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https://www.readbyqxmd.com/read/29677007/near-continuous-glucose-monitoring-makes-glycemic-control-safer-in-icu-patients
#1
Jean-Charles Preiser, Olivier Lheureux, Aurelie Thooft, Serge Brimioulle, Jacques Goldstein, Jean-Louis Vincent
OBJECTIVES: Tight glycemic control using intermittent blood glucose measurements is associated with a risk of hypoglycemia. Glucose concentrations can now be measured near continuously (every 5-15 min). We assessed the quality and safety of glycemic control guided by a near-continuous glucose monitoring system in ICU patients. DESIGN: Prospective, cluster-randomized, crossover study. SETTING: Thirty-five-bed medico-surgical department of intensive care with four separate ICUs...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29669237/current-practice-of-diagnosis-and-management-of-acute-kidney-injury-in-intensive-care-unit-in-resource-limited-settings
#2
Nattachai Srisawat, Nattaya Sintawichai, Win Kulvichit, Nuttha Lumlertgul, Patita Sitticharoenchai, Nicha Thamrongsat, Sadudee Peerapornratana
PURPOSE: In a resource limited settings, there is sparse information about the management of acute kidney injury (AKI) based on systemic data collection. This survey aimed to described the current management of AKI in intensive care units (ICUs) across Thailand. MATERIALS AND METHODS: Questionnaires were distributed to 160 physicians involved in the intensive care between January and December 2014 across Thailand. Distribution was done through an online survey platform or telephone interview...
April 11, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29667378/alarming-results-of-nosocomial-infections-in-a-multicenter-program-of-surveillance-in-polish-intensive-care-units
#3
Michał Wałaszek, Anna Różańska, Małgorzata Bulanda, Jadwiga Wojkowska-Mach, Polish Society of Hospital Infections Team
INTRODUCTION: Nosocomial bloodstream infections (BSI) among patients in intensive care units (ICU) are the most common form of nosocomial infections and they are serious complications of the treatment process. The etiological factors of these infections and the proper antibiotic therapy can influence the effects of patient treatment. The aim of the study was to analyze the epidemiology, microbiology and antibiotic therapy of nosocomial BSI in Polish ICU patients. MATERIALS AND METHODS: The retrospective study covered patients hospitalized in seven ICUs for adults with a general profile, located in southern Poland...
2018: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/29667097/an-elevated-respiratory-quotient-predicts-complications-after-cardiac-surgery-under-extracorporeal-circulation-an-observational-pilot-study
#4
J Piot, A Hébrard, M Durand, J F Payen, P Albaladejo
Following cardiac surgery, hyperlactatemia due to anaerobic metabolism is associated with an increase in both morbidity and mortality. We previously found that an elevated respiratory quotient (RQ) predicts anaerobic metabolism. In the present study we aimed to demonstrate that it is also associated with poor outcome following cardiac surgery. This single institution, prospective, observational study includes all those patients that were consecutively admitted to the intensive care unit (ICU) after cardiac surgery with cardiopulmonary bypass, that had also been monitored using pulmonary artery catheter...
April 17, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29659467/a-standard-push-pull-protocol-for-waste-free-sampling-in-the-pediatric-intensive-care-unit
#5
Clare McBride, Suzan Miller-Hoover, James A Proudfoot
Blood sampling is a major source of blood loss in the pediatric intensive care unit (PICU). Blood-sparing sampling techniques such as the push-pull method can significantly reduce sampling-related blood loss and protect patients from anemia and blood transfusions. The push-pull method is supported by research evidence for central venous catheter (CVC) sampling, but research protocols differ and not all CVCs and laboratory tests have been studied. A standard push-pull protocol for the PICU was developed, implemented, and evaluated in this evidence-based practice project...
