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https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#1
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28314503/standard-donor-lung-procurement-with-normothermic-ex-vivo-lung-perfusion-a-prospective-randomized-clinical-trial
#2
Alexis Slama, Lukas Schillab, Maximilian Barta, Aris Benedek, Andreas Mitterbauer, Konrad Hoetzenecker, Shahrokh Taghavi, Gyoergy Lang, Jose Matilla, Hendrik Ankersmit, Helmut Hager, Georg Roth, Walter Klepetko, Clemens Aigner
BACKGROUND: Ex vivo lung perfusion (EVLP) was primarily developed for evaluation of impaired donor lungs. The good clinical results raise the question for its possible impact on lungs meeting standard criteria. Before application of EVLP on such lungs enters routine clinical practice, it must be demonstrated whether EVLP would affect or improve outcome when used in standard donor lungs. We performed a prospective randomized trial to investigate the role of EVLP in standard lung transplantation (Tx)...
February 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28296811/new-onset-atrial-fibrillation-in-the-critically-ill
#3
Travis J Moss, James Forrest Calland, Kyle B Enfield, Diana C Gomez-Manjarres, Caroline Ruminski, John P DiMarco, Douglas E Lake, J Randall Moorman
OBJECTIVE: To determine the association of new-onset atrial fibrillation with outcomes, including ICU length of stay and survival. DESIGN: Retrospective cohort of ICU admissions. We found atrial fibrillation using automated detection (≥ 90s in 30 min) and classed as new-onset if there was no prior diagnosis of atrial fibrillation. We identified determinants of new-onset atrial fibrillation and, using propensity matching, characterized its impact on outcomes. SETTING: Tertiary care academic center...
March 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28291652/cost-effectiveness-of-hospital-treatment-and-outcomes-of-acute-methanol-poisoning-during-the-czech-republic-mass-poisoning-outbreak
#4
Jan Rulisek, Martin Balik, Ferdinand Polak, Petr Waldauf, Daniela Pelclova, Jan Belohlavek, Sergey Zakharov
PURPOSE: During an outbreak of mass methanol poisoning in the Czech Republic in 2012-2014, we compared the total hospital costs and one-year medical costs in the patients treated with different antidotes (fomepizole versus ethanol) and modalities of hemodialysis (intermittent hemodialysis, IHD, versus continuous renal replacement therapy, CRRT). METHODS: Cross-sectional study in 106 patients with confirmed diagnosis treated in 30 ICU settings. For each patient, the following data were analyzed: admission laboratory data, GCS, PSS, ICU length of stay, organ failures, treatment, outcome, and total hospital costs...
March 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28273299/association-between-ratio-of-fresh-frozen-plasma-to-red-blood-cells-during-massive-transfusion-and-survival-among-patients-without-traumatic-injury
#5
Tomaz Mesar, Andreas Larentzakis, Walter Dzik, Yuchiao Chang, George Velmahos, Daniel Dante Yeh
Importance: Hemostatic resuscitation has been shown to be beneficial for patients with trauma, but there is little evidence that it is equally beneficial for bleeding patients without trauma. The practice of a high transfusion ratio of fresh frozen plasma (FFP) to red blood cells (RBCs) has spread to other surgical and medical fields. Objective: To identify whether ratio-based resuscitation in patients without trauma is associated with improved survival. Design, Setting, and Participants: This study is a retrospective review of all massive transfusions provided in an urban academic hospital from January 1, 2009, through December 31, 2012...
March 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28267682/a-retrospective-descriptive-comparative-study-to-identify-patient-variables-that-contribute-to-the-development-of-deep-tissue-injury-among-patients-in-intensive-care-units
#6
Holly Kirkland-Kyhn, Oleg Teleten, Machelle Wilson
Deep tissue injury (DTI) may develop in critically ill patients despite implementation of preventive interventions. A retrospective, descriptive study was conducted in a 620-bed, level 1 trauma, academic medical center with 7 adult intensive care units ([ICUs] cardiac surgery, trauma surgery, burn surgery, med-surgery, neurosurgery, medical, and transfer) among patients treated from January 1, 2010 to January 1, 2015. All patients 18 years of age or older that developed a sacral DTI that evolved into a Stage 3, Stage 4, or unstageable hospital-acquired pressure ulcers (HAPU) in the ICU were included...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28264714/evaluation-of-clinically-available-renal-biomarkers-in-critically-ill-adults-a-prospective-multicenter-observational-study
#7
Yujun Deng, Ruibin Chi, Shenglong Chen, Heng Ye, Jie Yuan, Lin Wang, Yiling Zhai, Lu Gao, Danqing Zhang, Linhui Hu, Bo Lv, Yi Long, Cheng Sun, Xiaobing Yang, Xia Zou, Chunbo Chen
BACKGROUND: Although serum cystatin C (sCysC), urinary N-acetyl-β-D-glucosaminidase (uNAG), and urinary albumin/creatinine ratio (uACR) are clinically available, their optimal combination for acute kidney injury (AKI) detection and prognosis prediction remains unclear. We aimed to assess the discriminative abilities of these biomarkers and their possible combinations for AKI detection and intensive care unit (ICU) mortality prediction in critically ill adults. METHODS: A multicenter, prospective observational study was conducted in mixed medical-surgical ICUs at three tertiary care hospitals...
