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Oral care ICU

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https://www.readbyqxmd.com/read/29211143/hospitalizations-due-to-diseases-associated-with-poor-sanitation-in-the-public-health-care-network-of-the-metropolitan-region-of-porto-alegre-rio-grande-do-sul-state-brazil-2010-2014
#1
Mariana Santiago Siqueira, Roger Dos Santos Rosa, Ronaldo Bordin, Rita de Cássia Nugem
OBJECTIVE: to describe the occurrence, characteristics and expenditures of hospitalizations due to diseases associated with poor sanitation funded by the Brazilian National Health System (SUS) among residents of the metropolitan region of Porto Alegre-RS, Brazil, from 2010 to 2014. METHODS: descriptive study with data from SUS Hospital Information System (SIH/SUS). RESULTS: out of 13,929 hospitalizations for diseases associated with poor sanitation, 93...
October 2017: Epidemiologia e Servicos de Saude: Revista do Sistema Unico de Saude do Brasil
https://www.readbyqxmd.com/read/29189950/cost-assessment-of-a-new-oral-care-program-in-the-intensive-care-unit-to-prevent-ventilator-associated-pneumonia
#2
Jérôme Ory, Charline Mourgues, Evelyne Raybaud, Russell Chabanne, Jean Christophe Jourdy, Fabien Belard, Renaud Guérin, Bernard Cosserant, Jean Sébastien Faure, Laure Calvet, Bruno Pereira, Dominique Guelon, Ousmane Traore, Laurent Gerbaud
OBJECTIVES: Ventilator-associated pneumonia (VAP) is the most frequent hospital-acquired infections in intensive care units (ICU). In the bundle of care to prevent the VAP, the oral care is very important strategies, to decrease the oropharyngeal bacterial colonization and presence of causative bacteria of VAP. In view of the paucity of medical economics studies, our objective was to determine the cost of implementing this oral care program for preventing VAP. MATERIALS AND METHODS: In five ICUs, during period 1, caregivers used a foam stick for oral care and, during period 2, a stick and tooth brushing with aspiration...
November 30, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29187048/multitargeted-feeding-strategies-improve-nutrition-outcome-and-are-associated-with-reduced-pneumonia-in-a-level-1-trauma-intensive-care-unit
#3
Jenny C Lee, George W Williams, Rosemary A Kozar, Lillian S Kao, Krislynn M Mueck, Andrew D Emerald, Natacha C Villegas, Laura J Moore
BACKGROUND: Factors impeding delivery of adequate enteral nutrition (EN) to trauma patients include delayed EN initiation, frequent surgeries and procedures, and postoperative ileus. We employed 3 feeding strategies to optimize EN delivery: (1) early EN initiation, (2) preoperative no nil per os feeding protocol, and (3) a catch-up feeding protocol. This study compared nutrition adequacy and clinical outcomes before and after implementation of these feeding strategies. METHODS: All trauma patients aged ≥18 years requiring mechanical ventilation for ≥7 days and receiving EN were included...
March 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29181195/survey-of-extent-of-translation-of-oral-healthcare-guidelines-for-icu-patients-into-clinical-practice-by-nursing-staff
#4
Vivek Agarwal, Rameshwari Singhal, Richa Khanna, Pavitra Rastogi, Avinash Agarwal, Shuchi Tripathi
Nosocomial infections in critically ill/ventilated patients result from bacterial load in oropharyngeal regions. Oral decontamination serves as the easiest effective means of controlling infections. Knowledge, attitude, and practices followed by healthcare personnel in intensive care settings need to be assessed to implement concrete measures in health-care. Survey questionnaire was constructed and implemented following its validation on seventy nursing and paramedical staff working in government and private intensive care units throughout Lucknow city...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29109881/hypothermia-with-extreme-bradycardia-following-spinal-cord-infarction-of-septic-origin
#5
Philippe Hantson, Thierry Duprez
Among other autonomic dysfunctions complicating acute spinal cord injury, deep hypothermia is rare but may induce serious cardiovascular complications. There are few pharmacological options to influence hypothermia. A 66-year-old woman was transferred to the intensive care unit (ICU) for serious cardiac arrhythmias (atrial fibrillation and asystole) in the context of a deep hypothermia (axillary temperature below 32°C). She had been admitted to the hospital two months before for an acute L4-L5 infectious spondylodiscitis without any initial neurological deficit...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29097138/does-length-of-intubation-before-tracheostomy-affect-intensive-care-unit-length-of-stay
#6
Shaun R Young, Gary F Bouloux, Sebastian D Perez, Shelly Abramowicz
OBJECTIVE: The purpose of this study was to determine if length of intubation before tracheotomy (LIT) affects length of stay in the intensive care unit (ICU). STUDY DESIGN: This was a retrospective case series of patients who had open tracheotomies at Grady Memorial Hospital by the Oral and Maxillofacial Surgery (OMS) service. Medical records were reviewed to document patient demographic characteristics, etiology for ventilator dependence, and complications. The primary predictor variable was LIT and primary outcome variable was length of stay in ICU after tracheotomy...
