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https://www.readbyqxmd.com/read/29788912/association-between-troponin-i-levels-and-outcome-in-critically-ill-patients-admitted-to-non-cardiac-intensive-care-unit-with-high-prevalence-of-cardiovascular-risk-factors
#1
Abdulaleem Alatassi, Mohamad Habbal, Hani Tamim, Musharaf Sadat, Eman Al Qasim, Yaseen M Arabi
BACKGROUND: The association of troponin-I levels and outcome in medical-surgical ICU patients has been studied before in populations with low to moderate prevalence of cardiovascular risk factors. The objective in this article is to examine the association of troponin-I levels with hospital mortality in patients with high prevalence of cardiovascular risk factors who were admitted with medical-surgical indications to a non-cardiac intensive care unit. METHODS: This was a retrospective study of adult patients admitted to a tertiary medical-surgical ICU between July 2001 and November 2011...
May 22, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29783029/comparison-of-stanford-b-aortic-dissection-patients-who-received-tevar-combined-with-or-without-sleep-apnea-syndrome
#2
Xin Li, Wenwu Cai, Ping Zhang, Kun Fang, Jieting Zhu, Chang Shu
BACKGROUND: Patients with Stanford B aortic dissection usually complicated with sleep apnea syndrome. This condition always threatens the patients' respiration situation. In this study, we collected and analysis data of patients' peri-operative managements of Thoracic Endovascular Aortic Repair (TEVAR) for Stanford B Aortic Dissection (AD) complicated with Sleep Apnea Syndrome (SAS). Comparison has been made between these SAS patients and those who without SAS. METHODS: Between June 2013 and June 2014, the clinical data and outcomes of the Stanford B AD patients in the department of vascular surgery in the Second Xiangya Hospital were retrospectively reviewed and studied...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29775080/mindfulness-meditation-and-interprofessional-cardiopulmonary-resuscitation-a-mixed-methods-pilot-study
#3
Diana J Kelm, Jennifer L Ridgeway, Becca L Gas, Monali Mohan, David A Cook, Darlene R Nelson, Roberto P Benzo
PROBLEM: Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress...
May 18, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29769112/association-between-%C3%AE-blocker-use-and-mortality-in-critically-ill-patients-a-nested-cohort-study
#4
Shmeylan A Al Harbi, Khalid A Al Sulaiman, Hani Tamim, Hasan M Al-Dorzi, Musharaf Sadat, Yaseen Arabi
BACKGROUND: β-blockers have several indications in critically ill patients and are commonly used. The aim of this study is to examine the relationship between the use of β-blockers in critically ill patients and mortality. METHODS: This was a nested cohort study in which all medical-surgical ICU patients (N = 523) enrolled in a randomized clinical trial of intensive insulin therapy (ISRCTN07413772) were grouped according to β-blocker use during ICU stay. To account for the indication of β-blockers, we constructed a propensity score using selected clinically-relevant and statistically-significant variables related to β-blocker exposure and outcome...
May 16, 2018: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29765580/predictive-factors-associated-with-mortality-and-discharge-in-intensive-care-units-a-retrospective-cohort-study
#5
Mohammad Ghorbani, Haleh Ghaem, Abbas Rezaianzadeh, Zahra Shayan, Farid Zand, Reza Nikandish
Background and aim: Accurate prediction of prognosis of patients admitted to intensive care units (ICUs) is very important for the clinical management of the patients. The present study aims to identify independent factors affecting death and discharge in ICUs using competing risk modeling. Methods: This retrospective cohort study was conducted on enrolling 880 patients admitted to emergency ICU in Namazi hospital, Shiraz University of Medical Sciences, Shiraz, Iran during 2013-2015...
