by the Zika virus (ZIKV), an RNA virus belonging to the genus Flavivirus. ZIKV can be transmitted by bites from Aedes aegypti and Aedes albopictus species, sexual activity, blood transfusion and from mother to fetus during pregnancy and delivery. A total of 50 territories and countries in the Americas had reported ZIKV infections. For those with symptoms, the presentation is similar to dengue fever with body aches, joint pain, fatigue, malaise, fever and conjunctivitis lasting up to seven days...
April 5, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29776701/nonstandard-advance-directives-in-emergency-medicine-what-should-we-do
#2
Kenneth V Iserson
BACKGROUND: Critically ill or injured emergency department or prehospital patients who lack decision-making capacity sometimes present with a non-standard advance directive, such as a "Do Not Resuscitate" tattoo or medallion. Emergency clinicians must immediately address the question of whether to withhold treatment based on what may or may not be a valid patient directive. DISCUSSION: Advance directives have been standardized for a good reason. Emergency department or prehospital healthcare providers must be able to immediately interpret and act on them without needing a legal interpretation...
May 16, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29769084/resilience-trust-and-civic-engagement-in-the-post-ccsvi-era
#3
Shelly Benjaminy, Andrew Schepmyer, Judy Illes, Anthony Traboulsee
BACKGROUND: Scientific and financial investments in chronic cerebrospinal venous insufficiency (CCSVI) research have been made to address both the hope for and scepticism over this interventional strategy for MS. Despite limited evidence in support of the CCSVI hypothesis, the funding of clinical research was responsive to a demand by the public rarely seen in the history of medicine. We characterize patient perspectives about the CCSVI research trajectory, with particular attention to its impact on other non-pharmaceutical areas of MS research with a focus on stem cell interventions...
May 16, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29767451/feline-ureteral-obstructions-part-1-medical-management
#4
REVIEW
D L Clarke
Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of acute kidney injury, electrolyte disturbances, and may have comorbidities such as heart disease that complicate perioperative and long-term management. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in feline ureteral obstruction patients...
May 16, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29766208/-adequate-anti-infective-treatment-importance-of-individual-dosing-and-application
#5
A Brinkmann, A C Röhr, A Köberer, T Fuchs, W A Krüger, C König, D Richter, M A Weigand, O R Frey
Sepsis-induced changes in pharmacokinetic parameters are a well-known problem in intensive care medicine. Dosing of antibiotics in this setting is therefore challenging. Alterations to the substance-specific kinetics of anti-infective substances have an effect on the distribution and excretion processes in the body. Increased clearance and an increased distribution volume (Vd ) and particularly compromized organ function with reduced antibiotic elimination are often encountered in patients with sepsis. Renal replacement treatment, which is frequently used in intensive care medicine, represents a substantial intervention in this system...
May 15, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29764560/-discussion-of-the-implementation-of-mimic-database-in-emergency-medical-study
#6
Kaiyuan Li, Cong Feng, Lijing Jia, Li Chen, Fei Pan, Tanshi Li
To introduce Medical Information Mart for Intensive Care (MIMIC) database and elaborate the approach of critically emergent research with big data based on the feature of MIMIC and updated studies both domestic and overseas, we put forward the feasibility and necessity of introducing medical big data to research in emergency. Then we discuss the role of MIMIC database in emergency clinical study, as well as the principles and key notes of experimental design and implementation under the medical big data circumstance...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29763385/pyruvate-enriched-resuscitation-for-shock
#7
Robert T Mallet, Albert H Olivencia-Yurvati, Rolf Bünger
This commentary addresses the recent retraction of an article which reported favorable outcomes in septic patients treated with intravenous pyruvate. The retracted report was cited in the authors' recent minireview on the cellular mechanisms and clinical application of pyruvate to improve cardiac performance. Because the retracted article reports pyruvate-enhanced resuscitation of critically ill patients, the authors wish to inform the readership, especially critical care providers, that this particular clinical application of pyruvate is not now supported by robust evidence...
May 2018: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29761755/a-deadly-wait-for-u-s-health-insurance-coverage-sitting-on-the-couch-with-malaria
#8
Jonathan S Schultz, Adam J Atherly, Andrés F Henao-Martínez
Uninsured and unprepared travelers to countries with endemic tropical diseases pose great health-care burdens and financial risks on returning to the United States. We discuss the delayed presentation of an uninsured U.S. traveler returning from West Africa with severe malaria who required intensive care measures to save his life. Despite being critically ill on his return, he sat rigoring on his couch taking antipyretics for 3 days, while he applied for insurance on the Affordable Care Act website and waited for approval because he was fearful of the costs of seeking care...
