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https://www.readbyqxmd.com/read/29223941/-medical-futility-and-family-obstinacy-in-intensive-therapy-when-to-stop-and-when-to-keep-going
#1
Alejandro R Grinberg, Vilma A Tripodoro
There have been several recent publications related to therapeutic obstinacy and futility in the Intensive Care Unit. However, little has been published about "the family obstinacy" in persisting with invasive measures in seriously ill patients, despite the appropriate information provided to them about the patient's poor short-term prognosis. On certain occasions, these critical patients are unable to make decisions on the proposed treatments and, unfortunately, many of them have not previously indicated their preferences in terms of limits to invasive measures (advanced directives)...
2017: Medicina
https://www.readbyqxmd.com/read/29223744/effect-of-various-antipsychotic-regimens-on-incidence-of-delirium-in-critically-ill-adults
#2
W Anthony Hawkins, Stephanie V Phan, Stacey L Campbell
PURPOSE: Delirium is common during critical illness but it is unknown whether the choice of antipsychotic or dosing strategy impacts delirium outcomes. We evaluated the incidence of delirium in critically ill adults receiving different antipsychotic regimens. MATERIALS AND METHODS: Single center retrospective cohort study of adult patients admitted to the intensive care unit (ICU). Patients who received haloperidol or quetiapine and scored negative on the Confusion Assessment Method for the ICU (CAM-ICU) prior to initiation were included...
November 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29223743/early-vs-late-tracheostomy-in-intensive-care-settings-impact-on-icu-and-hospital-costs
#3
Brent Herritt, Dipayan Chaudhuri, Kednapa Thavorn, Dalibor Kubelik, Kwadwo Kyeremanteng
INTRODUCTION: Up to 12% of the 800,000 patients who undergo mechanical ventilation in the United States every year require tracheostomies. A recent systematic review showed that early tracheostomy was associated with better outcomes: more ventilator-free days, shorter ICU stays, less sedation and reduced long-term mortality. However, the financial impact of early tracheostomies remain unknown. OBJECTIVES: To conduct a cost-analysis on the timing of tracheostomy in mechanically ventilated patients...
December 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29223725/transfusion-associated-circulatory-overload-a-survey-among-dutch-intensive-care-fellows
#4
R B Klanderman, I Attaye, J J Bosboom, D P Veelo, B F Geerts, A P J Vlaar
OBJECTIVES: Transfusion-associated circulatory overload (TACO) is a severe pulmonary transfusion reaction and leading cause of transfusion-related morbidity and mortality in Europe. TACO is of particular importance in critically ill patients, since they often receive blood transfusions and have multiple risk factors for TACO. This study investigates transfusion practices in patients at risk of developing TACO, and furthermore knowledge concerning risk factors, diagnoses and treatment strategies among Dutch intensive care unit (ICU) fellows...
December 6, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/29223567/predictive-ability-of-the-evaruci-scale-and-comhon-index-for-pressure-injury-risk-in-critically-ill-patients-a-diagnostic-accuracy-study
#5
M de Los Ángeles Leal-Felipe, M Del Carmen Arroyo-López, M Del Cristo Robayna-Delgado, Ana Gómez-Espejo, Patricia Perera-Díaz, Carmen D Chinea-Rodríguez, Natalia García-Correa, Alejandro Jiménez-Sosa
BACKGROUND: Hospital-acquired pressure injuries are a costly and largely preventable complication occurring in a variety of acute care settings. Patients admitted to the intensive care unit are at greater risk of developing pressure injuries. OBJECTIVE: To determine whether the efficiency of scales to measure pressure injury risk increase when a continuously updated 3-day moving average method is used. METHODS: With a retrospective cohort design we recruited 3085 patients treated between June 2011 and February 2015 in the intensive care unit of a tertiary level university hospital...
