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https://www.readbyqxmd.com/read/29336972/general-anesthesia-for-transcatheter-aortic-valve-replacement-total-intravenous-anesthesia-is-associated-with-less-delirium-as-compared-to-volatile-agent-technique
#1
Allie E Goins, Alan Smeltz, Cassandra Ramm, Paula D Strassle, Emily G Teeter, John P Vavalle, Lavinia Kolarczyk
OBJECTIVE: Investigate the effect of volatile anesthesia versus total intravenous anesthesia on the incidence of postoperative delirium and length of stay in patients undergoing transcatheter aortic valve replacement under general anesthesia. DESIGN: Retrospective study. SETTING: Single institution, academic medical center. PARTICIPANTS: Adult patients who underwent transcatheter aortic valve replacement under general anesthesia between November 2014 and February 2017...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29329162/reorganizing-care-with-the-implementation-of-electronic-medical-records-a-time-motion-study-in-the-picu
#2
Nadia Roumeliotis, Geneviève Parisien, Sylvie Charette, Elizabeth Arpin, Fabrice Brunet, Philippe Jouvet
OBJECTIVES: To assess caregivers' patient care time before and after the implementation of a reorganization of care plan with electronic medical records. DESIGN: A prospective, observational, time-motion study. SETTING: A level 3 PICU. PARTICIPANTS: Nurses and orderlies caring for intubated patients during an 8-hour work shift before (2008-2009) and after (2016) implementation of reorganization of care in 2013. INTERVENTIONS: The reorganization plan included improved telecommunication for healthcare workers, increased tasks delegated to orderlies, and an ICU-specific electronic medical record (Intellispace Critical Care and Anesthesia information system, Philips Healthcare)...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29318326/-reimbursement-of-intensive-care-services-in-austria-use-of-the-lkf-system
#3
REVIEW
M Joannidis, S J Klein, P Metnitz, A Valentin
In Austria, the reimbursement of intensive care services is based on a Diagnosis-Related Groups (DRG) system which has been adapted to the Austrian framework conditions. Compared to Germany where economic considerations had led to personnel cuts, mandatory targets outlined in both the LKF ("Leistungsorientierte Krankenanstaltenfinanzierung", Performance-oriented Hospital Financing) and ÖSG ("Österreichischer Strukturplan Gesundheit", Austrian Health Care Structure Plan) plans ensure a high level of medical and intensive care...
January 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29310372/acute-kidney-injury-due-to-povidone-iodine-ingestion-a-case-report
#4
Chang Seong Kim, Sung Sun Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
RATIONALE: Povidone-iodine is a broad-spectrum antiseptic applied topically to treat wounds and prevent their infection. There have been several case reports of acute kidney injury (AKI) in burn patients after povidone-iodine irrigation and in patients receiving the substance as a sclerotherapy agent for management of lymphocele after renal transplantation. However, biopsy-confirmed AKI after ingestion of povidone-iodine has not previously been described. PATIENT CONCERNS: A 47-year-old man who had apparently ingested povidone-iodine solution and presented with nausea, vomiting, and reduced urine output...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29304746/a-multi-center-study-on-the-risk-factors-of-infection-caused-by-multi-drug-resistant-acinetobacter-baumannii
#5
Huiping Huang, Borong Chen, Gang Liu, Jing Ran, Xianyu Lian, Xinhua Huang, Nan Wang, Zhengjie Huang
BACKGROUND: Acinetobacter baumannii (AB) is critical for healthcare-associated infections (HAI) with significant regional differences in the resistance rate, but its risk factors and infection trends has not been well studied. We aimed to explore the risk factors, epidemiological characteristics and resistance of multidrug-resistant Acinetobacter baumannii (MDR-AB) in intensive care unit inpatients. METHODS: Data of patients with MDR-AB (195 cases), and with antibiotic-sensitive AB infection (294 cases, control) during January to December, 2015 in three medical centers in Xiamen, China were conducted and analyzed in the present retrospective study...