September 27, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29055604/treatment-of-primary-graft-dysfunction-after-lung-transplantation-with-orally-inhaled-ap301-a-prospective-randomized-pilot-study
#7
Clemens Aigner, Alexis Slama, Maximilian Barta, Andreas Mitterbauer, Gyoergy Lang, Shahrokh Taghavi, Jose Matilla, Roman Ullrich, Katharina Krenn, Peter Jaksch, Klaus Markstaller, Walter Klepetko
BACKGROUND: Primary graft dysfunction (PGD) after lung transplantation (LTx) carries significant morbidity and mortality in the early post-operative period and is associated with the development of chronic lung allograft dysfunction. AP301, an activator of epithelial sodium channel-mediated Na(+) uptake represents a new concept for prevention and treatment of pulmonary edema and has shown promising results in the pre-clinical setting. This pilot study investigated the clinical effect of inhaled AP301 on patients with development of PGD > 1 according to International Society of Heart and Lung Transplantation criteria after primary LTx in a high-volume center and was conducted as a randomized, placebo-controlled, single-center pilot-study including 20 patients...
September 30, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29033819/an-unusual-presentation-of-pyoderma-gangrenosum-leading-to-systemic-inflammatory-response-syndrome
#8
Ali Didan, Alan Donnelly, Hock Chua
This is a report of an atypical presentation of pyoderma gangrenosum (PG) in a 26-year-old male who had a negative septic screen. The patient had a life-threatening presentation requiring an intensive care unit (ICU) admission for vasopressor support. It was thought that the likely cause of circulatory collapse was an overwhelming cytokine reaction or systemic inflammatory response syndrome (SIRS) secondary to extensive PG lesions rather than septic shock. The patient presented with multiple large ulcers, the largest being 4 cm in diameter on the central chest...
September 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28976870/efficacy-of-a-bundle-approach-in-preventing-the-incidence-of-ventilator-associated-pneumonia-vap
#9
Sandra Burja, Tina Belec, Nika Bizjak, Jernej Mori, Andrej Markota, Andreja Sinkovič
Ventilator-associated pneumonia (VAP) is a potentially preventable iatrogenic illness that may develop following mechanical ventilation. A bundle for the prevention of VAP consists of different measures which may vary between institutions, and may include: elevation of the head of the bed, oral care with chlorhexidine, subglottic suctioning, daily assessment for extubation and the need for proton-pump inhibitors, use of closed suction systems, and maintaining endotracheal cuff pressure at 25 cmH2O. Our aim was to determine the efficacy of a VAP prevention bundle, consisting of the above-mentioned measures, by evaluating the incidence of VAP before (no-VAP-B group) and after (VAP-B group) the introduction of the bundle...
October 4, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28936962/-evaluation-of-the-effect-of-a-new-fixation-tape-for-tracheal-catheter-in-intensive-care-patients
#10
Limin Chen, Ruihong Liu, Biyu Shen, Lingling Wang, Zhiming Cui, Guanhua Xu
OBJECTIVE: To evaluate the effect of a new type of fixation tape for tracheal catheter in intensive care patients. METHODS: A purposive sampling study was conducted. Ninety patients experienced oral tracheal intubation for mechanical ventilation, and admitted to respiratory intensive care unit (ICU) of the Second Affiliated Hospital of Nantong University from November 2015 to February 2017 were enrolled. All the patients were randomly (random number) divided into the control group and the observation group with 45 patients in each group...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28933744/energy-and-protein-in-critically-ill-patients-with-aki-a-prospective-multicenter-observational-study-using-indirect-calorimetry-and-protein-catabolic-rate
#11
Alice Sabatino, Miriam Theilla, Moran Hellerman, Pierre Singer, Umberto Maggiore, Maria Barbagallo, Giuseppe Regolisti, Enrico Fiaccadori
The optimal nutritional support in Acute Kidney Injury (AKI) still remains an open issue. The present study was aimed at evaluating the validity of conventional predictive formulas for the calculation of both energy expenditure and protein needs in critically ill patients with AKI. A prospective, multicenter, observational study was conducted on adult patients hospitalized with AKI in three different intensive care units (ICU). Nutrient needs were estimated by different methods: the Guidelines of the European Society of Parenteral and Enteral Nutrition (ESPEN) for both calories and proteins, the Harris-Benedict equation, the Penn-State and Faisy-Fagon equations for energy...
