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https://www.readbyqxmd.com/read/28185627/epidemiology-of-bleeding-in-critically-ill-children
#1
Lauren J White, Ryan Fredericks, Candace N Mannarino, Stephen Janofsky, Edward Vincent S Faustino
OBJECTIVE: To determine the epidemiology of bleeding in critically ill children. STUDY DESIGN: We conducted a cohort study of children <18 years old admitted to the pediatric intensive care unit for >24 hours and without clinically relevant bleed (CRB) on admission. CRB was defined as resulting in severe physiologic derangements, occurring at a critical site or requiring major therapeutic interventions. Using a novel bleeding assessment tool that we developed, characteristics of the CRB were abstracted from the medical records independently and in duplicate...
February 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28157394/how-well-prepared-are-medical-and-nursing-students-to-identify-common-hazards-in-the-icu
#2
Alison S Clay, Saumil M Chudgar, Kathleen M Turner, Jacqueline Vaughn, Nancy W Knudsen, Jeanne M Farnan, Vineet M Arora, Margory A Molloy
RATIONALE: Care in the hospital is hazardous. Harm in the hospital may prolong hospitalization, increase suffering, result in death, and increase costs of care. While the interprofessional team is critical to eliminating hazards that may result in adverse events to patients, professional students' formal education may not prepare students adequately for this role. OBJECTIVES: To determine if medical and nursing students can identify hazards of hospitalization that could result in harm to patients and to detect differences between professions in the types of hazards identified...
February 3, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28110095/prophylaxis-for-stress-ulcers-with-proton-pump-inhibitors-is-not-associated-with-increased-risk-of-bloodstream-infections-in-the-intensive-care-unit
#3
Margot E Cohen, Joanne M Hathway, Hojjat Salmasian, Jianfang Liu, Melissa Terry, Julian A Abrams, Daniel E Freedberg
BACKGROUND & AIMS: Proton pump inhibitors (PPIs) have been associated with increased risk of infection, likely due to changes in intestinal epithelial permeability and the gastrointestinal microbiome. PPIs are frequently given to patients in the intensive care unit (ICU) to prevent stress ulcers. These patients are at risk for bloodstream infections (BSIs), so we investigated the relationship between PPI use and BSIs among patients in the ICU. METHODS: We performed a retrospective cohort study of adults (≥18 years) admitted to 1 of 14 ICUs within a hospital network of 3 large hospitals from 2008 through 2014...
January 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28093644/guidelines-for-proton-pump-inhibitor-prescriptions-in-paediatric-intensive-care-unit
#4
P Joret-Descout, S Dauger, M Bellaiche, O Bourdon, S Prot-Labarthe
Background Stress ulcer prophylaxis (SUP) is recommended in some situations to prevent upper gastrointestinal bleeding and is a component of standard care for patients admitted to the intensive care unit (ICU). Proton pump inhibitors (PPIs), already among the most widely prescribed drug classes, are being increasingly used. Objective To describe PPI prescribing patterns and their changes after the dissemination of guidelines. Setting Paediatric ICU (PICU), Robert-Debré Teaching Hospital, Paris, France, which admits about 800 patients annually, from full-term neonates to 18-year-olds...
February 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28068292/a-rabbit-model-for-assessment-of-volatile-metabolite-changes-observed-from-skin-a-pressure-ulcer-case-study
#5
Michael Schivo, Alexander A Aksenov, Alberto Pasamontes, Raquel Cumeras, Sandra Weisker, Anita M Oberbauer, Cristina E Davis
Human skin presents a large, easily accessible matrix that is potentially useful for diagnostic applications based on whole body metabolite changes-some of which will be volatile and detected using minimally invasive tools. Unfortunately, identifying skin biomarkers that can be reliably linked to a particular condition is challenging due to a large variability of genetics, dietary intake, and environmental exposures within human populations. This leads to a paucity of clinically validated volatile skin biomarker compounds...
January 9, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28065217/early-enteral-combined-with-parenteral-nutrition-treatment-for-severe-traumatic-brain-injury-effects-on-immune-function-nutritional-status-and-outcomes-%C3%A2
#6
Fan Ming-Chao, Wang Qiao-Ling, Fang Wei, Jiang Yun-Xia, Li Lian-di, Sun Peng, Wang Zhi-Hong
Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN) with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patients with severe traumatic brain injury (STBI). Methods A prospective randomized control trial was carried out from January 2009 to May 2012 in Neurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow Coma Scale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were admi- nistrated EN, PN or EN+PN treatments respectively...
