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thromboembolism icu

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https://www.readbyqxmd.com/read/27903458/cardiac-arrest-among-patients-with-infections-causes-clinical-practice-and-research-implications
#1
REVIEW
Davide Leoni, Jordi Rello
The incidence of sepsis is increasing, and the condition is now the leading cause of death in general intensive care units (ICUs). Our review failed to identify studies of the causes of cardiac arrest among infected patients, even though non-cardiac causes represent 15% of out-of-hospital cardiac arrests and though one-third of events have positive blood cultures. Sudden cardiac arrest is the result of local damage to the heart and of the impact of systemic and pulmonary conditions on cardiac performance, and its danger is underestimated...
November 26, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27850788/1151-implementing-a-venous-thromboembolism-prevention-program-in-the-pediatric-intensive-care-unit
#2
Beth Wathen, Pamela Reiter, Bryce Clark, Brian Branchford
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27818170/association-between-delivery-methods-for-red-blood-cell-transfusion-and-the-risk-of-venous-thromboembolism-a-longitudinal-study
#3
Mary A M Rogers, Neil Blumberg, Steven J Bernstein, Scott A Flanders, Vineet Chopra
BACKGROUND: Mechanisms of red blood cell delivery and their contribution to the incidence of venous thromboembolism are not well understood in the clinical setting. We assessed whether red blood cell transfusion through peripherally inserted central catheters (PICCs) affects the risk of venous thromboembolism compared with transfusion through non-PICC devices. METHODS: We implemented a prospective study between Jan 1, 2013, and Sept 12, 2015, in patients (age ≥18 years) admitted to a general medicine ward or intensive care unit who received a PICC for any reason during clinical care in 47 hospitals in Michigan, USA, with a maximum follow-up of 70 days...
November 3, 2016: Lancet Haematology
https://www.readbyqxmd.com/read/27766677/surgical-management-of-driveline-infections-in-patients-with-left-ventricular-assist-devices
#4
Marina Pieri, Anna Mara Scandroglio, Marcus Müller, Panagiotis Pergantis, Alexandra Kretzschmar, Friedrich Kaufmann, Volkmar Falk, Thomas Krabatsch, Georg Arlt, Evgenij Potapov, Marian Kukucka
BACKGROUND AND AIM OF THE STUDY: Driveline infections in patients with implantable left ventricular assist devices (VAD) carry increasing risk for pump infection, thromboembolic events, decreased quality of life, and increased hospitalization. We report our experience with a surgical technique for refractory driveline infections without mediastinitis consisting of translocation and wrapping of the driveline with greater omentum tissue. METHODS: We retrospectively reviewed data of VAD patients who underwent surgical treatment by translocation and wrapping with omentum for severe chronic driveline infection...
December 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27764143/outcomes-in-critically-ill-patients-with-cancer-related-complications
#5
Viviane B L Torres, Juliana Vassalo, Ulysses V A Silva, Pedro Caruso, André P Torelly, Eliezer Silva, José M M Teles, Marcos Knibel, Ederlon Rezende, José J S Netto, Claudio Piras, Luciano C P Azevedo, Fernando A Bozza, Nelson Spector, Jorge I F Salluh, Marcio Soares
INTRODUCTION: Cancer patients are at risk for severe complications related to the underlying malignancy or its treatment and, therefore, usually require admission to intensive care units (ICU). Here, we evaluated the clinical characteristics and outcomes in this subgroup of patients. MATERIALS AND METHODS: Secondary analysis of two prospective cohorts of cancer patients admitted to ICUs. We used multivariable logistic regression to identify variables associated with hospital mortality...
2016: PloS One
https://www.readbyqxmd.com/read/27752976/pharmacogenomics-and-pharmacogenetics-for-the-intensive-care-unit-a-narrative-review
#6
Meghan MacKenzie, Richard Hall
PURPOSE: Knowledge of how alterations in pharmacogenomics and pharmacogenetics may affect drug therapy in the intensive care unit (ICU) has received little study. We review the clinically relevant application of pharmacogenetics and pharmacogenomics to drugs and conditions encountered in the ICU. SOURCE: We selected relevant literature to illustrate the important concepts contained within. PRINCIPAL FINDINGS: Two main approaches have been used to identify genetic abnormalities - the candidate gene approach and the genome-wide approach...
October 17, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27688669/recombinant-activated-factor-vii-for-uncontrolled-bleeding-postcardiac-surgery
#7
Aly Makram Habib, Ahmed Yehia Mousa, Zohair Al-Halees
UNLABELLED: A retrospective observational study to review the safety and efficacy of rFVIIa in persistent hemorrhage in post cardiac surgical patients. METHODS: Patients who had bleeding of 3 ml/kg/h or more for 2 consecutive hours after cardiac surgery were arranged into two groups; control group, who received conventional treatment and rFVIIa group, who received conventional treatment and rFVIIa. RESULTS: There was no significant difference in demographic and surgical characteristics of both groups...
