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https://www.readbyqxmd.com/read/29690893/inclusion-and-definition-of-acute-renal-dysfunction-in-critically-ill-patients-in-randomized-controlled-trials-a-systematic-review
#1
Rogerio da Hora Passos, Joao Gabriel Rosa Ramos, André Gobatto, Juliana Caldas, Etienne Macedo, Paulo Benigno Batista
BACKGROUND: In evidence-based medicine, multicenter, prospective, randomized controlled trials (RCTs) are the gold standard for evaluating treatment benefits and ensuring the effectiveness of interventions. Patient-centered outcomes, such as mortality, are most often the preferred evaluated outcomes. While there is currently agreement on how to classify renal dysfunction in critically ill patients , the application frequency of this new classification system in RCTs has not previously been evaluated...
April 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29688088/constant-light-during-lactation-programs-circadian-and-metabolic-systems
#2
Palma-Gómez Madahi, Osnaya Ivan, Balderas Adriana, Ortega Diana, Escobar Carolina
Exposure to light at night is a disruptive condition for the adult circadian system, leading to arrhythmicity in nocturnal rodents. Circadian disruption is a risk factor for developing physiological and behavioral alterations, including weight gain and metabolic disease. During early stages of development, the circadian system undergoes a critical period of adjustment, and it is especially vulnerable to altered lighting conditions that may program its function, leading to long-term effects. We hypothesized that during lactation a disrupted light-dark cycle due to light at night may disrupt the circadian system and in the long term induce metabolic disorders...
April 24, 2018: Chronobiology International
https://www.readbyqxmd.com/read/29687438/sleep-in-critically-ill-mechanically-ventilated-patients-with-severe-sepsis-or-copd
#3
Y Boyko, P Jennum, H Oerding, J T Lauridsen, M Nikolic, P Toft
BACKGROUND: The standard method for scoring polysomnographic (PSG) sleep is insufficient in the intensive care unit (ICU). A modified classification has been proposed, but has not been tested in specific groups of ICU patients. We aimed firstly to (1) use the modified classification to describe sleep in two groups of ICU patients: a severe sepsis group and a chronic obstructive pulmonary disease (COPD) group, and (2) to compare sleep stage distribution in the groups; secondly to compare the PSG findings with nurses' sleep evaluation...
April 23, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29686877/how-to-manage-various-arrhythmias-and-sudden-cardiac-death-in-the-cardiovascular-intensive-care
#4
REVIEW
Yoshinori Kobayashi
In the clinical practice of cardiovascular critical care, we often observe a variety of arrhythmias in the patients either with (secondary) or without (idiopathic) underlying heart diseases. In this manuscript, the clinical background and management of various arrhythmias treated in the CCU/ICU will be reviewed. The mechanism and background of lethal ventricular tachyarrhythmias vary as time elapses after the onset of MI that should be carefully considered to select a most suitable therapy. In the category of non-ischemic cardiomyopathy, several diseases are known to be complicated by the various ventricular tachyarrhythmias with some specific mechanisms...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29685062/prospective-observational-evaluation-of-sedation-and-pain-management-guideline-adherence-across-new-jersey-intensive-care-units
#5
Alison Brophy, Maria Cardinale, Liza B Andrews, Justin B Kaplan, Christopher Adams, Yekaterina Opsha, Kimberly A Brandt, Deepali Dixit, Steven F Nerenberg, Julie A Saleh
BACKGROUND: The practice guidelines for the management of pain, agitation, and delirium (PAD) from the Society of Critical Care Medicine shifted from primarily focusing on the treatment of anxiety in 2002 to the treatment of pain in 2013. OBJECTIVE: This prospective, observational, multicenter study aimed to assess the degree of practice adherence to the PAD guidelines for ventilated patients in New Jersey intensive care units (ICUs). METHODS: Pharmacist investigators at 8 centers designated 4 days at least 10 days apart to evaluate all patients on mechanical ventilation...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29684991/postoperative-delirium-in-elderly-patients-with-critical-limb-ischemia-undergoing-major-leg-amputation-a-retrospective-study
#6
Young-Hee Shin, Jin Sun Yoon, Hee Jung Jeon, Youngbae B Kim, Young Soo Kim, Ju Young Park
Background: Critical limb ischemia has been identified as a risk factor for the incidence of postoperative delirium in elderly patients. Limb amputation is the last option in critical limb ischemia treatments. We investigated the incidence and predisposing factors of postoperative delirium in patients undergoing major leg amputation. Methods: From January 2012 to December 2016, 121 patients aged over 60 years who had undergone major leg amputation were enrolled in this study...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29684773/late-organ-failures-in-patients-with-prolonged-intensive-care-unit-stays
#7
Elizabeth M Viglianti, Rachel Kramer, Andrew J Admon, Michael W Sjoding, Carol L Hodgson, Rinaldo Bellomo, Theodore J Iwashyna
PURPOSE: The purpose of this study was to characterize the organ failures that develop among patients with prolonged ICU stays, defined as those who spent a minimum of 14 days in an ICU. METHODS: We retrospectively studied a cohort of consecutive patients from a university hospital who were in an ICU for a minimum of 14 days during 2014-2016. We calculated daily Sequential Organ Failure Assessment (SOFA) scores from admission to ICU day 14. The primary outcome was the number of new late organ failures, defined as occurring on ICU day 4 through 14...
