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https://www.readbyqxmd.com/read/28343880/-acute-respiratory-distress-syndrome-in-childhood-changing-definition-and-news-from-the-pediatric-consensus-conference
#1
S Dauger, F Le Bourgeois, J Guichoux, O Brissaud
Acute respiratory distress syndrome (ARDS) is a rapidly progressive hypoxemic respiratory insufficiency induced by alveolar filling mainly caused by alveolocapillary wall disruption, following direct or indirect pulmonary injury. Much less frequent in children than in adults, pediatric intensivists had long applied adult guidelines to their daily practice. In 2015, experts from the Pediatric Acute Lung Injury Consensus Conference (PALICC) published the first international guidelines specifically dedicated to pediatric ARDS...
March 23, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28340911/ultrasound-guided-vascular-cannulation-in-critical-care-patients-a-practical-review
#2
P Blanco
Vascular cannulation is common practice in critical care, and is traditionally performed using the landmark technique - though failures and complications are not uncommon. In this regard, ultrasound guided vascular cannulation (USGVC) has been shown to improve the procedure success rate and reduce its associated complications. This review addresses the fundamental aspects of USGVC and discusses some training issues related to this technique which is currently regarded as essential for intensivists.
December 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/28336016/review-of-issues-and-challenges-of-practicing-emergency-medicine-above-30-000-feet-altitude-2-anonymized-cases
#3
Kam Lun Hon, Karen Ka Yan Leung
We present 2 anonymized cases to identify issues and challenges associated with long-haul in-flight medical emergencies. The first case involved a middle-aged man with a history of carditis on a systemic steroid who developed vomiting and rigor. Four physicians, including a pediatric intensivist, responded to the emergency call. In the second case, a pediatric trainee who was the only onboard medical personnel was summoned for help when a middle-aged man developed acute shortness of breath while traveling on a commercial flight...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28336015/ten-years-of-en-route-critical-care-training
#4
Mathieu Boutonnet, Pierre Pasquier, Laurent Raynaud, Laurent Vitiello, Jérôme Bancarel, Sébastien Coste, Guillaume Pelée de Saint Maurice, Sylvain Ausset
OBJECTIVE: The French Military Health Service (FMHS) has developed a training program for medical evacuation (MEDEVAC) of critical care patients on fixed wing aircraft. METHODS: We conducted a 10-year retrospective analysis (2006-2015) of the data from the FMHS Academy. The number of trainees was listed according to the different courses and medical specialties. The number of MEDEVACs recorded during the period was described. RESULTS: Since 2006, the FMHS has developed training courses designed for MEDEVAC of critical care patients...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#5
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#6
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28298944/4-point-ultrasonography-to-confirm-the-correct-position-of-the-nasogastric-tube-in-114-critically-ill-patients
#7
Marianna Zatelli, Norberto Vezzali
PURPOSE: Nasogastric feeding tube is routinely positioned in intensive care units. The complications of misplacement are rare but very dangerous for the patients. The aim of this study is to estimate the diagnostic accuracy of this new technique, 4-point ultrasonography to confirm nasogastric tube placement in intensive care. METHODS: One hundred fourteen critical ill patients monitored in ICU were included. The intensivist provided in real time to perform the exam in four steps: sonography from either the right or left side of the patient's neck to visualize the esophagus, sonography of epigastrium to confirm the passage through the esophagogastric junction and the positioning in antrum, sonography of the fundus...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28282303/diversity-in-the-emerging-critical-care-workforce-analysis-of-demographic-trends-in-critical-care-fellows-from-2004-to-2014
#8
Meghan B Lane-Fall, Todd A Miano, Jaya Aysola, John G T Augoustides
OBJECTIVES: Diversity in the physician workforce is essential to providing culturally effective care. In critical care, despite the high stakes and frequency with which cultural concerns arise, it is unknown whether physician diversity reflects that of critically ill patients. We sought to characterize demographic trends in critical care fellows, who represent the emerging intensivist workforce. DESIGN: We used published data to create logistic regression models comparing annual trends in the representation of women and racial/ethnic groups across critical care fellowship types...