January 5, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29299602/effect-of-standardized-handoff-curriculum-on-improved-clinician-preparedness-in-the-intensive-care-unit-a-stepped-wedge-cluster-randomized-clinical-trial
#6
Brodie Parent, Lacey N LaGrone, Mohamed T Albirair, Peter T Serina, Jonathan M Keller, Joseph Cuschieri, Erin J Addison, Lapio Choe, Genecelle B Delossantos, Cameron E Gaskill, Sarah D Moon, Jestine T MacDonald, Matthew J Stolzberg, Erik G Van Eaton, Jennifer M Zech, Patricia A Kritek
Importance: Clinician miscommunication contributes to an estimated 250 000 deaths in US hospitals per year. Efforts to standardize handoff communication may reduce errors and improve patient safety. Objective: To determine the effect of a standardized handoff curriculum, UW-IPASS, on interclinician communication and patient outcomes. Design, Setting, and Participants: This cluster randomized stepped-wedge randomized clinical trial was conducted from October 2015 to May 2016 at 8 medical and surgical intensive care units at 2 hospital systems within an academic tertiary referral center...
January 3, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29289257/the-association-between-major-depressive-disorder-and-outcomes-in-older-veterans-hospitalized-with-pneumonia
#7
Ami L DeWaters, Matthieu Chansard, Antonio Anzueto, Mary Jo Pugh, Eric M Mortensen
BACKGROUND: Major depressive disorder ("depression") has been identified as an independent risk factor for mortality for many comorbid conditions, including heart failure, cancer and stroke. Major depressive disorder has also been linked to immune suppression by generating a chronic inflammatory state. However, the association between major depression and pneumonia has not been examined. The aim of this study was to examine the association between depression and outcomes, including mortality and intensive care unit admission, in Veterans hospitalized with pneumonia...
January 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29283699/physician-level-variation-in-outcomes-of-mechanically-ventilated-patients
#8
Meeta Prasad Kerlin, Andrew Epstein, Jeremy M Kahn, Theodore J Iwashyna, David A Asch, Michael O Harhay, Sarah J Ratcliffe, Scott D Halpern
RATIONALE: Physicians are increasingly being held accountable for patient outcomes. Yet their specific contribution to the outcomes remains uncertain. OBJECTIVE: To determine variation in outcomes of mechanically ventilated patients among intensivists, as well as associations between intensivist experience and patient outcomes. METHODS: We performed a retrospective cohort study of mechanically ventilated Medicare fee-for-service patients in acute care hospitals in Pennsylvania, using administrative, clinical, and physician data from Centers for Medicare & Medicaid Services and the American Medical Association from 2008 and 2009...
December 28, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29274595/florbetapir-pet-%C3%AE-amyloid-imaging-and-associated-neuropsychological-trajectories-in-survivors-of-critical-illness-a-case-series
#9
James C Jackson, Hillary J Warrington, Robert Kessler, Amy L Kiehl, E Wesley Ely
PURPOSE: Cognitive impairment resembling Alzheimer's disease is common in survivors of critical illness. We hypothesized that Intensive Care Unit (ICU) survivors with cognitive impairment would have significant amyloid and designed a pilot study to explore this relationship. MATERIALS AND METHODS: A pilot, case series of a convenience sample of 14 adult medical and surgical ICU survivors, in a clinical neuroradiology clinic. Patients underwent cognitive testing at 3months, 1year, 4years, and 6years after hospital discharge with the Repeatable Battery for the Assessment of Neuropsychological Status...
