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https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#1
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28616666/the-role-of-psychosomatic-medicine-in-intensive-care-units
#2
REVIEW
Heidemarie Abrahamian, Diana Lebherz-Eichinger
Critically ill patients, their relatives, and intensive care staff are consistently exposed to stress. The principal elements of this exceptional burden are confrontation with a life-threatening disease, specific environmental conditions at the intensive care unit, and the social characteristics of intensive care medicine. The short- and long-term consequences of these stressors include a feeling of helplessness, distress, anxiety, depression, and even posttraumatic stress disorders. Not only the patients, but also their relatives and intensive care staff are at risk of developing such psychopathologies...
June 14, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#3
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28604159/spiritual-care-in-the-intensive-care-unit-a-narrative-review
#4
Jim Q Ho, Christopher D Nguyen, Richard Lopes, Stephen C Ezeji-Okoye, Ware G Kuschner
Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients' spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28601133/assessment-and-management-of-toxidromes-in-the-critical-care-unit
#5
REVIEW
J J Rasimas, Courtney M Sinclair
The most important diagnostic factor in uncovering a toxic etiology for delirium or critical illness is the clinician's openness to the possibility of its existence. Therefore, a consulting psychiatrist, already prepared to perform the detail-oriented work of sorting out behavioral manifestations of disease, can be a vital asset at the bedside if also attuned to the role of purposeful, accidental, and iatrogenic exposures in the intensive care unit. This article summarizes the presentation, evaluation, and treatment of toxidromes relevant to the work of acute psychosomatic medicine...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28596218/health-related-shame-an-affective-determinant-of-health
#6
Luna Dolezal, Barry Lyons
Despite shame being recognised as a powerful force in the clinical encounter, it is underacknowledged, under-researched and undertheorised in the contexts of health and medicine. In this paper we make two claims. The first is that emotional or affective states, in particular shame, can have a significant impact on health, illness and health-related behaviours. We outline four possible processes through which this might occur: (1) acute shame avoidance behaviour; (2) chronic shame health-related behaviours; (3) stigma and social status threat and (4) biological mechanisms...
June 8, 2017: Medical Humanities
https://www.readbyqxmd.com/read/28595818/do-not-resuscitate-orders-and-high-risk-pediatric%C3%A2-surgery-professional-nuisance-or%C3%A2-medical%C3%A2-necessity
#7
Lauren M Baumann, Kibileri Williams, Fizan Abdullah, Richard J Hendrickson, Tolulope A Oyetunji
BACKGROUND: There is a paucity of data in the literature regarding end-of-life care and do-not-resuscitate (DNR) status of the pediatric surgical patient, although invasive procedures are frequently performed in very high risk and critically ill children. Despite significant efforts in adult medicine to enhance discussions around end-of-life care, little is known about similar endeavors in the pediatric population. METHODS: A retrospective review of the National Surgical Quality Improvement Program Pediatric database was performed...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28595541/evaluating-the-role-of-interleukin-12-b-gene-polymorphism-in-prediction-of-disease-progression-in-patients-with-chronic-hepatitis-c-virus-infection
#8
Nadia Elwan, Khalda Amr, Sahar Elyamany, Walaa Elkhalawany, Shaimaa Soliman, Mohamed Ziada, Sherief Abd-Elsalam
Background &Aims: Cell-mediated immunity plays a critical role in viral clearance and disease progression during Hepatitis C virus (HCV) infection. Interleukin (IL)-12 is a cytokine that has been shown to be a potent antiviral cytokine. The aim of this work is to investigate the association of IL-12 B gene polymorphism with the progression of liver disease in chronic HCV patients. METHODS: This cross sectional study was carried out in tropical medicine department, Tanta university hospital, Egypt, on 120 chronic HCV patients with various stages of liver disease and 30 healthy subjects served as control...
June 5, 2017: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/28590164/care-of-the-critically-ill-burn-patient-an-overview-from-the-perspective-of-optimizing-palliative-care
#9
Daniel E Ray, Mohana B Karlekar, Donnelle L Crouse, Margaret Campbell, J Randall Curtis, Jeffrey Edwards, Dana R Lustbader, Anne C Mosenthal, Colleen Mulkerin, Kathleen A Puntillo, David E Weissman, Renee D Boss, Karen J Brasel, Judith E Nelson
Burn specialists have long recognized the need for and role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many US hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context...