March 9, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28279496/outcomes-of-nighttime-refusal-of-admission-to-the-intensive-care-unit-the-role-of-the-intensivist-in-triage
#9
Nicholas Hinds, Amit Borah, Erika J Yoo
PURPOSE: To compare outcomes of patients refused medical intensive care unit (MICU) admission overnight to those refused during the day and to examine the impact of the intensivist in triage. MATERIALS AND METHODS: Retrospective, observational study of patients refused MICU admission at an urban university hospital. RESULTS: Of 294 patients, 186 (63.3%) were refused admission overnight compared to 108 (36.7%) refused during the day. Severity-of-illness by the Mortality Probability Model was similar between the two groups (P=...
February 14, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28277245/surgery-start-time-does-not-impact-outcome-in-elective-cardiac-surgery
#10
Joshua A Heller, Rishi Kothari, Hung-Mo Lin, Matthew A Levin, Menachem Weiner
OBJECTIVE: Determine if surgery start time impacts patient outcomes in elective cardiac surgery. DESIGN: This was a retrospective study. SETTING: This study was based at a single academic institution. PARTICIPANTS: Patients undergoing elective cardiac surgery over a 3-year period were included. INTERVENTIONS: There were no interventions. MEASUREMENTS AND MAIN RESULTS: The authors performed a retrospective study of patients undergoing elective cardiac surgery over a 3-year period...
August 17, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28276672/current-adoption-of-lung-ultrasound-in-intensive-care-units-an-italian-multi-centre-survey
#11
Italo Calamai, Massimiliano Greco, Guido Bertolini, Rosario Spina
BACKGROUND: Lung ultrasound (LUS) is a useful tool for assessing lung status in critically ill patients, but is not widely applied in intensive care units (ICUs). The aim of this study was to investigate the use of LUS in Italian ICUs. METHODS: A questionnaire was distributed to 116 ICU representatives belonging to the Italian GiViTI network, participating in a national project on continuous quality of care assessment. The answers to the questionnaire were analysed with the data collected in the course of said project...
March 7, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28271450/patient-important-outcomes-in-randomized-controlled-trials-in-critically-ill-patients-a-systematic-review
#12
REVIEW
Stéphane Gaudry, Jonathan Messika, Jean-Damien Ricard, Sylvie Guillo, Blandine Pasquet, Emeline Dubief, Tanissia Boukertouta, Didier Dreyfuss, Florence Tubach
BACKGROUND: Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-important outcomes are reported in published randomized controlled trials (RCTs) in critically ill patients. METHODS: Literature search was conducted to identify eligible trials indexed from January to December 2013...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28271320/the-icm-research-agenda-on-critical-care-ultrasonography
#13
REVIEW
P Mayo, R Arntfield, M Balik, P Kory, G Mathis, G Schmidt, M Slama, G Volpicelli, N Xirouchaki, A McLean, A Vieillard-Baron
PURPOSE: Critical care ultrasonography has utility for the diagnosis and management of critical illness and is in widespread use by frontline intensivists. As there is a need for research to validate and extend its utility, the Editor of Intensive Care Medicine included critical care ultrasonography as a topic in the ICM Research Agenda issue. METHODS: Eleven international experts in the field of critical care ultrasonography contributed to the writing project. With the intention of developing a research agenda for the field, they reviewed best standards of care, new advances in the field, common beliefs that have been contradicted by recent trials, and unanswered questions related to critical care ultrasonography...
March 7, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28270114/violation-of-prophylactic-vancomycin-administration-timing-is-a-potential-risk-factor-for-rate-of-surgical-site-infections-in-cardiac-surgery-patients-a-prospective-cohort-study
#14
Paolo Cotogni, Cristina Barbero, Roberto Passera, Lucina Fossati, Giorgio Olivero, Mauro Rinaldi
BACKGROUND: Intensivists and cardiothoracic surgeons are commonly worried about surgical site infections (SSIs) due to increasing length of stay (LOS), costs and mortality. The antimicrobial prophylaxis is one of the most important tools in the prevention of SSIs. The objective of this study was to investigate the relationship between the timing of antimicrobial prophylaxis administration and the rate of SSIs. METHODS: A prospective cohort study was carried out over 1-year period in all consecutive adult patients undergoing elective cardiac surgery...