October 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29273362/the-risk-factors-of-venous-thromboembolism-in-massively-transfused-patients
#10
Navpreet K Dhillon, Eric J T Smith, Ara Ko, Megan Y Harada, Audrey R Yang, Kavita A Patel, Galinos Barmparas, Eric J Ley
BACKGROUND: Massive transfusion protocols (MTPs) are necessary for hemodynamically unstable trauma patients with active bleeding. Thrombotic events have been associated with blood transfusion; however, the risk factors for the development of venous thromboembolism (VTE) in trauma patients receiving MTP are unknown. METHODS: A retrospective review was conducted by reviewing the electronic medical records of all trauma patients admitted to a Level I trauma center who received MTP from 2011 to 2016...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29273359/antioxidant-supplementation-and-atrial-arrhythmias-in-critically-ill-trauma-patients
#11
Mina F Mirhoseini, Susan E Hamblin, W Paul Moore, Jonathan Pouliot, Judith M Jenkins, Wei Wang, Rameela Chandrasekhar, Bryan R Collier, Mayur B Patel
BACKGROUND: The purpose of this study is to determine if antioxidant supplementation influences the incidence of atrial arrhythmias in trauma intensive care unit (ICU) patients. MATERIALS AND METHODS: In this retrospective pre-post study, critically ill injured patients aged ≥18 years, admitted to a single-center trauma ICU for ≥48 hours were eligible for inclusion. The control group consists of patients admitted from January 2000 to September 2005, before routine antioxidant supplementation in our ICU...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29242524/clinical-implications-of-the-plasma-epha2-receptor-level-in-critically-ill-patients-with-septic-shock
#12
Su Hwan Lee, Ju Hye Shin, Joo Han Song, Ah Young Leem, Moo Suk Park, Young Sam Kim, Joon Chang, Kyung Soo Chung
The Eph/ephrin receptor ligand system is known to play a role in inflammation induced by infection, injury, and inflammatory diseases. The present study aimed to evaluate plasma EphA2 receptor levels in critically ill patients with sepsis. This study was a prospective cohort study evaluating samples and clinical data from the medical intensive care unit (MICU) of a 2000-bed university tertiary referral hospital in South Korea. Positive correlations of the plasma EphA2 receptor level with the acute physiology and chronic health evaluation (APACHE) II score and the sequential organ failure assessment (SOFA) score were observed...
December 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29239978/picu-length-of-stay-factors-associated-with-bed-utilization-and-development-of-a-benchmarking-model
#13
Murray M Pollack, Richard Holubkov, Ron Reeder, J Michael Dean, Kathleen L Meert, Robert A Berg, Christopher J L Newth, John T Berger, Rick E Harrison, Joseph Carcillo, Heidi Dalton, David L Wessel, Tammara L Jenkins, Robert Tamburro
OBJECTIVES: ICU length of stay is an important measure of resource use and economic performance. Our primary aims were to characterize the utilization of PICU beds and to develop a new model for PICU length of stay. DESIGN: Prospective cohort. The main outcomes were factors associated with PICU length of stay and the performance of a regression model for length of stay. SETTING: Eight PICUs. PATIENTS: Randomly selected patients (newborn to 18 yr) from eight PICUs were enrolled from December 4, 2011, to April 7, 2013...
December 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29239150/gender-differences-in-septic-intensive-care-unit-patients
#14
Francesco Campanelli, Giovanni Landoni, Luca Cabrini, Alberto Zangrillo
BACKGROUND: The world population is mostly male at birth, although there is a shift in predominance over 55 years of age with more females than males. Male gender was recently hypothesized to be a risk factor for sepsis and septic shock; the reasons and the consequences of this odd discrepancy are yet a matter of debate. We investigated the percentage of males and females in a large number of trials performed on septic adult patients admitted to Intensive Care Units. METHODS: We analysed all the multicentre randomized controlled trials ever published in peer-reviewed Journals reporting a significant effect on mortality in intensive care unit septic adult patients; furthermore, we retrieved all the manuscripts dealing with sepsis or septic shock patients published in the last 3 years in the three medical Journals with the highest impact factor...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29221294/using-m-mode-ultrasonography-to-assess-diaphragm-dysfunction-and-predict-the-success-of-mechanical-ventilation-weaning-in-elderly-patients
