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https://www.readbyqxmd.com/read/27909608/comparison-of-two-different-enteral-nutrition-protocol-in-critically-ill-patients
#1
Sibel Büyükçoban, Mert Akan, Uğur Koca, Merih Yıldız Eğlen, Meltem Çiçeklioğlu, Ömür Mavioğlu
OBJECTIVE: In this study, two enteral nutrition protocols with different gastric residual volumes (GRVs) and different monitoring intervals were compared with respect to gastrointestinal intolerance findings in intensive care unit (ICU) patients. METHODS: The study was carried out prospectively in 60 patients in the anaesthesiology and reanimation ICU under mechanical ventilation support, who were scheduled to take enteral feeding. Patients were sequentially divided into two groups: Group 1, GRV threshold of 100 mL, and monitoring interval of 4 hours, and Group 2, GRV threshold of 200 mL, monitoring interval of 8 hours...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27904641/the-effect-of-daily-sedation-interruption-protocol-on-early-incidence-of-ventilator-associated-pneumonia-among-patients-hospitalized-in-critical-care-units-receiving-mechanical-ventilation
#2
Mehdi Shahabi, Hojatollah Yousefi, Ahmad Reza Yazdannik, Babak Alikiaii
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common side effect in patients who receive intravenous sedation infusion. In routine care, after starting sedation infusion for patients who receive mechanical ventilation, interruption of sedation starts without protocol. This study aimed to evaluate the effect of daily sedation vacation protocol on the incidence of VAP in mechanically ventilated patients. MATERIALS AND METHODS: In this clinical trial study, 80 patients with intravenous sedation infusion were selected and randomly allocated to intervention and control groups...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27903602/whole-genome-sequencing-of-mycobacterium-tuberculosis-provides-insight-into-the-evolution-and-genetic-composition-of-drug-resistant-tuberculosis-in-belarus
#3
Kurt R Wollenberg, Christopher A Desjardins, Aksana Zalutskaya, Vervara Slodovnikova, Andrew J Oler, Mariam Quiñones, Thomas Abeel, Sinead B Chapman, Michael Tartakovsky, Andrei Gabrielian, Sven Hoffner, Aliaksandr Skrahin, Bruce W Birren, Alexander Rosenthal, Alena Skrahina, Ashlee M Earl
The emergence and spread of drug resistant Mycobacterium tuberculosis (DR-TB) is a critical global health issue. Eastern Europe has some of the highest incidences of DR-TB, particularly multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB. To better understand the genetic composition and evolution of MDR- and XDR-TB in the region, we sequenced and analyzed the genomes of 138 M. tuberculosis isolates from 97 patients sampled between 2010 and 2013 in Minsk, Belarus. MDR and XDR-TB isolates were significantly more likely to belong to the Beijing lineage than to the Euro-American lineage, and known resistance-conferring loci accounted for the majority of phenotypic resistance to first- and second-line drugs in MDR and XDR-TB...
November 30, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27903201/nutrition-in-the-intensive-care-unit-you-must-breathe-what-you-eat
#4
John F Cade, Daryl A Jones, Rinaldo Bellomo
The imprecision in prescribing of enteral nutrition in critically ill patients must result in occasions of overfeeding as well as underfeeding. Overfeeding could cause increased CO2 production and thus increased work of breathing and prolonged ventilator dependence. This possibility is supported by the limited relevant literature. We examined this possibility mathematically using the data in The Augmented versus Routine Approach to Giving Energy Trial (TARGET) feasibility study and in its main study protocol...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27898439/limiting-sedation-for-patients-with-acute-respiratory-distress-syndrome-time-to-wake-up
#5
Faraaz Ali Shah, Timothy D Girard, Sachin Yende
PURPOSE OF REVIEW: Critically ill patients with acute respiratory distress syndrome (ARDS) may require sedation in their clinical care. The goals of sedation in ARDS patients are to improve patient comfort and tolerance of supportive and therapeutic measures without contributing to adverse outcomes. This review discusses the current evidence for sedation management in patients with ARDS. RECENT FINDINGS: Deep sedation strategies should be avoided in the care of patients with ARDS because deep sedation has been associated with increased time on mechanical ventilation, longer ICU and hospital length of stay, and higher mortality in critically ill patients...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27895065/social-determinants-and-maternal-exposure-to-intimate-partner-violence-of-obstetric-patients-with-severe-maternal-morbidity-in-the-intensive-care-unit-a-systematic-review-protocol
#6
Beatriz Paulina Ayala Quintanilla, Angela Taft, Susan McDonald, Wendy Pollock, Joel Christian Roque Henriquez
INTRODUCTION: Maternal mortality is a potentially preventable public health issue. Maternal morbidity is increasingly of interest to aid the reduction of maternal mortality. Obstetric patients admitted to the intensive care unit (ICU) are an important part of the global burden of maternal morbidity. Social determinants influence health outcomes of pregnant women. Additionally, intimate partner violence has a great negative impact on women's health and pregnancy outcome. However, little is known about the contextual and social aspects of obstetric patients treated in the ICU...