March 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28263192/the-confusion-assessment-method-for-the-icu-7-delirium-severity-scale-a-novel-delirium-severity-instrument-for-use-in-the-icu
#8
Babar A Khan, Anthony J Perkins, Sujuan Gao, Siu L Hui, Noll L Campbell, Mark O Farber, Linda L Chlan, Malaz A Boustani
OBJECTIVES: Delirium severity is independently associated with longer hospital stays, nursing home placement, and death in patients outside the ICU. Delirium severity in the ICU is not routinely measured because the available instruments are difficult to complete in critically ill patients. We designed our study to assess the reliability and validity of a new ICU delirium severity tool, the Confusion Assessment Method for the ICU-7 delirium severity scale. DESIGN: Observational cohort study...
March 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28262914/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#9
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28260911/increased-risk-of-endotracheal-intubation-and-heart-failure-following-acute-myocardial-infarction-in-patients-with-urolithiasis-a-nationwide-population-based-study
#10
Shun-Ku Lin, Jui-Ming Liu, Ying-Hsu Chang, Yuan-Tien Ting, See-Tong Pang, Ren-Jun Hsu, Po-Hung Lin
BACKGROUND: Urolithiasis is a common urinary tract disease worldwide. It has been connected to systemic diseases, including hypertension, diabetes mellitus, metabolic syndrome, and cardiovascular disease. In the current study, we aimed to evaluate the relationship between urolithiasis and the complications of acute myocardial infarction (AMI). MATERIALS AND METHODS: Data were obtained from the Longitudinal Health Insurance Database 2005 of the National Health Insurance Research Database...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28257336/preadmission-oral-corticosteroids-are-associated-with-reduced-risk-of-acute-respiratory-distress-syndrome-in-critically-ill-adults-with-sepsis
#11
Andrew C McKown, Erin M McGuinn, Lorraine B Ware, Li Wang, David R Janz, Todd W Rice, Matthew W Semler
OBJECTIVES: To determine the association between preadmission oral corticosteroid receipt and the development of acute respiratory distress syndrome in critically ill patients with sepsis. DESIGN: Retrospective observational study. SETTING: Medical, surgical, trauma, and cardiovascular ICUs of an academic medical center. PATIENTS: A total of 1,080 critically ill patients with sepsis. INTERVENTIONS: None...
March 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28251105/carbapenemase-producing-enterobacteriaceae-risk-factors-for-infection-and-impact-of-resistance-on-outcomes
#12
Shanthi Mariappan, Uma Sekar, Arunagiri Kamalanathan
BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) have increased in recent years leading to limitations of treatment options. The present study was undertaken to detect CPE, risk factors for acquiring them and their impact on clinical outcomes. METHODS: This retrospective observational study included 111 clinically significant Enterobacteriaceae resistant to cephalosporins subclass III and exhibiting a positive modified Hodge test. Screening for carbapenemase production was done by phenotypic methods, and polymerase chain reaction was performed to detect genes encoding them...
January 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28248846/outcomes-in-pelvic-organ-prolapse-surgery-in-women-using-chronic-antithrombotic-therapy
#13
Rachel High, Alex Kavanagh, Rose Khavari, Julie Stewart, Danielle D Antosh
INTRODUCTION: Chronic antithrombotic therapy is common among patients requiring surgery for pelvic organ prolapse because of age and comorbidities. The impact of chronic anticoagulation on postoperative complications in pelvic organ prolapse surgery has not been investigated. This study aims to determine if patients on chronic antithrombotic therapy are at increased risk for postoperative complications. METHODS: This retrospective cohort study included women having prolapse surgery from 2012 to 2015, identified by Current Procedural Terminology codes, excluding patients undergoing concomitant major nonurogynecologic procedures...
February 28, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28244940/elevated-mean-airway-pressure-and-central-venous-pressure-in-the-first-day-of-mechanical-ventilation-indicated-poor-outcome
#14
Yun Long, Longxiang Su, Qing Zhang, Xiang Zhou, Hao Wang, Na Cui, Wenzhao Chai, Xiaoting Wang, Xi Rui, Dawei Liu
OBJECTIVES: The relationship between respiratory mechanical parameters and hemodynamic variables remains unclear. This study was performed to determine whether mean airway pressure and central venous pressure in the first day of mechanical ventilation are associated with patient outcomes. DESIGN: Retrospective first 24-hour comparison during ICU stay. SETTING: The Department of Critical Care Medicine of Peking Union Medical College Hospital...