July 26, 2017: Nutrients
https://www.readbyqxmd.com/read/28923476/evaluation-of-nutrition-support-practices-results-from-a-nationwide-survey
#12
Wajdy Abi Saleh, Pierre Bou Khalil, Krystel Ouaijan, Fayez Abillama, Sandra Akiki, Nehmat Ahmad, Lama Mattar
BACKGROUND: Multiple clinical guidelines are available to improve and standardize the delivery of nutrition support. However, recommendations are not being universally applied at the bedside due to challenges of resources and barriers of knowledge. Assessing the current level of nutrition support practice is the first step to understand the barriers and ultimately implement potential strategies to increase guideline adherence and promote quality nutrition support in hospitals. There are no published data concerning the practice of nutrition support in Lebanese hospitals...
September 7, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28915879/the-effect-of-sedation-and-or-analgesia-as-rescue-treatment-during-noninvasive-positive-pressure-ventilation-in-the-patients-with-interface-intolerance-after-extubation
#13
Yue-Nan Ni, Ting Wang, He Yu, Bin-Miao Liang, Zong-An Liang
BACKGROUND: Sedation and/or analgesia can relieve the patient-ventilator asynchrony. However, whether sedation and/or analgesia can benefit the clinical outcome of the patients with interface intolerance is still unclear. METHODS: A retrospective study was performed on patients with interface intolerance who received noninvasive positive pressure ventilation (NIPPV) after extubation in seven intensive care units (ICU) of West China Hospital, Sichuan University. The primary outcome was rate of NIPPV failure (defined as need for reintubation and mechanical ventilation); Secondary outcomes were hospital mortality rate and length of ICU stay after extubation...
September 15, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28889900/a-62-year-old-woman-with-wheezing-respiratory-failure-and-an-abnormal-ct%C3%A2-scan
#14
Peter Hountras, Hector Cajigas
A previously healthy 62-year-old woman was transferred to the ICU from the medical ward with acute bronchospastic respiratory failure requiring intubation and mechanical ventilation. Four weeks before, the patient was vacationing in Arizona and acquired a mildly productive cough as well as mild dyspnea. She presented to an urgent care facility and was diagnosed with community-acquired pneumonia. She received a 5-day course of azithromycin, with partial improvement of her symptoms. The patient returned home 1 week prior to admission, reporting worsening dyspnea, chest pressure, cough, and fever...
September 2017: Chest
https://www.readbyqxmd.com/read/28881078/the-effects-of-nurse-led-clinical-pathway-in-coronary-artery-bypass-graft-surgery-a-quasi-experimental-study
#15
Ayda Kebapçı, Nevin Kanan
AIMS AND OBJECTIVE: Develop and evaluate the effects of a nurse-led clinical pathway (CP) for patients undergoing CABG (Coronary Artery Bypass Graft Surgery). BACKGROUND: A CP is a multidisciplinary care plan, based on evidence and guidelines to provide consistent, quality care to patients and improve outcomes. DESIGN: Prospective, quasi-experimental design. METHODS: Patients hospitalized for CABG between April 2014 and November 2015 in a hospital in Turkey were studied...