November 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28006826/predictive-performance-of-the-simplified-acute-physiology-score-saps-ii-and-the-initial-sequential-organ-failure-assessment-sofa-score-in-acutely-ill-intensive-care-patients-post-hoc-analyses-of-the-sup-icu-inception-cohort-study
#7
Anders Granholm, Morten Hylander Møller, Mette Krag, Anders Perner, Peter Buhl Hjortrup
PURPOSE: Severity scores including the Simplified Acute Physiology Score (SAPS) II and the Sequential Organ Failure Assessment (SOFA) score are used in intensive care units (ICUs) to assess disease severity, predict mortality and in research. We aimed to assess the predictive performance of SAPS II and the initial SOFA score for in-hospital and 90-day mortality in a contemporary international cohort. METHODS: This was a post-hoc study of the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) inception cohort study, which included acutely ill adults from ICUs across 11 countries (n = 1034)...
2016: PloS One
https://www.readbyqxmd.com/read/27920417/intensive-care-unit-stress-ulcer-prophylaxis-is-it-still-needed
#8
EDITORIAL
Majid A Almadi, Alan N Barkun
No abstract text is available yet for this article.
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#9
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27903209/incidence-and-cost-of-stress-ulcer-prophylaxis-after-discharge-from-the-intensive-care-unit-a-retrospective-study
#10
Benedict Tan, Richard Norman, Ed Litton, Chloe Heath, David J Hawkins, Ravi Krishnamurthy, Ravikiran Sonawane, Matthew H Anstey
OBJECTIVE: To describe current patterns in initiation and cessation of proton pump inhibitors (PPIs) for stress ulcer prophylaxis (SUP) in intensive care units, and to assess the costs associated with inappropriate (non-evidence-based) SUP. DESIGN, SETTING AND PARTICIPANTS: Retrospective observational study in five ICUs in Western Australia. We assessed the medical records of consecutive patients admitted to the ICUs between September 2013 and January 2015. Patients aged < 18 years were excluded...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27884335/pneumonia-prevention-in-intubated-patients-given-sucralfate-versus-proton-pump-inhibitors-and-or-histamine-ii-receptor-blockers
#11
Gene A Grindlinger, Sarah B Cairo, Carole B Duperre
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common cause of infectious morbidity and mortality in the intensive care unit (ICU). The type of stress-ulcer prophylaxis (SUP) given to ventilated patients may, in part, be responsible. We observed an increase in VAP as ventilator bundle compliance increased and a decrease in VAP when bundle compliance decreased. We reasoned that SUP which raises gastric pH such as proton-pump inhibitors (PPIs) and histamine II (H2) receptor antagonists as opposed to SUP which does not raise pH such as sucralfate (S) may be responsible and also may alter the causative bacteria...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27837045/pharmacologic-stress-gastropathy-prophylaxis-may-not-be-necessary-in-at-risk-surgical-trauma-icu-patients-tolerating-enteral-nutrition
#12
Nicole M Palm, Brian McKinzie, Pamela L Ferguson, Emily Chapman, Margaret Dorlon, Evert A Eriksson, Brent Jewett, Stuart M Leon, Alicia R Privette, Samir M Fakhry
OBJECTIVE: Stress gastropathy is a rare complication of the intensive care unit stay with high morbidity and mortality. There are data that support the concept that patients tolerating enteral nutrition have sufficient gut blood flow to obviate the need for prophylaxis; however, no robust studies exist. This study assesses the incidence of clinically significant gastrointestinal bleeding in surgical trauma intensive care unit (STICU) patients at risk of stress gastropathy secondary to mechanical ventilation receiving enteral nutrition without pharmacologic prophylaxis...
November 10, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27809338/cost-effectiveness-of-histamine2-receptor-antagonists-versus-proton-pump-inhibitors-for-stress-ulcer-prophylaxis-in-critically-ill-patients
#13
Drayton A Hammond, Niranjan Kathe, Anuj Shah, Bradley C Martin
STUDY OBJECTIVE: To determine the cost-effectiveness of stress ulcer prophylaxis with histamine2 receptor antagonists (H2RAs) versus proton pump inhibitors (PPIs) in critically ill and mechanically ventilated adults. DESIGN: A decision analytic model estimating the costs and effectiveness of stress ulcer prophylaxis (with H2RAs and PPIs) from a health care institutional perspective. PATIENTS: Adult mixed intensive care unit (ICU) population who received an H2RA or PPI for up to 9 days...