March 2018: Electronic Physician
https://www.readbyqxmd.com/read/29765435/mortality-of-adult-intensive-care-units-in-turkey-using-the-apache-ii-and-sofa-systems-outcome-assessment-in-turkish-intensive-care-units
#6
Cetin Kaymak, Irfan Sencan, Seval Izdes, Aydin Sari, Hatice Yagmurdur, Derya Karadas, Derya Oztuna
Introduction: The aim of this study was to evaluate intensive care unit (ICU) performance using risk-adjusted ICU mortality rates nationally, assessing patients who died or had been discharged from the ICU. For this purpose, this study analyzed the Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) databases, containing detailed clinical and physiological information and mortality of mixed critically ill patients in a medical ICU at secondary and tertiary referral ICUs in Turkey...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29756534/neurostimulant-prescribing-patterns-in-children-admitted-to-the-icu-after-traumatic-brain-injury
#7
Amanda Marie Morrison, Amy Houtrow, James Zullo, Patrick M Kochanek, Carol Vetterly, Ericka L Fink
Neurostimulant medications are commonly prescribed following traumatic brain injury (TBI) in adults; little is known about their use in children with TBI. Our objective was to analyze neurostimulant prescribing practices from 2005 to 2015 in children admitted to the intensive care unit (ICU) with TBI. We hypothesized that neurostimulant prescriptions have increased over time and are associated with older age and injury severity. A retrospective cohort study of patients aged 1 month to 18 years with an ICD-9-CM discharge diagnosis code for TBI admitted to the ICU between 2005 and 2015 in 37 pediatric hospitals included in the Pediatric Health Information System was conducted...
May 14, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29754841/-risks-associated-with-the-use-of-non-steroidal-anti-inflammatory-drugs-during-pneumonia
#8
REVIEW
G Voiriot, M Chalumeau, J Messika, D Basille, B Philippe, J-D Ricard, C Andrejak, V Jounieaux, O Sanchez, M Fartoukh
INTRODUCTION: Outpatient treatment of community-acquired pneumonia (CAP) patients with non-steroidal anti-inflammatory drugs (NSAIDs) is frequent, although this is not based on clinical recommendations and there is no scientific evidence supporting better symptom relief in comparison to acetaminophen. STATE OF THE ART: Experimental data suggest that NSAIDs alter the intrinsic functions of neutrophils, limit their locoregional recruitment, alter bacterial clearance and delay the resolution of inflammatory processes during acute bacterial pulmonary challenge...
May 10, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29752218/elevated-international-normalized-ratio-is-not-associated-with-increased-perioperative-morbidity-in-podiatric-limb-salvage-surgery-a-retrospective-analysis
#9
Nalini Vadivelu, Alice M Kai, Feng Dai, Hosni Mikhael, Rima Aouad, Peter Blume
The risk of hemorrhage always exists in anticoagulated patients with an elevated international normalized ratio (INR), a risk that must be measured against the necessity for surgical procedures. The objective of the present retrospective medical record study was to assess the safety with which limb salvage procedures can be conducted in patients with an INR >1.4. The medical records of 231 patients who had undergone limb salvage procedures by 1 surgeon at the Yale New Haven Health System from November 2008 through July 2014 were reviewed...