May 14, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29752973/big-data-and-data-science-in-critical-care
#9
REVIEW
L Nelson Sanchez-Pinto, Yuan Luo, Matthew M Churpek
The digitalization of the healthcare system has resulted in a deluge of clinical Big Data and has prompted the rapid growth of data science in medicine. Data science, which is the field of study dedicated to the principled extraction of knowledge from complex data, is particularly relevant in the critical care setting. The availability of large amounts of data in the intensive care unit, the need for better evidence-based care, and the complexity of critical illness makes the use of data science techniques and data-driven research particularly appealing to intensivists...
May 9, 2018: Chest
https://www.readbyqxmd.com/read/29747699/clinical-chronobiology-a-timely-consideration-in-critical-care-medicine
#10
REVIEW
Helen McKenna, Gijsbertus T J van der Horst, Irwin Reiss, Daniel Martin
A fundamental aspect of human physiology is its cyclical nature over a 24-h period, a feature conserved across most life on Earth. Organisms compartmentalise processes with respect to time in order to promote survival, in a manner that mirrors the rotation of the planet and accompanying diurnal cycles of light and darkness. The influence of circadian rhythms can no longer be overlooked in clinical settings; this review provides intensivists with an up-to-date understanding of the burgeoning field of chronobiology, and suggests ways to incorporate these concepts into daily practice to improve patient outcomes...
May 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29743761/predictors-of-mortality-in-acute-kidney-injury-patients-admitted-to-medicine-intensive-care-unit-in-a-rural-tertiary-care-hospital
#11
Amrish Saxena, Shrikant V Meshram
Background: Acute kidney injury (AKI) is a challenging problem faced by intensive care clinicians worldwide, and it is associated with high morbidity and mortality, especially in critically ill patients. Materials and Methods: A hospital-based prospective, observational study was conducted in patients of AKI admitted to the Intensive Care Unit (ICU) of the Department of Medicine in a rural tertiary care hospital located in central India. Data of all consecutive AKI inpatients related to demographic variables, clinical profile, and laboratory investigations were collected from patient's medical records...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29742788/-the-relevance-of-hemolysis-in-anesthesia-and-intensive-care-medicine
#12
Jan A Graw, David M Baron, Roland C E Francis
Hemolysis leads to an increase of circulating intravascular cell-free hemoglobin. Increased plasma concentrations of cell-free hemoglobin are relevant in critically ill patients because cell-free hemoglobin causes vasoconstriction by depletion of endothelial nitric oxide, oxidative stress, and inflammation. Furthermore, cell-free hemoglobin contributes to tissue injuries such as renal failure and intestinal mucosa damage after cardiac surgery. High concentrations of cell-free hemoglobin are associated with an increased mortality in patients with sepsis...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29729659/improving-health-care-for-critically-ill-patients-using-an-evidence-based-collaborative-approach-to-abcdef-bundle-dissemination-and-implementation
#13
Mary Ann Barnes-Daly, Brenda T Pun, Lori A Harmon, Diane G Byrum, Vishakha K Kumar, John W Devlin, Joanna L Stollings, Kathleen A Puntillo, Heidi J Engel, Patricia J Posa, Juliana Barr, William D Schweickert, Cheryl L Esbrook, Ken D Hargett, Shannon S Carson, J Matthew Aldrich, E Wesley Ely, Michele C Balas
BACKGROUND: Patients admitted to intensive care units (ICUs) often experience pain, oversedation, prolonged mechanical ventilation, delirium, and weakness. These conditions are important in that they often lead to protracted physical, neurocognitive, and mental health sequelae now termed postintensive care syndrome. Changing current ICU practice will not only require the adoption of evidence-based interventions but the development of effective and reliable teams to support these new practices...
May 5, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29728212/-admission-discharge-and-triage-guidelines-for-paediatric-intensive-care-units-in-spain
#14
Pedro de la Oliva, Francisco José Cambra-Lasaosa, Manuel Quintana-Díaz, Corsino Rey-Galán, Juan Ignacio Sánchez-Díaz, María Cruz Martín-Delgado, Juan Carlos de Carlos-Vicente, Ramón Hernández-Rastrollo, María Soledad Holanda-Peña, Francisco Javier Pilar-Orive, Esther Ocete-Hita, Antonio Rodríguez-Núñez, Ana Serrano-González, Luis Blanch
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs...