April 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29684341/predictors-of-outcome-in-patients-with-hematologic-malignancies-admitted-to-the-intensive-care-unit
#8
Nassar Al-Zubaidi, Emad Shehada, Khaled Alshabani, Jihane ZazaDitYafawi, Pascal Kingah, Ayman O Soubani
PURPOSE: Several studies showed conflicting results about prognosis and predictors of outcome of critically ill patients with hematological malignancies (HM). The aim of this study is to determine the hospital outcome of critically ill patients with HM and the factors predicting the outcome. METHODS AND MATERIALS: All patients with HM admitted to MICU at a tertiary academic medical center were enrolled. Clinical data upon admission and during ICU stay were collected...
April 17, 2018: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/29683522/magnifying-lenses-to-aid-umbilical-catheter-insertion
#9
Aisling M O'Riordan, Oksana Kozdoba, John Fa Murphy, Lisa K McCarthy
Umbilical venous and arterial catheters are frequently inserted into critically ill and preterm newborns in the neonatal intensive care unit (NICU) to administer fluids, drugs and parenteral nutrition; to monitor blood pressure; and for blood sampling(1). Successful catheterisation can be difficult and failure is common because the vessels are small, they are mobile, slippery and easily traumatised. Repeated probing and failure to adequately dilate the opening can cause a false passage adjacent to the vessel that is difficult to correct(2)...
April 23, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29682365/bedside-endoscopic-retrograde-cholangiopancreatography-using-portable-x-ray-in-acute-severe-cholangitis
#10
Rushikesh Shah, Emad Qayed
Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29680878/quantitative-computed-tomography-in-comparison-with-transpulmonary-thermodilution-for-the-estimation-of-pulmonary-fluid-status-a-clinical-study-in-critically-ill-patients
#11
Bernd Saugel, Moritz Wildgruber, Albrecht Staudt, Michael Dieckmeyer, Konstantin Holzapfel, Georgios Kaissis, Mikhail Y Kirov, Vsevolod V Kuzkov, Roland M Schmid, Wolfgang Huber
Extravascular lung water (index) (EVLW(I)) can be estimated using transpulmonary thermodilution (TPTD). Computed tomography (CT) with quantitative analysis of lung tissue density has been proposed to quantify pulmonary edema. We compared variables of pulmonary fluid status assessed using quantitative CT and TPTD in critically ill patients. In 21 intensive care unit patients, we performed TPTD measurements directly before and after chest CT. Based on the density data of segmented CT images we calculated the tissue volume (TV), tissue volume index (TVI), and the mean weighted index of voxel aqueous density (VMWaq)...
April 21, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29680327/clinical-characteristics-of-patients-with-newly-developed-acute-cholecystitis-after-admission-to-the-intensive-care-unit
#12
Soo Jung Kim, Seok Jeong Lee, Su Hwan Lee, Jin Hwa Lee, Jung Hyun Chang, Yon Ju Ryu
INTRODUCTION: Critical care patients have many risk factors for acute cholecystitis (AC). However, less data are available regarding newly developed AC in critically ill patients. OBJECTIVES: To investigate the clinical features of AC occurring in critically ill patients after admission to an intensive care unit (ICU). METHODS: We performed a retrospective cohort study from January 2006 to August 2016 at a tertiary care university hospital...