May 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29731080/carbapenem-resistant-acinetobacter-baumannii-bacteremia-in-liver-transplant-recipients
#10
Y J Kim, S I Kim, Y D Lee, H J Choi, J Y Choi, S K Yoon, Y-K You, D-G Kim
BACKGROUND: Acinetobacter baumannii has become an increasingly important nosocomial pathogen. Carbapenem is the preferred drug of choice for treatment of multidrug-resistant gram-negative bacilli, but carbapenem-resistant A baumannii (CRAB) has now emerged. The aim of this study was to determine the incidence, outcomes, and risk factors for CRAB bacteremia in liver transplant recipients. METHODS: The medical records of 393 subjects who underwent living donor liver transplant at Seoul St...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29727367/insidious-harm-of-medication-diluents-as-a-contributor-to-cumulative-volume-and-hyperchloremia-a-prospective-open-label-sequential-period-pilot-study
#11
Carolyn A Magee, Melissa L Thompson Bastin, Melanie E Laine, Brittany D Bissell, Gavin T Howington, Peter R Moran, Emily J McCleary, Gary D Owen, Lauren E Kane, Emily A Higdon, Cathy A Pierce, Peter E Morris, Alexander H Flannery
OBJECTIVES: Although the potential dangers of hyperchloremia from resuscitation fluids continue to emerge, no study to date has considered the contribution of medication diluents to cumulative volume and hyperchloremia. This study compares saline versus dextrose 5% in water as the primary medication diluent and the occurrence of hyperchloremia in critically ill patients. DESIGN: Prospective, open-label, sequential period pilot study. SETTING: Medical ICU of a large academic medical center...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29720051/analysis-of-rothman-index-data-to-predict-postdischarge-adverse-events-in-a-medical-intensive-care-unit
#12
Deepa Bangalore Gotur, Faisal Masud, Jaya Paranilam, Janice L Zimmerman
OBJECTIVE: Currently, there are no objective metrics included in the intensive care unit (ICU) discharge decision making process. In this study, we evaluate Rothman Index(RI) data for a possible metric as part of a quality improvement project. Our objectives were to determine whether RI could predict adverse events occurring within 72 hours of ICU discharge decision, the optimal clinical cutoff value for this metric, and to determine whether there is a relation between the RI warning alert 24 hours prior to discharge and adverse events postdischarge...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29716905/mobilization-therapy-in-the-pediatric-intensive-care-unit-a-multidisciplinary-quality-improvement-initiative
#13
Blair R L Colwell, Cydni N Williams, Serena P Kelly, Laura M Ibsen
BACKGROUND: Mobilization is safe and associated with improved outcomes in critically ill adults, but little is known about mobilization of critically ill children. OBJECTIVE: To implement a standardized mobilization therapy protocol in a pediatric intensive care unit and improve mobilization of patients. METHODS: A goal-directed mobilization protocol was instituted as a quality improvement project in a 20-bed cardiac and medical-surgical pediatric intensive care unit within an academic tertiary care center...
May 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29708848/clostridium-difficile-infection-in-trauma-surgery-and-medical-patients-admitted-to-the-intensive-care-unit
#14
Richard R Watkins, Caroline Mangira, Farid Muakkassa, Curtis J Donskey, Nairmeen A Haller
BACKGROUND: Clostridium difficile infection (CDI) causes significant morbidity and mortality rates, especially for patients in the intensive care unit (ICU). Data comparing trauma and surgery patients with CDI in the ICU with medical patients with CDI in the ICU are limited. METHODS: In a single-center study, we analyzed retrospective data from 25 trauma patients and 13 surgery patients aged 18 years or older who had CDI and had been admitted to the ICU. A comparison group of 156 medical patients aged 18 years or greater who had CDI and were admitted to the ICU also was identified...
April 30, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29698253/auditory-icon-alarms-are-more-accurately-and-quickly-identified-than-current-standard-melodic-alarms-in-a-simulated-clinical-setting
#15
Richard R McNeer, Danielle Bodzin Horn, Christopher L Bennett, Judy Reed Edworthy, Roman Dudaryk
BACKGROUND: Current standard audible medical alarms are difficult to learn and distinguish from one another. Auditory icons represent a new type of alarm that has been shown to be easier to learn and identify in laboratory settings by lay subjects. In this study, we test the hypothesis that icon alarms are easier to learn and identify than standard alarms by anesthesia providers in a simulated clinical setting. METHODS: Twenty anesthesia providers were assigned to standard or icon groups...
