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https://www.readbyqxmd.com/read/29679702/alamandine-attenuates-sepsis-associated-cardiac-dysfunction-via-inhibiting-mapks-signaling-pathways
#1
Peng Li, Xi-Ru Chen, Fei Xu, Chi Liu, Chang Li, Hui Liu, Hui Wang, Wei Sun, Yan-Hui Sheng, Xiang-Qing Kong
Sepsis-induced myocardial dysfunction represents a major cause of death in intensive care units. Alamandine is an important biologically active peptide in the renin-angiotensin system. The present study evaluated whether alamandine improves cardiac dysfunction, inflammation, and apoptosis, and affects the signaling pathways involved in these events. Experiments were carried out in mice treated with lipopolysaccharide (LPS) or alamandine, and in neonatal rat cardiomyocytes. Alamandine increased the ejection fraction and fractional shortening, both of which were decreased upon LPS infusion in mice...
April 18, 2018: Life Sciences
https://www.readbyqxmd.com/read/29679694/the-introduction-of-a-rapid-response-system-in-acute-hospitals-a-pragmatic-stepped-wedge-cluster-randomised-controlled-trial
#2
Filip Haegdorens, Peter Van Bogaert, Ella Roelant, Koen De Meester, Marie Misselyn, Kristien Wouters, Koenraad G Monsieurs
AIM: Deterioration of hospitalised patients is often missed, misinterpreted, and mismanaged. Rapid Response Systems (RRSs) have been proposed to solve this problem. This study aimed to investigate the effect of an RRS on the incidence of unexpected death, cardiac arrest with cardiopulmonary resuscitation (CPR), and unplanned intensive care unit (ICU) admission. METHODS: We conducted a stepped wedge cluster randomised controlled trial including 14 Belgian acute care hospitals with two medical and two surgical wards each...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29679531/the-association-of-early-postoperative-lactate-levels-with-morbidity-after-elective-major-abdominal-surgery
#3
Jelena Veličković, Ivan Palibrk, Biljana Miličić, Dejan Veličković, Bojan Jovanović, Goran Rakić, Milorad Petrović, Vesna Bumbaširević
Lactate levels are widely used as an indicator of outcome in critically ill patients. We investigated the prognostic value of postoperative lactate levels for postoperative complications (POC), mortality and length of hospital stay after elective major abdominal surgery. A total of 195 patients were prospectively evaluated. Lactate levels were assessed on admission to the intensive care unit (ICU) [L0], 4 hours (L4), 12 hours (L12), and 24 hours (L24) after the operation. Demographic and perioperative clinical data were collected...
April 21, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29679047/a-quality-improvement-initiative-to-reduce-necrotizing-enterocolitis-across-hospital-systems
#4
Amy T Nathan, Laura Ward, Kurt Schibler, Laurel Moyer, Andrew South, Heather C Kaplan
OBJECTIVE: Necrotizing enterocolitis (NEC) is a devastating intestinal disease in premature infants. Local rates of NEC were unacceptably high. We hypothesized that utilizing quality improvement methodology to standardize care and apply evidence-based practices would reduce our rate of NEC. STUDY DESIGN: A multidisciplinary team used the model for improvement to prioritize interventions. Three neonatal intensive care units (NICUs) developed a standardized feeding protocol for very low birth weight (VLBW) infants, and employed strategies to increase the use of human milk, maximize intestinal perfusion, and promote a healthy microbiome...
April 20, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29679046/impact-of-antenatal-corticosteroids-in-preterm-neonates-based-on-maternal-body-mass-index
#5
Maheer Faden, Sarah D McDonald, Prakeshkumar S Shah, Amit Mukerji
OBJECTIVE: Impact of antenatal corticosteroid (ACS) in context of maternal body mass index (BMI) as it relates to neonatal outcomes remains unclear. We sought to evaluate effects of ACS on clinical outcomes of preterm infants based on maternal BMI. METHODS: We performed a retrospective cohort study among neonates 23-33 weeks' GA at a tertiary neonatal intensive care unit from 2011 to 2015. Outcomes of neonates exposed to any ACS and pre-pregnancy maternal BMI ≥ 25 (N = 491) were compared with maternal BMI < 25 (N = 484)...
April 20, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29678895/healthcare-utilization-after-acute-kidney-injury-in-the-pediatric-intensive-care-unit
#6
Erin Hessey, Geneviève Morissette, Jacques Lacroix, Sylvie Perreault, Susan Samuel, Marc Dorais, Véronique Phan, Philippe Jouvet, Jean-Philippe Lafrance, Jacques LeLorier, Ana Palijan, Michael Pizzi, Louise Roy, Michael Zappitelli
BACKGROUND AND OBJECTIVES: Little is known about the long-term burden of AKI in the pediatric intensive care unit. We aim to evaluate if pediatric AKI is associated with higher health service use post-hospital discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is a retrospective cohort study of children (≤18 years old) admitted to two tertiary centers in Montreal, Canada. Only the first admission per patient was included. AKI was defined in two ways: serum creatinine alone or serum creatinine and/or urine output...