February 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28244700/the-influence-of-protein-provision-in-the-early-phase-of-intensive-care-on-clinical-outcomes-for-critically-ill-patients-on-mechanical-ventilation
#15
Joo Han Song, Ho Sun Lee, Song Yee Kim, Eun Young Kim, Jie Ye Jung, Young Ae Kang, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Kyung Soo Chung
BACKGROUND AND OBJECTIVES: Mechanically ventilated patients often face progressive and rapid losses of body mass and muscle because of hypermetabolism and increased protein catabolism. To investigate the impact of adequate nutritional provision during the early phase of intensive care unit (ICU) admission on the clinical outcomes in patients with medical illnesses receiving mechanical ventilation support. METHODS AND STUDY DESIGN: Two hundred and eleven mechanically ventilated patients admitted to a 30-bed medical ICU were included...
March 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28243502/ceeg-electrode-related-pressure-ulcers-in-acutely-hospitalized-patients
#16
Lidia M V R Moura, Thiago S Carneiro, David Kwasnik, Valdery F Moura, Christine S Blodgett, Joseph Cohen, Mary McKenna Guanci, Daniel B Hoch, John Hsu, Andrew J Cole, M Brandon Westover
BACKGROUND: Pressure ulcers resulting from continuous EEG (cEEG) monitoring in hospitalized patients have gained attention as a preventable medical complication. We measured their incidence and risk factors. METHODS: We performed an observational investigation of cEEG-electrode-related pressure ulcers (EERPU) among acutely ill patients over a 22-month period. Variables analyzed included age, sex, monitoring duration, hospital location, application methods, vasopressor usage, nutritional status, skin allergies, fever, and presence/severity of EERPU...
February 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28243161/perioperative-neutrophil-to-lymphocyte-ratio-as-a-predictor-of-poor-cardiac-surgery-patient-outcomes
#17
Konstantinos Giakoumidakis, Nikolaos V Fotos, Athina Patelarou, Stavros Theologou, Mihalis Argiriou, Anastasia A Chatziefstratiou, Christina Katzilieri, Hero Brokalaki
PURPOSE: The purpose of the present study was to investigate the association between the perioperative neutrophil to lymphocyte ratio (NLR) and cardiac surgery patient outcomes. PATIENTS AND METHODS: A retrospective cohort study of 145 patients who underwent cardiac surgery in a tertiary hospital of Athens, Greece, from January to March 2015, was conducted. By using a structured short questionnaire, this study reviewed the electronic hospital database and the medical and nursing patient records for data collection purposes...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28238693/digital-rectal-examination-reduces-hospital-admissions-endoscopies-and-medical-therapy-in-patients-with-acute-gastrointestinal-bleeding
#18
Manish P Shrestha, Mark Borgstrom, Eugene Trowers
BACKGROUND: Although digital rectal examination is an established part of physical examination in patients with acute gastrointestinal bleeding, clinicians are reluctant to perform rectal examination. We intended to assess if rectal examination affects the clinical management decision in these patients. STUDY: We performed a single-center, retrospective, cross-sectional study using data from electronic health record of patients ≥18 years old presenting to emergency with acute gastrointestinal bleeding...
February 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28203417/clinical-factors-associated-with-weaning-failure-in-patients-requiring-prolonged-mechanical-ventilation
#19
Hong-Joon Shin, Jin-Sun Chang, Seong Ahn, Tae-Ok Kim, Cheol-Kyu Park, Jung-Hwan Lim, In-Jae Oh, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim, Yong-Soo Kwon
BACKGROUND: For patients requiring prolonged mechanical ventilation (PMV), weaning is difficult and mortality is very high. PMV has been defined recently, by consensus, as constituting ≥21 consecutive days of mechanical ventilation (MV) for ≥6 hours per day. This study aimed to evaluate the clinical factors predicting weaning failure in patients undergoing PMV in medical intensive care unit (ICU). METHODS: We retrospectively reviewed the clinical and laboratory characteristics of 127 patients who received MV for more than 21 days in the medical ICU at Chonnam National University Hospital in South Korea between January 2005 and December 2014...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28185893/united-states-clergy-religious-values-and-relationships-to-end-of-life-discussions-and-care
#20
Michael J Balboni, Adam Sullivan, Andrea C Enzinger, Patrick T Smith, Christine Mitchell, John R Peteet, James Tulsky, Tyler VanderWeele, Tracy A Balboni
CONTEXT: While clergy interact with approximately half of U.S. patients facing end-of-life medical decisions, little is known about clergy-congregant interactions or clergy influence on end-of-life decisions. OBJECTIVE: To conduct a nationally representative survey of clergy beliefs and practices. METHODS: A mailed survey to a nationally representative sample of clergy completed in March 2015 with 1005 of 1665 responding (60% response rate)...
February 6, 2017: Journal of Pain and Symptom Management
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