December 6, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29222857/serum-levels-of-the-s100b-protein-and-neuron-specific-enolase-are-associated-with-mortality-in-critically-ill-patients
#6
Izabela Duda, Łukasz Krzych, Halina Jędrzejowska-Szypułka, Joanna Lewin-Kowalik
INTRODUCTION: Evaluation of the prognostic potential of the S100B protein and neuron-specific enolase (NSE) as predictors of mortality in critically ill patients in intensive care units (ICU). MATERIALS AND METHODS: The study was conducted on 62 patients. Basic clinical variables and blood samples for S100B and NSE level testing were obtained during the first four days after admission. Mortality was described as the patient's death during hospitalization in the ICU...
December 10, 2017: Acta Biochimica Polonica
https://www.readbyqxmd.com/read/29222034/management-of-invasive-candidiasis-and-candidemia-in-critically-ill-adults-expert-opinion-of-the-european-society-of-anaesthesia-esa-intensive-care-scientific-subcommittee
#7
REVIEW
Ruth-Aoibheann OLeary, Sharon Einav, Marc Leone, Krisztina Madách, Claude Martin, Ignacio Martin-Loeches
OBJECTIVE: The global burden of invasive fungal disease is increasing. Candida albicans remains the leading cause of fungal blood stream infections although non-albicans Candidal infections are emerging. Areas of controversy regarding diagnosis and management are hampering our ability to respond effectively to this evolving threat. The purpose of this narrative review is to address current controversies and provide recommendations to supplement guidelines. DIAGNOSIS OF INVASIVE CANDIDIASIS: Diagnosis of invasive candidiasis requires a combination of diagnostic tests and patient risk factors...
December 5, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29221978/influence-of-6-hydroxyethyl-starch-130-0-4-versus-crystalloid-solution-on-structural-renal-damage-markers-after-coronary-artery-bypass-grafting-a-post-hoc-subgroup-analysis-of-a-prospective-trial
#8
Thomas Datzmann, Markus Hoenicka, Helmut Reinelt, Andreas Liebold, Hagen Gorki
OBJECTIVE: The restriction of hydroxyethyl starch (HES) has mandated changes in volume management based on data of critically ill patients. Reliable data of structural renal damage after HES treatment in cardiac surgical patients are lacking. The influence of 6% HES 130/0.4 was investigated in this study. DESIGN: An exploratory post hoc subgroup analysis of a prospective trial was performed. SETTING: The study was carried out at a university hospital...
May 25, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221616/dengue-fever-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#9
REVIEW
Pravin Amin, Özlem Acicbe, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Tim Baker, Guy A Richards
Dengue is an arbovirus affecting humans and spread by mosquitoes. Severe dengue follows a secondary infection with a different virus serotype. The problem is truly global as it is endemic in over 100 countries. Severe dengue can be a life-threatening because of increased vascular permeability, resulting in leakage of fluid from the intravascular compartment to the extravascular space. When major bleeding does occur, it is almost invariably combined with profound shock since this, in combination with thrombocytopenia, hypoxia, and acidosis, can lead to multiple organ failure and disseminated intravascular coagulation...
November 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29221433/hyporesponsiveness-of-natural-killer-cells-and-impaired-inflammatory-responses-in-critically-ill-patients
#10
Minkyung Kim, Minjoo Kim, Hana Jeong, Jey Sook Chae, Young Sam Kim, Jae Gil Lee, Younsoo Cho, Jong Ho Lee
BACKGROUND: To investigate natural killer (NK) cell activity, circulating cytokine level and peripheral blood mononuclear cell (PBMC) cytokine production status in critically ill patients. METHODS: Blood samples were collected <24 h after admission from 24 intensive care unit (ICU) patients and 24 age-, sex-, and body mass index (BMI)-matched healthy controls. Serum cytokine concentrations and cytokine production by PBMCs and lipopolysaccharide (LPS)-stimulated PBMCs were measured...