April 20, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29678435/prediction-of-patient-length-of-stay-on-the-intensive-care-unit-following-cardiac-surgery-a-logistic-regression-analysis-based-on-the-cardiac-operative-mortality-risk-calculator-euroscore
#7
Katherine Meadows, Richard Gibbens, Caroline Gerrard, Alain Vuylsteke
OBJECTIVE: The aim of this study was to develop a statistical model based on patient parameters to predict the length of stay (LOS) in the intensive care unit (ICU) following cardiac surgery in a single center. DESIGN: Data were collected from patients admitted to the ICU following cardiac surgery over a 10-year period (2006-2016). Both the additive and logistic EuroSCORE were calculated, and logistic regression analysis was carried out to formulate a model relating the predicted LOS to the EuroSCORE...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29678361/chikungunya-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#8
Pravin Amin, Gisele Sampaio Silva, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Dilip R Karnad, Guy A Richards
Chikungunya is an arbovirus that is transmitted by the Aedes mosquito causing a febrile illness with periodic outbreaks in large parts of the world. In the last decade it has become a public health concern in a host of countries and has affected international tourists. In the vast majority of cases Chikungunya presents as an acute febrile illness, associated with rash, headache, myalgia and debilitating arthralgia or even polyarthritis. A small proportion of patients present atypically with nervous, ocular, renal, myocardial, respiratory and renal system involvement and may require ICU management...
April 7, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29678304/improving-postoperative-neonatal-nutritional-practices-in-an-intensive-care-unit-using-the-pdsa-cycle
#9
Jennifer Newcombe, Eileen Fry-Bowers
Quality Improvement models offer a framework for health care professionals to follow in implementing process improvement changes. Use of these models promotes a systematic approach to problem solving, keeps providers from eliminating important steps, facilitates team work, and provides a clear plan for ongoing communication. This paper describes use of the Plan-Do-Study-Act model to implement a unit-based quality improvement project that focused on improving postoperative nutritional practices for neonates with critical congenital heart disease following complex cardiac surgery...
April 17, 2018: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29678257/-functional-status-as-an-independent-risk-factor-in-elderly-patients-admitted-to-an-intensive-care-unit
#10
Federico Gordo, Cristina Castro, Inés Torrejón, Sonia Bartolomé, Francisco Coca, Ana Abella
OBJECTIVE: To assess the association of previous functional status in elderly patients admitted to the ICU, estimated by the Barthel and Short Form-Late Life Function and Disability instrument scales, and the relationship with prognosis and functional capacity at hospital discharge. MATERIAL AND METHODS: Observational prospective study of ICU-admitted patients older than 74 years, with a length of stay greater than 48hours. Demographic data, social background, comorbidities, disability questionnaire (Barthel, Short Form-Late Life Function and Disability instrument), main diagnosis and severity (SAPS 3) on ICU admission were recorded...
April 17, 2018: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29678158/dexmedetomidine-infusion-as-an-analgesic-adjuvant-during-laparoscopic-%C3%B1-holecystectomy-a-randomized-controlled-study
#11
Kateryna Bielka, Iurii Kuchyn, Volodymyr Babych, Kseniia Martycshenko, Oleksii Inozemtsev
BACKGROUND: Dexmedetomidine (DEX) has sedative, sympatholytic and analgesic effects and might be beneficial if used as an adjuvant to: improve analgesia; modulate haemodynamic responses to intubation and pneumoperitoneum and; reduce the number of opioid-associated adverse events. The aim of this study was to evaluate the efficacy and safety of DEX infusion during elective laparoscopic cholecystectomy (LC). METHODS: A randomized, single-centre, parallel-group, placebo-controlled study was carried out between May 2016 and June 2017...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29678147/protocol-based-evaluation-for-feasibility-of-extubation-compared-to-clinical-scoring-systems-after-major-oral-cancer-surgery-safely-reduces-the-need-for-tracheostomy-a-retrospective-cohort-study
#12
Axel Schmutz, Rolf Dieterich, Johannes Kalbhenn, Pit Voss, Torsten Loop, Sebastian Heinrich
BACKGROUND: Despite risks, complications and negative impact to quality of life, tracheostomy is widely used to bypass upper airway obstruction after major oral cancer surgery (MOCS). Decision to tracheostomy is frequently based on clinical scoring systems which mainly have not been validated by different cohorts. Delayed extubation in the Intensive Care Unit (ICU) may be a suitable alternative in selected cases. We hypothesize that delayed routine ICU extubation after MOCS instead of scoring system based tracheostomy is safe, feasible and leads to lower tracheostomy rates...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29678013/implementation-of-a-new-traceability-process-for-breast-milk-feeding
#13
Mariana Y Daus, Thelma G Maydana, Daniel A Rizzato Lede, Daniel R Luna
Many newborns at the neonatal intensive care unit are unable to feed themselves, and receive human milk through enteric nutrition devices such as orogastric or nasogastric probes. The mothers extract their milk, and the nursing staff is responsible for the fractionation, storage and administration when prescribed by physicians. It is very important to remind that it is a bodily fluid that carries the risk of disease transmission if misused. Health information technologies can enhance patient safety by avoiding preventable adverse events...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29677966/reducing-nosocomial-infections-in-surgical-icus-in-sri-lanka-co-creating-a-safety-culture-using-an-ehealth-intervention
#14
Nadish Kariyawasam, Ming Chao Wong, Paul Turner
Nosocomial infections are a major public health risk more prevalent among vulnerable patients in intensive care units of lower and lower-middle income countries. Despite advances in health care, the prevalence of nosocomial infections is alarming. The reasons for these infections are multifactorial and include organisational, cultural and individual factors. This paper discusses the findings associated with research undertaken in six surgical intensive care units in Sri Lanka to evaluate the impact of an eHealth system prototype in contributing to the improvement of hand hygiene compliance and thereby reduction of nosocomial infections...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29677892/re-oxalate-nephropathy-following-vitamin-c-intake-within-intensive-care-unit
#15
Dean G Assimos
No abstract text is available yet for this article.