May 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/29657370/delirium-in-the-intensive-care-unit-incidence-risk-factors-and-impact-on-outcome
#6
Nejla Tilouche, Mohamed Fekih Hassen, Habiba Ben Sik Ali, Oussamma Jaoued, Rim Gharbi, S Souheil El Atrous
Background: The incidence and risk factors for delirium vary among studies. Objective: We aimed to determine the incidence, risk factors, and impact on outcome of delirium in a medical Intensive Care Unit (ICU) in Tunisia using a prospective observational study. Patients: All consecutive patients admitted to the ICU between May 2012 and April 2013 were included if they were aged more than 18 years and had an ICU stay of more than 24 h. Patients who had a cardiac arrest or have a history of dementia or psychosis were excluded...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29651905/the-intracavitary-electrocardiography-method-for-tip-location-of-jugular-internal-vein-access-device-in-infants-of-less-than-5-kg-a-pilot-study
#7
Rossella Mastroianni, Antonella Capasso, Gaetano Ausanio
PURPOSE: This is a prospective observational study conducted by neonatologists in neonatal intensive care unit from Sant'Anna and San Sebastiano Hospital, Caserta, Italy. The objective of the study is to verify the feasibility of intracavitary electrocardiography method for tip location of central venous access device in infants of less than 5 kg and evaluate the accuracy of the method in comparison with post-procedural echocardiographical verification of the tip position. PATIENTS AND METHODS: We enrolled 27 patients weighted between 0...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29649820/accuracy-of-acid-base-diagnoses-using-the-central-venous-blood-gas-in-the-medical-intensive-care-unit
#8
Sarah J Schrauben, Dan Negoianu, Cristiana Costa, Raphael M Cohen, Stanley Goldfarb, Barry D Fuchs, Jeffrey S Berns
BACKGROUND: Acid-base disturbances are frequent in critically ill patients. Arterial blood gas (ABG) is the gold standard in the diagnosis of these disturbances, but it is invasive with potential hazards. For patients with a central venous catheter, venous blood gas (VBG) sampling may be an alternative, less-invasive diagnostic tool. However, the accuracy of a central VBG-based acid-base disorder diagnosis compared to an ABG is unknown. The primary objective of this study was to assess the accuracy of a central VBG-based acid-base disorder diagnosis compared to the "gold standard" ABG in critically ill patients...
April 12, 2018: Nephron
https://www.readbyqxmd.com/read/29642728/tunnelling-a-midline-catheter-when-the-traffic-light-shifts-from-yellow-to-green
#9
Adam Fabiani, Lorella Dreas, Gianfranco Sanson
INTRODUCTION: A safe, largely used practice for difficult venous access patients is positioning a catheter in deeper veins under ultrasound guide. However, the risk of complications is increased when there is a high catheter-to-vein ratio or when the insertion site is in a zone with particular anatomical/physiological characteristics. CASE DESCRIPTION: A 60-year-old woman admitted to a post-operative intensive care unit after cardiac surgery had a complicated post-operative course...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29642724/foley-catheter-with-simultaneous-oxytocin-on-labor-induction-a-meta-analysis-of-randomized-controlled-trials
#10
Jing Liu, Guang Song, Tao Meng, Lu Ji
OBJECTIVE: It is unclear that whether Foley catheter with simultaneous oxytocin could improve the efficacy of induction outcome. METHOD: To conduct a meta-analysis of randomized controlled trial (RCT) studies to evaluate the effect of Foley catheter with simultaneous oxytocin on labor induction. PubMed, Embase, and other databases were searched from their inception to July 2017. We included all RCTs comparing Foley catheter with simultaneous oxytocin (i.e. intervention group) with Foley catheter followed by oxytocin (i...