#15
Daozheng Huang, Huan Ma, Wenzhao Zhong, Xiaoting Wang, Yan Wu, Tiehe Qin, Shouhong Wang, Ning Tan
Background: Ultrasonography (US) is a non-invasive and commonly available bedside diagnostic tool. The aim of this study was to assess the utility of M-mode US on ventilator weaning outcomes in elderly patients. Methods: This was a single center, prospective, observational study in patients aged 80 years or older who were in the medical intensive care unit, had undergone mechanical ventilation for >48 hours, and met the criteria for a spontaneous breathing trial (SBT)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29216944/-prognostic-value-of-oxygen-challenge-test-for-patients-with-cardiogenic-shock-receiving-extracorporeal-membrane-oxygenation
#16
Liang Dong, Xiuhong Zhang, Fengming Liang, Xuan Yu, Ting Yang, Lang Li
OBJECTIVE: To investigate the prognostic value of oxygen challenge test (OCT) for patients with cardiogenic shock receiving extracorporeal membrane oxygenation (ECMO). METHODS: A retrospective analysis was conducted. Seventy-eight patients diagnosed with cardiogenic shock receiving veno-arterial (V-A) ECMO admitted to Department of intensive care unit (ICU) of Wuxi People's Hospital Affiliated to Nanjing Medical University from June 2012 to May 2017 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216937/-significance-of-peripheral-perfusion-index-in-early-diagnosis-and-goal-directed-therapy-of-septic-shock-patients-a-prospective-single-blind-randomized-controlled-trial
#17
Yuanfeng Shi, Ruihong Yin, Yanli Wang, Jiguang Li, Xiaobing Chen, Yongpeng Xie, Caihong Gu, Xiuzhen Zou, Kexi Liu
OBJECTIVE: To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216782/reduction-in-central-line-associated-bloodstream-infections-correlated-with-the-introduction-of-a-novel-silver-plated-dressing-for-central-venous-catheters-and-maintained-for-6-years
#18
Rachel Karlnoski, Elia Charbel Abboud, Peggy Thompson, Asa Z Oxner, John T Sinnott, Jorge E Marcet
OBJECTIVE: To assess a novel silver-plated dressing (SD) for central venous catheters in comparison to chlorhexidine gluconate-impregnated sponge (CHGIS) dressings in preventing central line-associated bloodstream infections (CLABSIs) in adult intensive care unit (ICU) patients. DESIGN: Retrospective cohort study. SETTING: Tampa General Hospital, an academic medical tertiary care center. PATIENTS: All adult ICU patients of an academic medical tertiary care center from January 2009 to December 2010...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29210786/selective-serotonin-reuptake-inhibitors-and-serotonin-norepinephrine-reuptake-inhibitors-are-not-associated-with-bleeding-or-transfusion-in-cardiac-surgical-patients
#19
Mark M Smith, Bradford B Smith, Brian D Lahr, Gregory A Nuttall, William J Mauermann, Timothy J Weister, Joseph A Dearani, David W Barbara
BACKGROUND: Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) use is known to alter platelet activation and aggregation leading to impairment in hemostasis. Previous studies are ambiguous with regard to bleeding, transfusion, and perioperative complications in patients undergoing cardiac surgery. The purpose of this study was to evaluate the risk of perioperative bleeding, transfusion, morbidity, and mortality in cardiac surgical patients taking SSRI/SNRIs compared with propensity-matched controls...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29209982/adherence-to-inhaled-medications-and-its-effect-on-healthcare-utilization-and-costs-among-high-grade-chronic-obstructive-pulmonary-disease-patients
#20
Jee-Ae Kim, Min Kyoung Lim, Kunil Kim, JuHee Park, Chin Kook Rhee
BACKGROUND: Adherence to inhaled medication regimens affects chronic obstructive pulmonary disease (COPD) prognosis and quality of life, and reduces the use of healthcare services, resulting in cost savings. OBJECTIVES: To examine the effects of adherence to inhaled medication regimens on healthcare utilization and costs in high-grade COPD patients. METHODS: We performed an observational retrospective cohort study using a longitudinal data set from the Korean Health Insurance Review and Assessment Service (2008-2013) containing healthcare services' information for 50 million beneficiaries...
December 5, 2017: Clinical Drug Investigation
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