December 8, 2017: BMC Immunology
https://www.readbyqxmd.com/read/29220756/the-impact-of-sustained-new-onset-atrial-fibrillation-on-mortality-and-stroke-incidence-in-critically-ill-patients-a-retrospective-cohort-study
#11
Takuo Yoshida, Shigehiko Uchino, Taisuke Yokota, Tomoko Fujii, Shoichi Uezono, Masanori Takinami
PURPOSE: The purpose of the study is to evaluate the impact of sustained new-onset AF on mortality and the incidence of stroke in critically ill non-cardiac surgery patients. MATERIAL AND METHODS: This was a retrospective cohort study of non-cardiac surgery patients with new-onset AF conducted in a general intensive care unit. We compared patients remaining in AF with those restored to sinus rhythm (SR) at 6h after the onset of AF and conducted multivariable logistic regression analysis for in-hospital mortality...
December 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29219939/psychometric-evaluation-of-the-chinese-respiratory-distress-observation-scale-on-critically-ill-patients-with-cardiopulmonary-diseases
#12
Ya-Hsiang Chan, Hua-Shan Wu, Chih-Ching Yen, Margaret L Campbell
BACKGROUND: Respiratory distress is a common and distressing experience that strikes most critically ill patients with cardiopulmonary diseases. Now, most dyspnea assessment tools rely on patient's self-report. Only one instrument, the Respiratory Distress Observation Scale (RDOS), is valid for assessing respiratory distress when the patient cannot provide a dyspnea self-report. PURPOSE: The aims of this study were to develop the Chinese version of RDOS through two-way translation and examine its reliability and validity...
December 6, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29219875/ehealth-interventions-for-parents-in-neonatal-intensive-care-units-a-systematic-review
#13
Justine Dol, Alannah Delahunty-Pike, Sheren Anwar Siani, Marsha Campbell-Yeo
BACKGROUND: As technology becomes increasingly more advanced, particularly video technology and interactive learning platforms, some neonatal intensive care units are embracing electronic health (eHealth) technologies to enhance and expand their family-centered care environments. Despite the emergence of eHealth, there has been a lack of systematic evaluation of its effectiveness thus far. OBJECTIVES: To examine the effect of eHealth interventions used in neonatal intensive care units on parent-related and infant outcomes...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29218549/accuracy-and-reliability-of-a-subcutaneous-continuous-glucose-monitoring-device-in-critically-ill-patients
#14
S Rijkenberg, S C van Steen, J H DeVries, P H J van der Voort
Subcutaneous continuous glucose monitoring (CGM) may have benefits in achieving glycemic control in critically ill patients. The aim of this study was to assess the accuracy and reliability of the FreeStyle Navigator I in critically ill patients and to assess patient related factors influencing the accuracy and reliability. This study is a retrospective analysis of data from a randomized controlled trial conducted in a 20-bed mixed intensive care unit. Analytical accuracy, clinical accuracy and reliability were assessed against arterial blood glucose samples as reference...
December 7, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29218262/neurologic-outcomes-following-care-in-the-pediatric-intensive-care-unit
#15
Sherrill D Caprarola, Sapna R Kudchadkar, Melania M Bembea
Purpose of review: With increasing survival of children requiring admission to pediatric intensive care units (PICU), neurodevelopmental outcomes of these patients are an area of increased attention. Our goal was to systematically review recently published literature on neurologic outcomes of PICU patients. Recent Findings: Decline in neurofunctional status occurs in 3%-20% of children requiring PICU care. This proportion varies based on primary diagnosis and severity of illness, with children admitted for primary neurologic diagnosis, children who suffer cardiac arrest or who require invasive interventions during the PICU admission, having worse outcomes...