March 8, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28255613/intensive-care-medicine-research-agenda-on-invasive-fungal-infection-in-critically-ill-patients
#15
REVIEW
Matteo Bassetti, Jose Garnacho-Montero, Thierry Calandra, Bartjan Kullberg, George Dimopoulos, Elie Azoulay, Arunaloke Chakrabarti, Daniel Kett, Cristobal Leon, Luis Ostrosky-Zeichner, Maurizio Sanguinetti, Jean-Francois Timsit, Malcom D Richardson, Andrew Shorr, Oliver A Cornely
PURPOSE: To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. METHODS: A systematic review of the medical literature taking account of national and international guidelines and expert opinion...
March 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28242771/improving-outcomes-from-high-risk-surgery-a-multimethod-evaluation-of-a-patient-centred-advanced-care-planning-intervention
#16
Amanda Selwood, Siva Senthuran, Brette Blakely, Paul Lane, John North, Robyn Clay-Williams
INTRODUCTION: Patients who are frail, have multiple comorbidities or have a terminal illness often have poor outcomes from surgery. However, sole specialists may recommend surgery in these patients without consultation with other treating clinicians or allowing for patient goals. The Patient-Centred Advanced Care Planning (PC-ACP) model of care provides a framework in which a multidisciplinary advanced care plan is devised to incorporate high-risk patients' values and goals. Decision-making is performed collaboratively by patients, their family, surgeons, anaesthetists, intensivists and surgical case managers...
February 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28239054/critical-care-management-focused-on-optimizing-brain-function-after-cardiac-arrest
#17
Ryuta Nakashima, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Satoshi Egawa, Akihiko Inoue, Ryutaro Seo, Nobuhiro Inagaki, Yasuhiro Kuroda
The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia...
February 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28236174/prone-positioning-in-acute-respiratory-distress-syndrome-after-abdominal-surgery-a-multicenter-retrospective-study-sapronadonf-study-of-ards-and-prone-position-after-abdominal-surgery-in-france
#18
Stéphane Gaudry, Samuel Tuffet, Anne-Claire Lukaszewicz, Christian Laplace, Noémie Zucman, Marc Pocard, Bruno Costaglioli, Simon Msika, Jacques Duranteau, Didier Payen, Didier Dreyfuss, David Hajage, Jean-Damien Ricard
BACKGROUND: The recent demonstration of prone position's strong benefit on patient survival has rendered proning a major therapeutic intervention in severe ARDS. Uncertainties remain as to whether or not ARDS patients in the postoperative period of abdominal surgery should be turned prone because of the risk of abdominal complications. Our aim was to investigate the prevalence of surgical complications between patients with and without prone position after abdominal surgery. METHODS: This study was a multicenter retrospective cohort of patients with ARDS in a context of recent abdominal surgery...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28229241/acquired-prolongation-of-qt-interval-as-a-risk-factor-for-torsade-de-pointes-ventricular-tachycardia-a-narrative-review-for-the-anesthesiologist-and-intensivist
#19
REVIEW
Arsen Uvelin, Jasmina Pejaković, Vesna Mijatović
More than 70% of intensive care unit (ICU) patients experience heart rhythm disturbances, and these patients have correspondingly higher mortality rates. Consequently, one of the standards of care in ICUs is continuous electrocardiography monitoring. One of the potentially preventable dysrhythmic events is the occurrence of torsade de pointes ventricular tachycardia in the setting of acquired prolonged QT interval. This type of ventricular tachycardia can be malignant because it often progresses to ventricular fibrillation...
February 22, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28220224/what-do-sepsis-induced-coagulation-test-result-abnormalities-mean-to-intensivists
#20
EDITORIAL
Marcel Levi, Marcus J Schultz
No abstract text is available yet for this article.
April 2017: Intensive Care Medicine
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