October 2016: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/27688624/comparison-of-low-and-high-dose-recombinant-activated-factor-vii-for-postcardiac-surgical-bleeding
#8
Aly Makram Habib
AIM OF THE STUDY: A retrospective observational study to compare safety and efficacy of high and low doses of recombinant activated factor VIIa (rFVIIa) in severe postcardiac surgical bleeding. PATIENTS AND METHODS: From 2004 to 2014, all patients who received rFVIIa for bleeding after cardiac surgery were included and arranged in two groups; Group 1: Low dose (40-50 mcg/kg) (n = 98) and Group 2: High dose (90-120 mcg/kg) (n = 156). RESULTS: There was no significant difference in demographic and surgical characteristics of both groups on admission to Cardiac Surgical Intensive Care Unit (CSICU)...
September 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27682749/association-of-mechanism-of-injury-with-risk-for-venous-thromboembolism-after-trauma
#9
Charles A Karcutskie, Jonathan P Meizoso, Juliet J Ray, Davis Horkan, Xiomara D Ruiz, Carl I Schulman, Nicholas Namias, Kenneth G Proctor
Importance: To date, no study has assessed whether the risk of venous thromboembolism (VTE) varies with blunt or penetrating trauma. Objective: To test whether the mechanism of injury alters risk of VTE after trauma. Design, Setting, and Participants: A retrospective database review was conducted of adults admitted to the intensive care unit of an American College of Surgeons-verified level I trauma center between August 1, 2011, and January 1, 2015, with blunt or penetrating injuries...
September 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27643835/the-impact-of-peripheral-nerve-blocks-on-perioperative-outcome-in-hip-and-knee-arthroplasty-a-population-based-study
#10
Stavros G Memtsoudis, Jashvant Poeran, Crispiana Cozowicz, Nicole Zubizarreta, Umut Ozbek, Madhu Mazumdar
The role of anesthesia techniques on perioperative outcomes on a population level has recently gained widespread interest. Although mainly neuraxial vs general anesthesia has been addressed, population-level data on the impact of peripheral nerve blocks (PNBs) are still lacking. Therefore, we investigated the association between PNB use and outcomes using retrospective data on 1,062,152 recipients of hip and knee arthroplasties (total hip arthroplasty [THA]/total knee arthroplasty [TKA]) from the national Premier Perspective database (2006-2013)...
October 2016: Pain
https://www.readbyqxmd.com/read/27628009/deep-vein-thrombosis-in-intensive-care
#11
Maria Boddi, Adriano Peris
Venous thromboembolism (VTE) which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) is a severe complication in critically ill patients generally affected by multiorgan disfunction associated with immobilization also prolonged.Nowadays, VTE prophylaxis is included in the requirements of hospital accreditation and evaluation of the maintenance of standards of quality of care. ICU patients are characterized by a dynamic day-to-day variation both of thromboembolic that bleeding risk and DVT incidence in presence of thromboprophylaxis ranges between 5 and 15 %...
September 15, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27618376/progressive-mobility-protocol-reduces-venous-thromboembolism-rate-in-trauma-intensive-care-patients-a-quality-improvement-project
#12
Kathryn Booth, Josh Rivet, Richelle Flici, Ellen Harvey, Mark Hamill, Douglas Hundley, Katelyn Holland, Sandra Hubbard, Apurva Trivedi, Bryan Collier
The intensive care unit (ICU) trauma population is at high risk for complications associated with immobility. The purpose of this project was to compare ICU trauma patient outcomes before and after implementation of a structured progressive mobility (PM) protocol. Outcomes included hospital and ICU stays, ventilator days, falls, respiratory failure, pneumonia, or venous thromboembolism (VTE). In the preintervention cohort, physical therapy (PT) consults were placed 53% of the time. This rose to more than 90% during the postintervention period...
September 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27558534/4-factor-prothrombin-complex-concentrate-pcc4-kcentra%C3%A2-protocol-reduces-blood-requirements-for-heart-transplantation-a-novel-protocol
#13
Jacqueline Pratt Cleary, Laura Hodge, Brittany Palmer, Christopher J Barreiro, Amanda Ingemi
BACKGROUND All patients with a ventricular assist device (VAD) awaiting heart transplantation are anticoagulated with warfarin to prevent thromboembolism. The use of 4 factor prothrombin complex concentrate (PCC4, Kcentra®) for anticoagulation reversal prior to surgery may include benefits such as quicker reversal, longer duration of action, and a reduction in total volume of blood products used compared to other reversal practices. The study objective is to evaluate benefits of using an anticoagulation reversal protocol featuring PCC4, over standard of care in heart transplant patients requiring anticoagulation...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/27555152/cardiac-arrest-during-radical-nephrectomy-due-to-a-mass-in-the-right-ventricular-outflow-tract
#14
Hee Young Kim, Seung-Hoon Baek, Ji Uk Yoon, Dong Hoon Lee, Gyeong-Jo Byeon, Ji Hye Ahn
We report cardiac arrest due to obstruction of the right ventricular outflow tract (RVOT) caused by an RVOT mass that was not identified preoperatively. A 62-year-old woman with renal cell carcinoma (RCC) experienced deteriorating hypotension and bradycardia during radical nephrectomy. Hemodynamic stability was maintained on extracorporeal membrane oxygenation, and after surgery, she was transferred to the intensive care unit. On postoperative day 3, transthoracic echocardiography showed an intracardiac mass obstructing the RVOT, which caused severe functional pulmonary stenosis and moderate resting pulmonary hypertension...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27546747/prevalence-and-factors-associated-with-the-absence-of-pharmacologic-venous-thromboembolism-prophylaxis-a-cross-sectional-study-of-georgia-intensive-care-units
#15
Anthony Hawkins, Michael Mazzeffi, Prasad Abraham, Christopher Paciullo
PURPOSE: The need for venous thromboembolism prophylaxis is well accepted in the intensive care unit (ICU) and supported by a variety of guideline recommendations. Several studies have highlighted poor adherence to these recommendations, but it is unknown why this discrepancy exists. The aim of this study is assess the prevalence of pharmacoprophylaxis and characterize the practice of withholding prophylaxis. MATERIALS AND METHODS: Multicenter, cross-sectional study conducted in adults admitted to a Georgia ICU at participating institutions on March 12, 2014...
