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https://www.readbyqxmd.com/read/28921446/can-a-novel-icu-data-display-positively-affect-patient-outcomes-and-save-lives
#1
Natalia Olchanski, Mikhail A Dziadzko, Ing C Tiong, Craig E Daniels, Steve G Peters, John C O'Horo, Michelle N Gong
The aim of this study was to quantify the impact of ProCCESs AWARE, Ambient Clinical Analytics, Rochester, MN, a novel acute care electronic medical record interface, on a range of care process and patient health outcome metrics in intensive care units (ICUs). ProCCESs AWARE is a novel acute care EMR interface that contains built-in tools for error prevention, practice surveillance, decision support and reporting. We compared outcomes before and after AWARE implementation using a prospective cohort and a historical control...
September 18, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28918911/mortality-of-severe-septic-patients-between-physician-s-high-and-low-care-volumes
#2
Chun-Yao Lin, Jo-Chi Tseng, Chih-Yu Huang, Chien-Ming Chu, Huang-Pin Wu
BACKGROUND: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. METHODS: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28914722/factors-associated-with-pediatric-ventilator-associated-conditions-in-six-u-s-hospitals-a-nested-case-control-study
#3
Noelle M Cocoros, Gregory Priebe, James E Gray, Philip Toltzis, Gitte Y Larsen, Latania K Logan, Susan Coffin, Julia S Sammons, Kathleen Deakins, Kelly Horan, Matthew Lakoma, Jessica Young, Michael Burton, Michael Klompas, Grace M Lee
OBJECTIVES: A newly proposed surveillance definition for ventilator-associated conditions among neonatal and pediatric patients has been associated with increased morbidity and mortality among ventilated patients in cardiac ICU, neonatal ICU, and PICU. This study aimed to identify potential risk factors associated with pediatric ventilator-associated conditions. DESIGN: Retrospective cohort. SETTING: Six U.S. hospitals PATIENTS:: Children less than or equal to 18 years old ventilated for greater than or equal to 1 day...
September 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28912909/the-use-of-tranexamic-acid-for-upper-gastrointestinal-bleeding-by-medical-and-surgical-intensivists-a-single-center-experience
#4
Jason Chertoff, Grant Lowther, Hassan Alnuaimat, Ali Ataya
BACKGROUND: Tranexamic acid (TXA) may be beneficial in the management of upper gastrointestinal bleeding (UGIB). We sought to investigate how frequently intensivists at our academic institution use TXA for patients with UGIB, and to investigate whether the utilization rate of TXA differs between surgical and medical intensivists, and provide an updated literature review on the subject. METHODS: We performed a retrospective cohort study of patients admitted for UGIB to the surgical intensive care unit (SICU) and the medical intensive care unit (MICU) at our academic healthcare facility (University of Florida Health - Shands Hospital) from January 1, 2013 to December 31, 2016...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912532/chronic-kidney-disease-is-associated-with-poorer-in-hospital-outcomes-in-patients-hospitalized-with-infections-electronic-record-analysis-from-china
#5
Guobin Su, Hong Xu, Gaetano Marrone, Bengt Lindholm, Zehuai Wen, Xusheng Liu, Juan-Jesus Carrero, Cecilia Stålsby Lundborg
Predominantly based on studies from high-income countries, reduced estimated glomerular filtration rate (eGFR) has been associated with increased risk of infections and infection-related hospitalizations (IRHs). We here explore in-hospital outcomes of IRHs in patients with different kidney function. A total of 6,283 adults, not on renal replacement therapy, with a discharge diagnosis of infection, and with an eGFR 1-12 months before index hospitalization, were included from four hospitals in China. We compared in-hospital outcomes (death, intensive care unit (ICU) admission, length of hospital stay (LOHS) and medical expenses), between patients with and without chronic kidney disease (CKD, defined as eGFR ≤ 60 ml/min per 1...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28905701/outcomes-of-patients-with-severe-influenza-infection-admitted-to-intensive-care-units-a-retrospective-study-in-a-medical-centre
#6
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Kuo-Shu Yuan, Chin-Ming Chen
PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20...
September 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28904480/association-of-massive-transfusion-for-resuscitation-in-gastrointestinal-bleeding-with-transfusion-related-acute-lung-injury
#7
James J Case, Nasreen Khan, Michael Delrahim, Jasmina Dizdarevic, Dane J Nichols, Martin A Schreiber, Thomas G Deloughery, Akram Khan
BACKGROUND AND AIMS: This study aimed to understand the use of massive transfusion (MT) for gastrointestinal bleeding (GIB). PATIENTS AND METHODS: We performed a retrospective analysis of patients admitted to our medical Intensive Care Unit (ICU) with GIB for the type of bleeding, quantity of blood products transfused, and risk of transfusion-related acute lung injury (TRALI) and death. MT was defined as transfusion of 10 or more units of red blood cell (RBC) within a 24-h period in a 1-unit RBC: 1-unit fresh frozen plasma: and 1-unit platelet ratio...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28891977/polytrauma-defined-by-the-new-berlin-definition-a-validation-test-based-on-propensity-score-matching-approach
#8
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. This study was designed to investigate the outcome of patients with polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS) ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension [systolic blood pressure ≤ 90 mmHg], unconsciousness [Glasgow Coma Scale score ≤ 8], acidosis [base excess ≤ -6...