November 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/27886604/a-low-cost-and-palm-size-analyzer-for-rapid-and-sensitive-protein-detection-by-ac-electrokinetics-capacitive-sensing
#7
Xiaozhu Liu, Cheng Cheng, Jayne Wu, Shigetoshi Eda, Yongcai Guo
Specific detection of protein biomarkers has a wide range of applications in areas such as medical science, diagnostics, and pharmacology. Quantitative detection of protein biomarkers in biological media, such as serum, is critically important in detecting disease or physiological malfunction, or tracking disease progression. Among various detection methods, electrical detection is particularly well suited for point-of-care (POC) specific protein detection, being of low cost, light weight and small form factor...
November 11, 2016: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/27881152/fitness-and-mobility-training-in-patients-with-intensive-care-unit-acquired-muscle-weakness-fitonicu-study-protocol-for-a-randomised-controlled-trial
#8
Jan Mehrholz, Simone Thomas, Jane H Burridge, André Schmidt, Bettina Scheffler, Ralph Schellin, Stefan Rückriem, Daniel Meißner, Katja Mehrholz, Wolfgang Sauter, Ulf Bodechtel, Bernhard Elsner
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living...
November 24, 2016: Trials
https://www.readbyqxmd.com/read/27876084/a-trial-to-determine-whether-septic-shock-reversal-is-quicker-in-pediatric-patients-randomized-to-an-early-goal-directed-fluid-sparing-strategy-versus-usual-care-squeeze-study-protocol-for-a-pilot-randomized-controlled-trial
#9
Melissa J Parker, Lehana Thabane, Alison Fox-Robichaud, Patricia Liaw, Karen Choong
BACKGROUND: Current pediatric septic shock resuscitation guidelines from the American College of Critical Care Medicine focus on the early and goal-directed administration of intravascular fluid followed by vasoactive medication infusions for persistent and fluid-refractory shock. However, accumulating adult and pediatric data suggest that excessive fluid administration is associated with worse patient outcomes and even increased risk of death. The optimal amount of intravascular fluid required in early pediatric septic shock resuscitation prior to the initiation of vasoactive support remains unanswered...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27876082/evaluating-data-abstraction-assistant-a-novel-software-application-for-data-abstraction-during-systematic-reviews-protocol-for-a-randomized-controlled-trial
#10
Ian J Saldanha, Christopher H Schmid, Joseph Lau, Kay Dickersin, Jesse A Berlin, Jens Jap, Bryant T Smith, Simona Carini, Wiley Chan, Berry De Bruijn, Byron C Wallace, Susan M Hutfless, Ida Sim, M Hassan Murad, Sandra A Walsh, Elizabeth J Whamond, Tianjing Li
BACKGROUND: Data abstraction, a critical systematic review step, is time-consuming and prone to errors. Current standards for approaches to data abstraction rest on a weak evidence base. We developed the Data Abstraction Assistant (DAA), a novel software application designed to facilitate the abstraction process by allowing users to (1) view study article PDFs juxtaposed to electronic data abstraction forms linked to a data abstraction system, (2) highlight (or "pin") the location of the text in the PDF, and (3) copy relevant text from the PDF into the form...
November 22, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27871314/a-mixed-methods-systematic-review-protocol-to-examine-the-use-of-physical-restraint-with-critically-ill-adults-and-strategies-for-minimizing-their-use
#11
Louise Rose, Craig Dale, Orla M Smith, Lisa Burry, Glenn Enright, Dean Fergusson, Samir Sinha, Lesley Wiesenfeld, Tasnim Sinuff, Sangeeta Mehta
BACKGROUND: Critically ill patients frequently experience severe agitation placing them at risk of harm. Physical restraint is common in intensive care units (ICUs) for clinician concerns about safety. However, physical restraint may not prevent medical device removal and has been associated with negative physical and psychological consequences. While professional society guidelines, legislation, and accreditation standards recommend physical restraint minimization, guidelines for critically ill patients are over a decade old, with recommendations that are non-specific...