June 22, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27537564/a-nationwide-study-of-acquired-c1-inhibitor-deficiency-in-france-characteristics-and-treatment-responses-in-92-patients
#16
Delphine Gobert, Romain Paule, Denise Ponard, Pierre Levy, Véronique Frémeaux-Bacchi, Laurence Bouillet, Isabelle Boccon-Gibod, Christian Drouet, Stéphane Gayet, David Launay, Ludovic Martin, Arsène Mekinian, Véronique Leblond, Olivier Fain
Acquired angioedema (AAE) due to C1-inhibitor (C1INH) deficiency is rare. Treatment options for acute attacks are variable and used off-label. Successful treatment of the associated lymphoma with rituximab seems to prevent acute attacks in subjects with AAE. The aim of this study was to describe AAE manifestations, its associated diseases, and patients' responses to treatments in a representative cohort.A retrospective nationwide study was conducted in France. The inclusion criteria were recurrent angioedema attacks and an acquired decrease in functional C1INH <50% of the reference value...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27488490/anti-xa-guided-enoxaparin-thromboprophylaxis-reduces-rate-of-deep-venous-thromboembolism-in-high-risk-trauma-patients
#17
George A Singer, Gina Riggi, Charles A Karcutskie, Tanaz M Vaghaiwalla, Howard M Lieberman, Enrique Ginzburg, Nicholas Namias, Edward B Lineen
BACKGROUND: Appropriate prophylaxis against venous thromboembolism (VTE) remains undefined. This study evaluated an anti-Xa-guided enoxaparin thromboprophylaxis protocol on the incidence of VTE in high-risk trauma patients based upon Greenfield's Risk Assessment Profile (RAP) score. METHODS: This is a retrospective observational study of patients admitted to a trauma ICU over a 12-month period. Patients were included if they received anti-Xa-guided enoxaparin thromboprophylaxis...
August 3, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27464648/the-bariatric-patient-in-the-intensive-care-unit-pitfalls-and-management
#18
REVIEW
Carlos E Pompilio, Paolo Pelosi, Melina G Castro
The increasing number of bariatric/metabolic operations as important alternatives for the treatment of obesity and type 2 diabetes brought several concerns about the intensive care of patients undergoing those procedures. Intensive Care Unit admission criteria are needed in order to better allocate resources and avoid unnecessary interventions. Furthermore, well-established protocols, helpful in many clinical situations, are not directly applicable to obese patients. Indeed, difficult airway management, mechanical ventilation, fluid therapy protocols, prophylaxis, and treatment of venous thromboembolic events have unique aspects that should be taken into consideration...
September 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27402424/perioperative-management-of-pediatric-en-bloc-combined-heart-liver-transplants-a-case-series-review
#19
Manchula Navaratnam, Ann Ng, Glyn D Williams, Katsuhide Maeda, Julianne M Mendoza, Waldo Concepcion, Seth A Hollander, Chandra Ramamoorthy
BACKGROUND: Combined heart and liver transplantation (CHLT) in the pediatric population involves a complex group of patients, many of whom have palliated congenital heart disease (CHD) involving single ventricle physiology. OBJECTIVE: The purpose of this study was to describe the perioperative management of pediatric patients undergoing CHLT at a single institution and to identify management strategies that may be used to optimize perioperative care. METHODS: We did a retrospective database review of all patients receiving CHLT at a children's hospital between 2006 and 2014...
October 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27401184/risk-factors-for-mortality-in-patients-admitted-to-intensive-care-units-with-pneumonia
#20
Guowei Li, Deborah J Cook, Lehana Thabane, Jan O Friedrich, Tim M Crozier, John Muscedere, John Granton, Sangeeta Mehta, Steven C Reynolds, Renato D Lopes, Lauzier Francois, Andreas P Freitag, Mitchell A H Levine
BACKGROUND: Despite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited. METHODS: In this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship between baseline and time-dependent variables and hospital and ICU mortality...
July 11, 2016: Respiratory Research
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