September 7, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28877374/role-of-oral-nystatin-prophylaxis-in-cardiac-surgery-with-prolongedextracorporeal-circulation
#16
Alessandro Russo, Giovanni Carriero, Alessio Farcomeni, Giancarlo Ceccarelli, Luigi Tritapepe, Mario Venditti
Duration >120 minutes of extracorporeal circulation (ECC) during cardiopulmonary bypass procedure was associated to an increased risk of candidemia in the intensive care unit (ICU). To evaluate oral nystatin prophylaxis in cardiac surgery considering its exclusive effect on Candida, in the absence of systemic effects and selection of resistant strains to polyene. We conducted an observational study in the postcardiac surgery ICU of Policlinico "Umberto I" of Rome. From January 2014, all patients with a prolonged ECC >120 minutes were systematically treated with oral nystatin (Prophylaxis group)...
September 6, 2017: Mycoses
https://www.readbyqxmd.com/read/28873293/the-role-of-midodrine-for-hypotension-outside-of-the-intensive-care-unit
#17
Lawrence B Gutman, Ben J Wilson
Midodrine is an oral, peripherally acting alpha-adrenergic agonist. After gaining Food and Drug Administration (FDA) approval in 1996 for orthostatic hypotension, its use has evolved to target vasoplegic conditions such as intradialytic hypotension in the end-stage renal disease population, refractory ascites in cirrhotic patients to support diuresis, and in hepatorenal syndrome. Upon oral ingestion, the drug undergoes enzymatic hydrolysis to an active metabolite, desglymidodrine. Its use has been well tolerated at 2...
August 23, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28830529/oral-hygiene-in-intensive-care-unit-patients-with-photodynamic-therapy-study-protocol-for-randomised-controlled-trial
#18
Gabriela Alves Da Collina, Anna Carolina Ratto Tempestini-Horliana, Daniela de Fátima Teixeira da Silva, Priscila Larcher Longo, Maria Luisa Faria Makabe, Christiane Pavani
BACKGROUND: In intensive care units (ICUs), nosocomial infections are prevalent conditions and they have been related to high mortality indexes. Some studies have suggested that inefficient oral hygiene and ventilator-associated pneumonia (VAP) are related. Nowadays, in the Brazilian public health system there is no well-defined protocol for oral hygiene in an ICU. Due to the drawbacks of the use of antibiotics, photodynamic therapy (PDT) has emerged as an interesting technique in order to reduce antimicrobial-resistant pathogens...
August 22, 2017: Trials
https://www.readbyqxmd.com/read/28829877/effect-of-ganciclovir-on-il-6-levels-among-cytomegalovirus-seropositive-adults-with-critical-illness-a-randomized-clinical-trial
#19
RANDOMIZED CONTROLLED TRIAL
Ajit P Limaye, Renee D Stapleton, Lili Peng, Scott R Gunn, Louise E Kimball, Robert Hyzy, Matthew C Exline, D Clark Files, Peter E Morris, Stephen K Frankel, Mark E Mikkelsen, Duncan Hite, Kyle B Enfield, Jay Steingrub, James O'Brien, Polly E Parsons, Joseph Cuschieri, Richard G Wunderink, David L Hotchkin, Ying Q Chen, Gordon D Rubenfeld, Michael Boeckh
Importance: The role of cytomegalovirus (CMV) reactivation in mediating adverse clinical outcomes in nonimmunosuppressed adults with critical illness is unknown. Objective: To determine whether ganciclovir prophylaxis reduces plasma interleukin 6 (IL-6) levels in CMV-seropositive adults who are critically ill. Design, Setting, and Participants: Double-blind, placebo-controlled, randomized clinical trial (conducted March 10, 2011-April 29, 2016) with a follow-up of 180 days (November 10, 2016) that included 160 CMV-seropositive adults with either sepsis or trauma and respiratory failure at 14 university intensive care units (ICUs) across the United States...
August 22, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28800373/dysphagia-and-speech-language-pathology-involvement-following-chemical-ingestion-injury-a-review-of-44-cases-admitted-to-a-quaternary-australian-hospital-2008-2012
#20
Anna F Rumbach, Rebecca Cremer
Purpose: This study aimed to explore the clinical characteristics of an adult chemical ingestion population and examine the course of return to oral intake post injury and speech-language pathologist (SLP) involvement during the initial acute-care admission. Method: A retrospective chart review of adults admitted to a quaternary hospital for the treatment of an acute chemical ingestion injury between 2008 and 2012 was conducted. Results: Forty-four adults (23 men, 21 women) were identified as receiving treatment for ingestion injury, of whom 18 (40...
November 8, 2017: American Journal of Speech-language Pathology
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