April 26, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29685512/causes-and-outcomes-of-finger-ischemia-in-hospitalized-patients-in-the-intensive-care-unit
#16
Gregory J Landry, Courtney J Mostul, Daniel S Ahn, Bryant J McLafferty, Timothy K Liem, Erica L Mitchell, Enjae Jung, Cherrie Z Abraham, Amir F Azarbal, Robert B McLafferty, Gregory L Moneta
OBJECTIVE: Vascular surgeons may be consulted to evaluate hospitalized patients with finger ischemia. We sought to characterize causes and outcomes of finger ischemia in intensive care unit (ICU) patients. METHODS: All ICU patients who underwent evaluation for finger ischemia from 2008 to 2015 were reviewed. All were evaluated with finger photoplethysmography. The patients' demographics, comorbidities, ICU care (ventilator status, arterial lines, use of vasoactive medications), finger amputations, and survival were also recorded...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29673564/factors-affecting-the-efficacy-and-safety-of-aminophylline-in-treatment-of-apnea-of-prematurity-in-neonatal-intensive-care-unit
#17
Chaohui Ye, Caiyun Miao, Li Yu, Zhuoya Dong, Jie Zhang, Yingying Mao, Xiaodong Lu, Qin Lyu
BACKGROUND: The factors affecting the safety and efficacy of aminophylline use in the treatment of apnea of prematurity (AOP) in the neonatal intensive care unit (NICU) are not clear. In this study, we aimed to evaluate the potential factors affecting the efficacy and safety of aminophylline in AOP treatment at standard doses and to determine appropriate patients for this therapy. METHODS: Over a 3-year period (January 2012 to December 2014), the medical records of 206 preterm infants with apnea who were admitted to the NICU of our hospital to receive aminophylline infusions were retrospectively reviewed...
March 30, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29667584/pharmacist-interventions-during-patient-rounds-in-two-intensive-care-units-clinical-and-financial-impact
#18
B E Bosma, P M L A van den Bemt, P H G J Melief, J van Bommel, S S Tan, N G M Hunfeld
INTRODUCTION: The risk of prescribing errors and related adverse drug events (ADE) on the intensive care unit (ICU) is high. Based on studies carried out in North America or the UK, a clinical pharmacy service can reduce ADEs and lower overall costs. This study looks into the clinical and financial impact of interventions made by pharmacists during patient rounds in two ICU settings in the Netherlands. MATERIALS AND METHODS: A quality improvement study was performed in a general teaching hospital (GTH) and a university hospital (UH) in the Netherlands...
April 2018: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29665826/association-between-afterhours-admission-to-the-intensive-care-unit-strained-capacity-and-mortality-a-retrospective-cohort-study
#19
Adam M Hall, Henry T Stelfox, Xioaming Wang, Guanmin Chen, Danny J Zuege, Peter Dodek, Allan Garland, Damon C Scales, Luc Berthiaume, David A Zygun, Sean M Bagshaw
BACKGROUND: Admission to the intensive care unit (ICU) outside daytime hours has been shown to be variably associated with increased morbidity and mortality. We aimed to describe the characteristics and outcomes of patients admitted to the ICU afterhours (22:00-06:59 h) in a large Canadian health region. We further hypothesized that the association between afterhours admission and mortality would be modified by indicators of strained ICU capacity. METHODS: This is a population-based cohort study of 12,265 adults admitted to nine ICUs in Alberta from June 2012 to December 2014...
April 17, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29663999/-analysis-of-high-risk-factors-of-intensive-care-unit-acquired-weakness-in-patients-with-sepsis
#20
Xiaofan Yu, Xiaohong Wan, Linjun Wan, Qingqing Huang
OBJECTIVE: To investigate high risk factors of intensive care unit-acquired weakness (ICUAW) in patients with sepsis. METHODS: A retrospective study was conducted. 164 patients with mechanical ventilation (MV) who were diagnosed sepsis and multiple organ dysfunction syndrome (MODS), admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Kunming Medical University from January 1st, 2015 to September 30th, 2017 were enrolled. The general situation, the basic diseases (hypertension, diabetes), body mass index (BMI), protopathy diseases, the level of albumin before ICU admission, the MV time, whether to use glucocorticoid and continuous renal replacement therapy (CRRT) or not, nutrition supply (nutritional way, nutrition initiation time, amino acid/protein supply, nutritional status on ICU 3 days and 7 days), myoglobin, the length of ICU stay, the length of hospital stay, and acute physiology and chronic health evaluation II (APACHE II) score were collected...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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