May 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29713622/nutritional-care-in-iranian-intensive-care-units
#15
Maryam Shabanpur, Seyed Mostafa Nachvak, Shima Moradi, Safora Hedayati, Mahboobe Hosseinikia, Yahya Pasdar, Shahrbanoo Gholizadeh, Mehnoosh Samadi
Intensive care units (ICUs) provides intensive treatment medicine to avoid complications such as malnutrition, infection and even death. As very little is currently known about the nutritional practices in Iranian ICUs, this study attempted to assess the various aspects of current nutrition support practices in Iranian ICUs. We conducted a cross-sectional study on 150 critically ill patients at 18 ICUs in 12 hospitals located in 2 provinces of Iran from February 2015 to March 2016. Data were collected through interview with supervisors of ICUs, medical record reviews and direct observation of patients during feeding...
April 2018: Clinical Nutrition Research
https://www.readbyqxmd.com/read/29704018/consensus-statement-for-cancer-patients-requiring-intensive-care-support
#16
M G Kiehl, G Beutel, B Böll, D Buchheidt, R Forkert, V Fuhrmann, P Knöbl, M Kochanek, F Kroschinsky, P La Rosée, T Liebregts, C Lück, U Olgemoeller, E Schalk, A Shimabukuro-Vornhagen, W R Sperr, T Staudinger, M von Bergwelt Baildon, P Wohlfarth, V Zeremski, P Schellongowski
This consensus statement is directed to intensivists, hematologists, and oncologists caring for critically ill cancer patients and focuses on the management of these patients.
April 27, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29699720/getting-inside-the-expert-s-head-an-analysis-of-physician-cognitive-processes-during-trauma-resuscitations
#17
Matthew R White, Heather Braund, Daniel Howes, Rylan Egan, Andreas Gegenfurtner, Jeroen J G van Merrienboer, Adam Szulewski
STUDY OBJECTIVE: Crisis resource management skills are integral to leading the resuscitation of a critically ill patient. Despite their importance, crisis resource management skills (and their associated cognitive processes) have traditionally been difficult to study in the real world. The objective of this study was to derive key cognitive processes underpinning expert performance in resuscitation medicine, using a new eye-tracking-based video capture method during clinical cases. METHODS: During an 18-month period, a sample of 10 trauma resuscitations led by 4 expert trauma team leaders was analyzed...
April 23, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29699643/admission-discharge-and-triage-guidelines-for-paediatric-intensive-care-units-in-spain
#18
Pedro de la Oliva, Francisco José Cambra-Lasaosa, Manuel Quintana-Díaz, Corsino Rey-Galán, Juan Ignacio Sánchez-Díaz, María Cruz Martín-Delgado, Juan Carlos de Carlos-Vicente, Ramón Hernández-Rastrollo, María Soledad Holanda-Peña, Francisco Javier Pilar-Orive, Esther Ocete-Hita, Antonio Rodríguez-Núñez, Ana Serrano-González, Luis Blanch
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs...
May 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29696124/diagnostic-value-of-sonography-for-confirmation-of-endotracheal-intubation-in-the-emergency-department
#19
Farzad Rahmani, Zahra Parsian, Kavous Shahsavarinia, Mahboob Pouraghaei, Sohrab Negargar, Robab Mehdizadeh Esfanjani, Hassan Soleimanpour
Background: Intubation and maintaining airway are crucial in the management of critically ill patients in the emergency department. Correct tracheal intubation should be confirmed by the physician, otherwise oesophageal intubation could lead to hypoxia with detrimental consequences and even death. Sonography can be used to determine proper placement of the tracheal tube. Methods: In this study, 75 patients, with an indication of intubation and age older than 18 years entered the study...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29690893/inclusion-and-definition-of-acute-renal-dysfunction-in-critically-ill-patients-in-randomized-controlled-trials-a-systematic-review
#20
Rogerio da Hora Passos, Joao Gabriel Rosa Ramos, André Gobatto, Juliana Caldas, Etienne Macedo, Paulo Benigno Batista
BACKGROUND: In evidence-based medicine, multicenter, prospective, randomized controlled trials (RCTs) are the gold standard for evaluating treatment benefits and ensuring the effectiveness of interventions. Patient-centered outcomes, such as mortality, are most often the preferred evaluated outcomes. While there is currently agreement on how to classify renal dysfunction in critically ill patients , the application frequency of this new classification system in RCTs has not previously been evaluated...
April 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
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