January 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27795911/combined-application-of-nasogastric-tubes-and-nasointestinal-tubes-in-neurosurgical-intensive-care-patients-with-stress-ulceration-a-novel-solution-to-treatment-and-early-enteral-nutrition
#14
Tianshu Lu, Jingyu Guan
OBJECTIVE: Stress ulcers occur frequently in neurosurgical intensive care patients and can pose serious risks. We summarized the clinical experience of the combined application of nasointestinal tubes for early restoration of enteral nutrition and of nasogastric (NG) tubes for stress ulceration treatment in patients hospitalized in a neurosurgical intensive care unit. METHODS: From January 2011 to June 2011, a series of 67 patients with stress ulceration hospitalized in a neurosurgical intensive care unit were randomized to two groups...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27784575/the-appropriate-use-of-proton-pump-inhibitors-ppis-need-for-a-reappraisal
#15
REVIEW
Vincenzo Savarino, Pietro Dulbecco, Nicola de Bortoli, Andrea Ottonello, Edoardo Savarino
The advent of powerful acid-suppressive drugs, such as proton pump inhibitors (PPIs), has revolutionized the management of acid-related diseases and has minimized the role of surgery. The major and universally recognized indications for their use are represented by treatment of gastro-esophageal reflux disease, eradication of Helicobacter pylori infection in combination with antibiotics, therapy of H. pylori-negative peptic ulcers, healing and prophylaxis of non-steroidal anti-inflammatory drug-associated gastric ulcers and control of several acid hypersecretory conditions...
January 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27752605/a-revised-risk-analysis-of-stress-ulcers-in-burn-patients-receiving-ulcer-prophylaxis
#16
Young Hwan Choi, Jong Ho Lee, Jae Jun Shin, Young Soon Cho
OBJECTIVE: Most of the literature about Curling's ulcer was published from 1960 through 1980. Therefore, an updated study of Curling's ulcer is needed. We analyzed the risk factors affecting ulcer incidence in burn patients. METHODS: We retrospectively analyzed the medical records of burn patients who were admitted to two burn centers. We collected information about the general characteristics of patients, burn area size, abbreviated burn severity index, whether surgery was performed, endoscopy results, and the total body surface area (TBSA)...
December 2015: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27687720/prevention-of-critical-care-complications-in-the-coronary-intensive-care-unit-protocols-bundles-and-insights-from-intensive-care-studies
#17
REVIEW
Sean van Diepen, Wendy I Sligl, Jeffrey B Washam, Ian C Gilchrist, Rakesh C Arora, Jason N Katz
Over the past half century, coronary care units have expanded from specialized ischemia arrhythmia monitoring units into intensive care units (ICUs) for acutely ill and medically complex patients with a primary cardiac diagnosis. Patients admitted to contemporary coronary intensive care units (CICUs) are at risk for common and preventable critical care complications, yet many CICUs have not adopted standard-of-care prevention protocols and practices from general ICUs. In this article, we (1) review evidence-based interventions and care bundles that reduce the incidence of ventilator-associated pneumonia, excess sedation during mechanical ventilation, central line infections, stress ulcers, malnutrition, delirium, and medication errors and (2) recommend pragmatic adaptations for common conditions in critically ill patients with cardiac disease, and (3) provide example order sets and practical CICU protocol implementation strategies...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27635481/pantoprazole-or-placebo-for-stress-ulcer-prophylaxis-pop-up-randomized-double-blind-exploratory-study
#18
Shane P Selvanderan, Matthew J Summers, Mark E Finnis, Mark P Plummer, Yasmine Ali Abdelhamid, Michael B Anderson, Marianne J Chapman, Christopher K Rayner, Adam M Deane
OBJECTIVES: Pantoprazole is frequently administered to critically ill patients for prophylaxis against gastrointestinal bleeding. However, comparison to placebo has been inadequately evaluated, and pantoprazole has the potential to cause harm. Our objective was to evaluate benefit or harm associated with pantoprazole administration. DESIGN: Prospective randomized double-blind parallel-group study. SETTING: University-affiliated mixed medical-surgical ICU...
October 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27596079/-relationship-between-changes-of-increased-amylase-or-lipase-levels-and-pancreas-injury-in-critically-ill-children
#19
(no author information available yet)
OBJECTIVE: To observe the occurrence rate of elevated serum amylase and lipase in critically ill children, to explore the relationship between elevated pancreatic enzymes and pancreatic injury, and the effect of elevated pancreatic enzymes on state of illness and the prognosis. METHOD: The data of cases treated in pediatric intensive care unit(ICU) of 17 children's hospitals were collected prospectively from January 2012 to March 2014 according to the inclusion and exclusion criteria...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27512710/adherence-to-stress-related-mucosal-damage-prophylaxis-guideline-in-patients-admitted-to-the-intensive-care-unit
#20
Niloofar Rafinazari, Saeed Abbasi, Shadi Farsaei, Marjan Mansourian, Peyman Adibi
OBJECTIVE: Concern about adverse effects of the inconsistent use of stress-related mucosal damage prophylaxis in intensive care unit (ICU) is increasing. Hence, this study was designed to prospectively evaluate the rate of inappropriate stress ulcer prophylaxis (SUP) administration upon ICU admission, at ICU discharge and determine the adherence to American Society of Health-System Pharmacists (ASHP) guideline during ICU stay. METHODS: In this study, 200 patients were randomly selected from all ICU admissions during 9 months...
July 2016: Journal of Research in Pharmacy Practice
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