November 21, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27870670/operating-room-supply-costs-in-orthopaedic-trauma-cost-containment-opportunities
#12
Taylor P Gurnea, Wesley P Frye, Peter L Althausen
In the current health care environment, cost containment is more important than ever. Most physicians currently are unaware of the cost of operating room supplies. A large amount of waste occurs secondary to lack of knowledge and absence of physician incentives for cost saving. Many of the decisions for supply use can be based on good scientific evidence, which supports specific cost saving measures. Careful attention to blood utilization and use of tranexamic acid has the potential to save millions in the hip fracture treatment and arthroplasty treatments...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870668/cost-savings-opportunities-in-perioperative-management-of-the-patients-with-orthopaedic-trauma
#13
Alastair E Moody, Catriona E Moody, Peter L Althausen
Considerable opportunities for cost savings exist surrounding the perioperative management of patients with orthopaedic fracture and trauma. Scientific evidence is available to support each potential cost savings measure. Much of these data had been documented for years but has never been adhered to, resulting in millions of dollars in unnecessary testing and treatment. Careful attention to preoperative laboratory testing can save huge amounts of money and expedite medical clearance for injured patients. The use of a dedicated orthopaedic trauma operating room has been shown to improve resource utilization, decrease costs, and surgical complications...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27858581/evidence-based-guidelines-for-fatigue-risk-management-in-ems-formulating-research-questions-and-selecting-outcomes
#14
P Daniel Patterson, J Stephen Higgins, Eddy S Lang, Michael S Runyon, Laura K Barger, Jonathan R Studnek, Charity G Moore, Kathy Robinson, Dia Gainor, Allison Infinger, Patricia M Weiss, Denisse J Sequeira, Christian Martin-Gill
BACKGROUND: Greater than half of Emergency Medical Services (EMS) personnel report work-related fatigue, yet there are no guidelines for the management of fatigue in EMS. A novel process has been established for evidence-based guideline (EBG) development germane to clinical EMS questions. This process has not yet been applied to operational EMS questions like fatigue risk management. The objective of this study was to develop content valid research questions in the Population, Intervention, Comparison, and Outcome (PICO) framework, and select outcomes to guide systematic reviews and development of EBGs for EMS fatigue risk management...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27858502/prehospital-providers-perceptions-on-providing-patient-and-family-centered-care
#15
Emily M Ayub, Esther M Sampayo, Manish I Shah, Cara B Doughty
BACKGROUND: A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. METHODS: We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27857787/a-study-of-neurosonogram-abnormalities-clinical-correlation-with-neurosonogram-findings-and-immediate-outcome-of-high-risk-neonates-in-neonatal-intensive-care-unit
#16
Niranjan Nagaraj, Pramod Kumar Berwal, Anusha Srinivas, Ramnarayan Sehra, Sarika Swami, Prathyusha Jeevaji, Gotam Swami, Lokesh Choudary, Ayush Berwal
BACKGROUND: Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27852357/a-multifaceted-approach-to-reduction-of-catheter-associated-urinary-tract-infections-in-the-intensive-care-unit-with-an-emphasis-on-stewardship-of-culturing
#17
Katherine M Mullin, Christopher S Kovacs, Cynthia Fatica, Colette Einloth, Elizabeth A Neuner, Jorge A Guzman, Eric Kaiser, Venu Menon, Leticia Castillo, Marc J Popovich, Edward M Manno, Steven M Gordon, Thomas G Fraser
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications. OBJECTIVE To implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture. METHODS A project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs...
November 17, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#18
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27846121/experiences-of-new-graduate-nurses-working-in-a-neonatal-intensive-care-setting-a-systematic-review-protocol-of-qualitative-evidence
#19
Jann Foster, Christine Taylor, Tiffany Patterson, Kim Psaila
The overall objective of this systematic review is to identify, critically appraise and synthesize the experiences of new graduate nurses in the neonatal intensive care unit (NICU). The specific review question is: what are the experiences of new graduate nurses working in a NICU setting?
October 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27836507/use-of-a-multi-level-mixed-methods-approach-to-study-the-effectiveness-of-a-primary-care-progressive-return-to-activity-protocol-after-acute-mild-traumatic-brain-injury-concussion-in-the-military
#20
Emma Gregory, Therese A West, Wesley R Cole, Jason M Bailie, Karen L McCulloch, Mark L Ettenhofer, Amy Cecchini, Felicia M Qashu
The large number of U.S. service members diagnosed with concussion/mild traumatic brain injury each year underscores the necessity for clear and effective clinical guidance for managing concussion. Relevant research continues to emerge supporting a gradual return to pre-injury activity levels without aggravating symptoms; however, available guidance does not provide detailed standards for this return to activity process. To fill this gap, the Defense and Veterans Brain Injury Center released a recommendation for primary care providers detailing a step-wise return to unrestricted activity during the acute phase of concussion...
November 8, 2016: Contemporary Clinical Trials
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