September 2017: Current Treatment Options in Pediatrics
https://www.readbyqxmd.com/read/29217500/peripheral-neuropathy-as-a-complication-of-diabetic-ketoacidosis-in-a-child-with-newly-diagnosed-diabetes-type-1-case-report
#16
Marta Baszyńska-Wilk, Marta Wysocka-Mincewicz, Anna Świercz, Jolanta Świderska, Magdalena Marszał, Mieczysław Szalecki
BACKGROUND: Neurological complications of diabetic ketoacidosis are considered to be very serious clinical problem. The most common complication is cerebral edema. However this group includes also less common syndromes such as ischemic or hemorrhagic stroke, cerebral venous and sinus thrombosis or very rare peripheral neuropathy. CASE REPORT: We present a case of 9-year old girl with new onset type 1 diabetes, diabetic ketoacidosis, cerebral edema, multifocal vasogenic brain lesions and lower limbs peripheral paresis...
December 8, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29217106/a-novel-mortality-prediction-model-for-the-current-population-in-an-adult-intensive-care-unit
#17
Sofia Fika, Serafeim Nanas, Georgios Baltopoulos, Efstratia Charitidou, Pavlos Myrianthefs
BACKGROUND: The accurate and reliable mortality prediction is very useful, in critical care medicine. There are various new variables proposed in the literature that could potentially increase the predictive ability for death in ICU of the new predictive scoring model. OBJECTIVE: To develop and validate a new intensive care unit (ICU) mortality prediction model, using data that are routinely collected during the first 24 h of ICU admission, and compare its performance to the most widely used conventional scoring systems...
January 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29217105/influence-of-muscle-strength-on-early-mobility-in-critically-ill-adult-patients-systematic-literature-review
#18
REVIEW
Audrey R Roberson, Angela Starkweather, Catherine Grossman, Edmund Acevedo, Jeanne Salyer
BACKGROUND: Muscle strength may be one indicator of readiness to mobilize that can be used to guide decisions regarding early mobility efforts and to progressively advance mobilization. OBJECTIVES: To provide a synthesis of current measures of muscle strength in the assessment of early mobilization in critically ill adult patients who are receiving MV therapy. METHODS: Research studies conducted between 2000-2015 were identified using PubMed, CINHAL, MEDLINE, and the Cochrane Database of Systematic Reviews databases using the search terms "muscle strength", "intensive care", "mechanical ventilation" and "muscle weakness"...
January 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29215801/the-barriers-to-the-prevention-of-ventilator-associated-pneumonia-from-the-perspective-of-critical-care-nurses-a-qualitative-descriptive-study
#19
Vajihe Atashi, Hojatollah Yousefi, Hosein Mahjobipoor, Ahmadreza Yazdannik
INTRODUCTION: Most patients hospitalized in intensive care units need mechanical ventilation. One of the most prevalent and serious complications of mechanical ventilation is ventilator-associated pneumonia. There are different barriers to the prevention of this kind of pneumonia. The aim of this study was to explore the perspectives of Iranian critical care nurses on the barriers to ventilator-associated pneumonia prevention in intensive care units. METHODS: This qualitative descriptive study was done on a purposive sample of 23 critical care nurses...
December 7, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29215080/risk-predictors-and-outcomes-of-acute-kidney-injury-in-patients-admitted-to-intensive-care-units-in-egypt
#20
Samar Abd ElHafeez, Giovanni Tripepi, Robert Quinn, Yasmine Naga, Sherif Abdelmonem, Mohamed AbdelHady, Ping Liu, Matthew James, Carmine Zoccali, Pietro Ravani
Epidemiology of acute kidney injury (AKI) in developing countries is under-studied. We evaluated the risk and prognosis of AKI in patients admitted to intensive care units (ICUs) in Egypt. We recruited consecutive adults admitted to ICUs in Alexandria Teaching Hospitals over six months. We used the KDIGO criteria for AKI. We followed participants until the earliest of ICU discharge, death, day 30 from entry or study end. Of the 532 participants (median age 45 (Interquartile range [IQR]: 30-62) years, 41.7% male, 23...
December 7, 2017: Scientific Reports
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