April 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29619335/role-of-neomycin-polymyxin-sulfate-solution-bladder-wash-for-prevention-of-catheter-associated-urinary-tract-infection-in-traumatic-brain-injury-patient-admitted-to-intensive-care-unit-a-prospective-randomized-study
#11
Neeraj Kumar, Yashpal Singh, Ghanshyam Yadav, S K Mathur, Umesh Kumar Bhadani
Background: Catheter - associated urinary tract infection (CAUTI) remains a critical threat for patients in intensive care unit especially in traumatic brain injury patients with low Glasgow coma score (GCS). Almost all patients in ICU receive antibiotic either prophylactic or therapeutic based on local antibiogram of particular ICU or hospital. For prophylaxis, systemic antibiotics are used. It will be helpful to avoid systemic side effects by introducing antibiotics locally through bladder irrigation...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29616357/preliminary-experience-on-the-safety-and-tolerability-of-mechanical-insufflation-exsufflation-in-subjects-with-artificial-airway
#12
Miguel Sánchez-García, Passio Santos, Gema Rodríguez-Trigo, Fernando Martínez-Sagasti, Tomás Fariña-González, Ángela Del Pino-Ramírez, Carlos Cardenal-Sánchez, Beatriz Busto-González, Mónica Requesens-Solera, Mercedes Nieto-Cabrera, Francisco Romero-Romero, Antonio Núñez-Reiz
BACKGROUND: Catheter suctioning of respiratory secretions in intubated subjects is limited to the proximal airway and associated with traumatic lesions to the mucosa and poor tolerance. "Mechanical insufflation-exsufflation" exerts positive pressure, followed by an abrupt drop to negative pressure. Potential advantages of this technique are aspiration of distal airway secretions, avoiding trauma, and improving tolerance. METHODS: We applied insufflation of 50 cmH2 O for 3 s and exsufflation of - 45 cmH2 O for 4 s in patients with an endotracheal tube or tracheostomy cannula requiring secretion suctioning...
April 3, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29615168/reasons-for-removal-of-non-tunneled-double-lumen-catheters-in-incident-dialysis-patients
#13
Ruqaya Qureshi, Beena Salman, Salman Imtiaz, Murtaza F Drohlia, Aasim Ahmad
OBJECTIVE: To evaluate the reasons of removal of non-tunneled double lumen catheters (NTDLC) in incident hemodialysis (HD) patients in a tertiary renal care hospital. STUDY DESIGN: Observational retrospective study. PLACE AND DURATION OF STUDY: Department of Nephrology, The Kidney Centre Postgraduate Training Institute (TKC PGTI), Karachi, from June 2015 to May 2016. METHODOLOGY: All patients were selected who had naive NTDLC placement at TKC PGTI either in Emergency Room (ER) or Intensive Care Unit (ICU) during the study period...
April 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29614572/-four-cases-of-acute-respiratory-distress-syndrome-patients-transported-with-veno-venous-extracorporeal-membrane-oxygenation
#14
Z Zhao, X Y Hong, Y Y Liu, X J Zhang, L S Bao, H T Gao, X H Liu, Z C Feng
Objective: To retrospectively review 4 cases diagnosed with pediatric acute respiratory distress syndrome (ARDS) who were transported with veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) from April 2016 to March 2017. Methods: Four patients were transported to Bayi Children's Hospital Afflicted to the PLA Army General Hospital, with V-V ECMO. Their vital signs, blood-gas analysis and chest X-ray before and after transportation were compared. The length of ECMO, pediatric intensive care unit (PICU) stay and hospitalization, and the prognosis were analyzed...
April 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29610936/impact-of-intravascular-thrombosis-on-failure-of-radial-arterial-catheters-in-critically-ill-patients-a-nested-case-control-study
#15
Yvan Fleury, Diego Arroyo, Caroline Couchepin, Helia Robert-Ebadi, Marc Righini, Johannes A Lobrinus, Bara Ricou, Nathalie Delieuvin Schmitt, Angèle Gayet-Ageron
PURPOSE: The patency of arterial catheters is essential for reliable invasive blood pressure monitoring. We sought to determine whether radial catheter failures were associated with intravascular thrombosis in critically ill adult patients. METHODS: This unmatched case-control study was conducted within a prospective cohort of patients admitted to an intensive care unit. The arterial catheter failure was the main outcome, which identified cases. Controls were patients with patent catheter until removal or 28 days of follow-up...