September 11, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28888825/multimodal-interventions-for-bundle-implementation-to-decrease-central-line-associated-bloodstream-infections-in-adult-intensive-care-units-in-a-teaching-hospital-in-taiwan-2009-2013
#9
Wu-Pu Lin, Yu-Ching Chang, Un-In Wu, Mei-Chuan Hung, Pao-Yu Chuang, Jann-Tay Wang, Wang-Huei Sheng, Yee-Chun Chen, Shan-Chwen Chang
BACKGROUND: Central line (CL)-associated bloodstream infection (CLABSI) poses a major threat to patient safety and is associated with additional cost. This study investigated the sustained effect of multimodal interventions focusing on CL bundle improvement in the adult intensive care units (ICUs) of a teaching hospital in Taiwan. METHODS: A before-after prospective study was conducted in 17 adult ICUs of a medical center in northern Taiwan from January 2009 to December 2013...
August 26, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28885936/vancomycin-vs-vancomycin-piperacillin-tazobactam-associated-acute-kidney-injury-in-noncritically-ill-patients-at-a-tertiary-care-military-treatment-facility
#10
Caleb W Anderson, Kathy S Cazares, Michael B Lustik, Shivam M Patel, Troy M Denunzio
BACKGROUND: Broad-spectrum antibiotics are often used as initial empiric therapy in patients at risk for infections by multidrug-resistant organisms. Emerging literature and anecdotal reports within Tripler Army Medical Center indicate an increased incidence of vancomycin-associated acute kidney injury when used in combination with piperacillin-tazobactam. This is a retrospective, single-center study comparing the incidence of acute kidney injury in noncritically ill patients receiving either vancomycin or vancomycin in combination with piperacillin-tazobactam in a 206-bed tertiary care military training facility...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28884908/analysis-of-dermatologic-consultations-in-a-neonatal-intensive-care-unit-over-a-7-year-period-retrospective-review-of-60-cases
#11
Jeong Nan Kang, Do Hyeong Kim, So Hee Park, Jung Eun Seol, Hyojin Kim
BACKGROUND/OBJECTIVES: The need for dermatology consultations for neonatal intensive care unit (NICU) patients is increasing, but no study has systemically examined the skin diseases of patients in NICUs. The aim of this study was to analyze dermatology consultations in the NICU of a tertiary medical center in Korea and determine the effect of the dermatology consultation on the clinical course and management of the patients after the consultation. METHODS: The medical records of patients undergoing dermatologic consultation during their stay in a NICU between March 2009 and February 2016 were reviewed retrospectively...
September 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28880805/a-prospective-one-year-microbiologic-survey-of-combined-pneumonia-and-respiratory-failure
#12
Kristen Fisher, Tracy Trupka, Scott T Micek, Paul Juang, Marin H Kollef
BACKGROUND: Pneumonia and respiratory failure are common problems in the intensive care unit (ICU) setting, often occurring together. The relative prevalence of pneumonia types (community acquired, hospital acquired, ventilator associated) and causative pathogens is not well described in patients with respiratory failure. METHODS: This was a prospective observational cohort study conducted in the medical ICU (34 beds) of Barnes-Jewish Hospital, an academic referral center of 1,300 beds from January 2016-December 2016...
September 7, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28870727/selective-digestive-and-oropharyngeal-decontamination-in-medical-and-surgical-icu-patients-an-individual-patient-data-meta-analysis
#13
Nienke L Plantinga, Anne Marie Ga de Smet, Evelien An Oostdijk, Evert de Jonge, Christophe Camus, Wolfgang A Krueger, Dennis Bergmans, Johannes B Reitsma, Marc Jm Bonten
OBJECTIVES: Selective Digestive Decontamination (SDD) and Selective Oropharyngeal Decontamination (SOD) improved ICU, hospital and 28-day survival in Intensive Care Units (ICU) with low levels of antibiotic resistance. Yet, it is unclear whether the effect differs between medical and surgical ICU patients. METHODS: In an individual patient data meta-analysis we systematically searched PubMed and included all randomized controlled studies published since 2000. We performed a two-stage meta-analysis with separate logistic regression models per study and per outcome (hospital survival and ICU survival) and subsequent pooling of main and interaction effects...