June 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28584667/melatonin-secretion-pattern-in-critically-ill-patients-a-pilot-descriptive-study
#10
Yuliya Boyko, René Holst, Poul Jennum, Helle Oerding, Miki Nikolic, Palle Toft
Critically ill patients have abnormal circadian and sleep homeostasis. This may be associated with higher morbidity and mortality. The aims of this pilot study were (1) to describe melatonin secretion in conscious critically ill mechanically ventilated patients and (2) to describe whether melatonin secretion and sleep patterns differed in these patients with and without remifentanil infusion. Eight patients were included. Blood-melatonin was taken every 4th hour, and polysomnography was carried out continually during a 48-hour period...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28577069/prevention-of-acute-kidney-injury-and-protection-of-renal-function-in-the-intensive-care-unit-update-2017-expert-opinion-of-the-working-group-on-prevention-aki-section-european-society-of-intensive-care-medicine
#11
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28574536/perceptions-of-hospital-dependent-patients-on-their-needs-for-hospitalization
#12
Tao Liu, Eliza Kiwak, Mary E Tinetti
In the United States, older adults account for a significant proportion of hospitalizations, and a subset become hospital-dependent, for reasons that are unclear. We conducted a qualitative study to explore these individuals' perspectives on their need for hospitalizations. Twenty patients hospitalized at an academic medical center underwent semistructured qualitative interviews. Criteria for selection included age 65 and older, at least three hospitalizations over six months, admission to the medical service at the time of the study, did not meet criteria for chronic critical illness, was not comfort measures only, and did not have a conservator...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28574294/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#13
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28574107/continuous-renal-replacement-therapy-forty-year-anniversary
#14
Claudio Ronco
In 1977 Peter Kramer performed the first CAVH (continuous arteriovenous hemofiltration) treatment in Gottingen, Germany. CAVH soon became a reliable alternative to hemo- or peritoneal dialysis in critically ill patients. The limitations of CAVH spurred new research and the discovery of new treatments such as CVVH and CVVHD (continuous veno-venous hemofiltration and continuous veno-venous hemodialysis). The alliance with industry led to development of new specialized equipment with improved accuracy and performance in delivering continuous renal replacement therapies (CRRTs)...
May 31, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28549789/systematic-approaches-to-adverse-events-in-obstetrics-part-i-event-identification-and-classification
#15
Christian M Pettker
Despite our best intentions to improve health when a patient presents for care, adverse events are ubiquitous in medical practice today. Known complications related to the course of a patient's illness or condition or to the characteristics of the treatment have been an openly stated part of taking care of patients for centuries. However, it is only in the past decade that preventable adverse events, instances of harm related to error and deviations in accepted practice have become a primary part of these conversations...
May 23, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28539083/patient-length-of-stay-and-mortality-prediction-a-survey
#16
Aya Awad, Mohamed Bader-El-Den, James McNicholas
Over the past few years, there has been increased interest in data mining and machine learning methods to improve hospital performance, in particular hospitals want to improve their intensive care unit statistics by reducing the number of patients dying inside the intensive care unit. Research has focused on prediction of measurable outcomes, including risk of complications, mortality and length of hospital stay. The length of stay is an important metric both for healthcare providers and patients, influenced by numerous factors...
May 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28538622/towards-precision-medicine-accurate-predictive-modeling-of-infectious-complications-in-combat-casualties
#17
Christopher J Dente, Matthew Bradley, Seth Schobel, Beverly Gaucher, Timothy Buchman, Allan D Kirk, Eric Elster
BACKGROUND: The biomarker profile of trauma patients may allow for the creation of models to assist bedside decision making & prediction of complications. We sought to determine the utility of modeling in the prediction of bacteremia & pneumonia in combat casualties. METHODS: This is a prospective, observational trial of patients with complex wounds treated at Walter Reed National Military Medical Center (2007-2012). Tissue, serum and wound effluent samples were collected during operative interventions until wound closure...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28534147/hypothyroidism-in-hospitalized-elderly-patients-a-sign-of-worse-prognosis
#18
N Sforza, J Rosenfarb, R Rujelman, M Rosmarin, E Blanc, C Frigerio, P Fossati, D Caruso, C Faingold, T Meroño, G Brenta
PURPOSE: Overt hypothyroidism has adverse clinical consequences and might worsen prognosis in critically ill elderly patients. However, the difficult interpretation of thyroid function tests (TFT) due to non-thyroidal illness (NTI) has led to discouragement of screening for thyroid dysfunction. Our aim was to determine the prevalence of TFT compatible with hypothyroidism and to study its influence on mortality among hospitalized elderly patients. METHODS: In this prospective study we consecutively included all patients ≥60 years admitted by the Internal Medicine Department to the hospital ward (n = 451) of the Cesar Milstein Hospital in Buenos Aires, Argentina...
May 22, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#19
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28529235/alternative-medicine-contagion-and-cure-in-karel-%C3%A4-apek-s-i-the-white-plague-i
#20
Alexis Soloski
Though written amid an atmosphere of unprecedented medical advance in both diagnosis and therapeutics, Karel Čapek's The White Plague takes a starkly critical stance against overconfidence in medical science and its dubious ethical orbit. This article explores Čapek's censure of those who would privilege scientific interest in disease over the holistic plight of the sufferer. Provocatively, Čapek achieves this not only via the play's content, but also-prefiguring aspects of contemporary live art practice by several decades-by placing audience members in worrying proximity to abject ill bodies...
2017: Literature and Medicine
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