April 2, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29607491/increased-single-balloon-foley-catheter-volume-for-induction-of-labor-and-time-to-delivery-a-systematic-review-and-meta-analysis
#16
Corina N Schoen, Gabriele Saccone, Sami Backley, Evelien M Sandberg, Ning Gu, Shani Delaney, Vincenzo Berghella
INTRODUCTION: Induction of labor is a common intervention. The objective was to investigate whether larger Foley catheter volumes for labor induction decrease the total time from induction to delivery. MATERIAL AND METHODS: Randomized controlled trials comparing larger single-balloon volumes (60-80 mL) during Foley catheter cervical ripening with usual volume (30 mL) in women undergoing labor induction were identified by searching electronic databases (MEDLINE, Scopus, ClinicalTrials...
April 1, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29603269/nutrition-delivery-during-pediatric-extracorporeal-membrane-oxygenation-therapy
#17
Lindsey B Armstrong, Katelyn Ariagno, Craig D Smallwood, Charles Hong, Mary Arbuthnot, Nilesh M Mehta
BACKGROUND: Macronutrient delivery during pediatric ECMO therapy can be challenging. We examined predictors of nutrient delivery in the first 2 weeks of extracorporeal membrane oxygenation (ECMO) therapy in the pediatric intensive care unit (ICU). METHODS: Details of macronutrient delivery were recorded in children (newborn-18 years of age) who survived 24 hours after cannulation to ECMO over a 3-year period (2012-2015). RESULTS: We analyzed data from 54 consecutive eligible patients, 43% female, with median (interquartile range) ECMO duration of 8...
March 30, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29582429/early-intervention-mobilization-or-active-exercise-for-critically-ill-adults-in-the-intensive-care-unit
#18
REVIEW
Katherine A Doiron, Tammy C Hoffmann, Elaine M Beller
BACKGROUND: Survivors of critical illness often experience a multitude of problems that begin in the intensive care unit (ICU) or present and continue after discharge. These can include muscle weakness, cognitive impairments, psychological difficulties, reduced physical function such as in activities of daily living (ADLs), and decreased quality of life. Early interventions such as mobilizations or active exercise, or both, may diminish the impact of the sequelae of critical illness. OBJECTIVES: To assess the effects of early intervention (mobilization or active exercise), commenced in the ICU, provided to critically ill adults either during or after the mechanical ventilation period, compared with delayed exercise or usual care, on improving physical function or performance, muscle strength and health-related quality of life...
March 27, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29580304/impact-of-discontinuing-contact-precautions-for-methicillin-resistant-staphylococcus-aureus-and-vancomycin-resistant-enterococcus-an-interrupted-time-series-analysis
#19
Gonzalo Bearman, Salma Abbas, Nadia Masroor, Kakotan Sanogo, Ginger Vanhoozer, Kaila Cooper, Michelle Doll, Michael P Stevens, Michael B Edmond
OBJECTIVETo investigate the impact of discontinuing contact precautions among patients infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) on rates of healthcare-associated infection (HAI). DESIGN: Single-center, quasi-experimental study conducted between 2011 and 2016.METHODSWe employed an interrupted time series design to evaluate the impact of 7 horizontal infection prevention interventions across intensive care units (ICUs) and hospital wards at an 865-bed urban, academic medical center...
March 27, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29576822/predisposing-factors-clinical-assessment-management-and-outcomes-of-agitation-in-the-trauma-intensive-care-unit
#20
Saeed Mahmood, Omaima Mahmood, Ayman El-Menyar, Mohammad Asim, Hassan Al-Thani
BACKGROUND: Agitation occurs frequently among critically ill patients admitted to the intensive care unit (ICU). We aimed to evaluate the frequency, predisposing factors and outcomes of agitation in trauma ICU. METHODS: A retrospective analysis was conducted to include patients who were admitted to the trauma ICU between April 2014 and March 2015. Data included patient's demographics, initial vitals, associated injuries, Ramsey Sedation Scale, Glasgow Coma Scale, head injury lesions, use of sedatives and analgesics, head interventions, ventilator days, and ICU length of stay...
2018: World Journal of Emergency Medicine
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