September 1, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28869492/the-lactate-albumin-ratio-a-valuable-tool-for-risk-stratification-in-septic-patients-admitted-to-icu
#14
Michael Lichtenauer, Bernhard Wernly, Bernhard Ohnewein, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Alexander Lauten, Paul Christian Schulze, Uta C Hoppe, Malte Kelm, Christian Jung
The lactate/albumin ratio has been reported to be associated with mortality in pediatric patients with sepsis. We aimed to evaluate the lactate/albumin ratio for its prognostic relevance in a larger collective of critically ill (adult) patients admitted to an intensive care unit (ICU). A total of 348 medical patients admitted to a German ICU for sepsis between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. The association of the lactate/albumin ratio (cut-off 0...
September 2, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28866836/colistin-nephrotoxicity-in-the-icu-is-it-different-in-the-geriatric-patients
#15
Burcu Başarık Aydoğan, Fatma Yıldırım, Avşar Zerman, Kamil Gönderen, Melda Türkoğlu, Gülbin Aygencel
OBJECTIVE: Most significant side effect of colistin therapy which is used for the treatment of multi-drug resistant Gram-negative infections is nephrotoxicity. Our aim was to investigate the differences of colistin nephrotoxicity between the geriatric age group (≥65 years) and the younger age group (<65 years) in critically ill medical intensive care unit (ICU) patients. MATERIAL AND METHOD: The medical records of the 76 patients who were taken colistin therapy due to multi-resistant Gram-negative infections between January 2010 and June 2014 in the our medical ICU were retrospectively investigated...
September 2, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28866320/differences-in-perioperative-femoral-and-radial-arterial-blood-pressure-in-neonates-and-infants-undergoing-pediatric-cardiac-surgery-requiring-cardiopulmonary-bypass
#16
Hwa Jin Cho, Sang Hoon Lee, In Seok Jeong, Nam Sik Yoon, Jae Sook Ma, Byoung Hee Ahn
OBJECTIVE: Several reports claim that blood pressure (BP) in the radial artery may underestimate the accurate BP in critically ill patients. Here, the authors evaluated differences in mean blood pressure (MBP) between the radial and femoral artery during pediatric cardiac surgery to determine the effectiveness of femoral arterial BP monitoring. METHOD: The medical records of children under 1 year of age who underwent open-heart surgery between 2007 and 2013 were retrospectively reviewed...
August 30, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28866139/impact-of-caloric-intake-in-critically-ill-patients-with-and-without-refeeding-syndrome-a-retrospective-study
#17
Laura E Olthof, W A C Kristine Koekkoek, Coralien van Setten, Johannes C N Kars, Dick van Blokland, Arthur R H van Zanten
BACKGROUND & AIMS: Refeeding syndrome comprises metabolic disturbances that occur after the reintroduction of feeding after prolonged fasting. Standard care consists of correcting fluid and electrolytes imbalances. Energy intake during refeeding syndrome is heavily debated. This study addresses the effect of caloric intake on outcome during the management of refeeding syndrome. METHODS: A retrospective study among critically ill invasive mechanically ventilated patients admitted for >7 days to a medical-surgical ICU...
August 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28863283/the-role-of-propionic-acid-at-diagnosis-predicts-mortality-in-patients-with-septic-shock
#18
Jie Weng, He Wu, Zhe Xu, Haitao Xi, Chan Chen, Daqing Chen, Yuqiang Gong, Ying Hua, Zhiyi Wang
PURPOSE: This study aims to assess the diagnostic and prognostic value of propionic acid in patients with septic shock on a medical intensive care unit (ICU). METHODS: Serum propionic acid and clinical common cytokines levels were measured within 24h after the diagnosis of sepsis, and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, and Mortality were recorded in ICU. A 28-day and 90-day follow-up was performed for all patients...
August 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28858068/inflammatory-bowel-disease-predictors-and-causes-of-early-and-late-hospital-readmissions
#19
Prashant Mudireddy, Frank Scott, Alexandra Feathers, Gary R Lichtenstein
BACKGROUND AND AIMS: The rate of hospital readmission after discharge has been studied extensively in chronic conditions such as hepatic cirrhosis, diabetes mellitus, chronic obstructive pulmonary disease, and heart failure. Causative factors associated with hospital readmission have not been adequately investigated in patients with inflammatory bowel disease (IBD). We studied the rate, causes, and factors that predict readmissions at 1 month, 3 months, and 1 year in patients with IBD...
August 29, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28855775/studying-morbidity-and-predicting-mortality-in-patients-with-blunt-chest-trauma-using-a-novel-clinical-score
#20
Priyadarshini Manay, Rajeev R Satoskar, V Karthik, Ram P Prajapati
BACKGROUND: A departmental audit in March 2015 revealed significant mortality rate of 40% in blunt chest trauma patients (much greater than the global 25%). A study was thus planned to study morbidity and predictors of mortality in blunt chest trauma patients admitted to our hospital. METHODS: This study was a prospective observational study of 139 patients with a history of blunt chest trauma between June 2015 and November 2015 after the Institutional Ethics Committee approval in April 2015...
July 2017: Journal of Emergencies, Trauma, and Shock
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