May 2018: Journal of Urology
https://www.readbyqxmd.com/read/29677007/near-continuous-glucose-monitoring-makes-glycemic-control-safer-in-icu-patients
#16
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/29676943/impact-of-preoperative-thrombocytopenia-on-the-outcome-after-coronary-artery-bypass-grafting
#17
Wail Nammas, Magnus Dalén, Stefano Rosato, Riccardo Gherli, Daniel Reichart, Giuseppe Gatti, Francesco Onorati, Giuseppe Faggian, Marisa De Feo, Ciro Bancone, Sidney Chocron, Sorosh Khodabandeh, Giuseppe Santarpino, Antonino S Rubino, Daniele Maselli, Saverio Nardella, Antonio Salsano, Tiziano Gherli, Francesco Nicolini, Marco Zanobini, Matteo Saccocci, Karl Bounader, Paola D'Errigo, Tuomas Kiviniemi, Eeva-Maija Kinnunen, Andrea Perrotti, Juhani Airaksinen, Giovanni Mariscalco, Vito G Ruggieri, Fausto Biancari
The impact of thrombocytopenia on postoperative bleeding and other major adverse events after cardiac surgery is unclear. This issue was investigated in a series of patients who underwent isolated coronary artery bypass grafting (CABG) from the prospective, multicenter E-CABG registry. Preoperative thrombocytopenia was defined as preoperative platelet count <150 × 109 /L and it was considered moderate-severe when preoperative platelet count was <100 × 109 /L. Multilevel mixed-effects regression analysis was performed to adjust the effect of thrombocytopenia on outcomes for baseline and operative covariates as well as for interinstitutional differences in patient-blood management...
April 20, 2018: Platelets
https://www.readbyqxmd.com/read/29676703/effect-of-intraoperative-single-shot-application-of-vancomycin-in-liver-transplant-recipients-on-postoperative-infections-with-enterococcus-faecium-and-enterococcus-faecalis
#18
Christian Siebers, Johannes Kinzinger, Ludwig C Hinske, Andreas Bauer, Patrick Scheiermann, Michael Zoller, Markus Guba, Martin Angele, Sebastian Pratschke, Thomas Weig
OBJECTIVES: Infections are major causes of morbidity and mortality in the early postoperative period after liver transplant. We observed a high rate of enterococcal infections at our center. Therefore, we added an intraoperative single shot of vancomycin to the standard regimen of meropenem given over 5 days. The aim of this study was to determine the prevalence of both Enterococcus faecium and Enterococcus faecalis infections during the first 28 days after surgery depending on the type of antibiotic prophylaxis and their implications on mortality and morbidity...
April 20, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29676033/fio-2-control-by-parents-of-preterm-infants-admitted-to-a-neonatal-intensive-care-unit-a-pilot-study
#19
M D Martín-Pelegrina, A Lorenzo-Rodríguez, D Lora-Pablos, B Muñóz-Amat, C Morales-Betancourt, C R Pallás-Alonso
When newborns are admitted to the neonatal intensive care unit for prematurity or other reasons, parents do not take on the role that they were expecting to assume. That is, they do not become the main caregivers of their children. To address this issue, neonatal units are currently trying to involve parents in the care of their children as soon as possible. Interesting experiences regarding this issue have been published. Most of the experiences show that when parents assume part of the responsibility for caring for their children, breastfeeding is prolonged, hospital-stay lengths decrease, weight gain increases and the numbers of readmissions decrease (1-4)...
April 19, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29675987/the-usage-of-procalcitonin-in-finland
#20
B Tujula, M Kokki, K Pulkki, J Romppanen, S Sjövall, H Tuominen, H Kokki
BACKGROUND: We have surveyed the use of procalcitonin (PCT) in Finland with a specific emphasis on intensive care unit (ICU) patients. METHODS: The PCT use was surveyed from all 11 laboratories providing services for all 15 secondary and all five tertiary care hospitals in Finland. The laboratories reported the PCT use of each hospital in 2014 and 2015. Four hospitals were analysed for the first 100 adult ICU patients with PCT measurements in 2015. The indication for PCT measurement and whether PCT values affected antibiotic treatment were collected from patient records...
April 19, 2018: Acta Anaesthesiologica Scandinavica
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