April 18, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29680262/clinical-implications-of-intravenous-drug-incompatibilities-in-critically-ill-patients
#13
REVIEW
Malik Benlabed, Maxime Perez, Romain Gaudy, Stéphanie Genay, Damien Lannoy, Christine Barthélémy, Pascal Odou, Gilles Lebuffe, Bertrand Décaudin
OBJECTIVE: The aim of this review is to analyse the clinical consequences of intravenous drug incompatibilities in critically ill patients, especially the incidence of organ dysfunctions and mortality. METHODS: A review of literature was conducted according to the PRISMA statement in June 2017, using Medline, ISI Web of Science and Clinicaltrials.gov. DATA EXTRACTION: Eligible studies were case reports and randomised controlled trials (RCTs) that evaluated the effects of drug incompatibilities in critically ill patients on morbidity or mortality as primary or secondary outcomes, or adverse events...
April 19, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29680212/impact-of-a-clinical-therapeutic-intervention-on-pain-assessment-management-and-nursing-practices-in-an-intensive-care-unit-a-before-and-after-study
#14
Vincenzo Damico, Flavio Cazzaniga, Liana Murano, Rita Ciceri, Giuseppe Nattino, Alberto Dal Molin
Accurate pain assessment and management constitute a major challenge for medical and nursing staff in intensive care units (ICUs). A distinct recollection of pain is reported by high proportions of ICU patients. A clinical therapeutic intervention directed at improving pain assessment and management in critically ill patients who are unable to communicate was implemented at an Italian ICU. In this before-and-after study, data were collected before (T0 ) and after (T1 ) the adoption of a protocol involving pain assessment with an ad hoc behavioral pain scale and the administration of analgesics, rather than sedatives, to patients with intermediate to high pain scores...
April 18, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29679531/the-association-of-early-postoperative-lactate-levels-with-morbidity-after-elective-major-abdominal-surgery
#15
Jelena Veličković, Ivan Palibrk, Biljana Miličić, Dejan Veličković, Bojan Jovanović, Goran Rakić, Milorad Petrović, Vesna Bumbaširević
Lactate levels are widely used as an indicator of outcome in critically ill patients. We investigated the prognostic value of postoperative lactate levels for postoperative complications (POC), mortality and length of hospital stay after elective major abdominal surgery. A total of 195 patients were prospectively evaluated. Lactate levels were assessed on admission to the intensive care unit (ICU) [L0], 4 hours (L4), 12 hours (L12), and 24 hours (L24) after the operation. Demographic and perioperative clinical data were collected...
April 21, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29678361/chikungunya-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#16
Pravin Amin, Gisele Sampaio Silva, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Dilip R Karnad, Guy A Richards
Chikungunya is an arbovirus that is transmitted by the Aedes mosquito causing a febrile illness with periodic outbreaks in large parts of the world. In the last decade it has become a public health concern in a host of countries and has affected international tourists. In the vast majority of cases Chikungunya presents as an acute febrile illness, associated with rash, headache, myalgia and debilitating arthralgia or even polyarthritis. A small proportion of patients present atypically with nervous, ocular, renal, myocardial, respiratory and renal system involvement and may require ICU management...
April 7, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29678304/improving-postoperative-neonatal-nutritional-practices-in-an-intensive-care-unit-using-the-pdsa-cycle
#17
Jennifer Newcombe, Eileen Fry-Bowers
Quality Improvement models offer a framework for health care professionals to follow in implementing process improvement changes. Use of these models promotes a systematic approach to problem solving, keeps providers from eliminating important steps, facilitates team work, and provides a clear plan for ongoing communication. This paper describes use of the Plan-Do-Study-Act model to implement a unit-based quality improvement project that focused on improving postoperative nutritional practices for neonates with critical congenital heart disease following complex cardiac surgery...
April 17, 2018: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29675709/acid-base-status-and-its-clinical-implications-in-critically-ill-patients-with-cirrhosis-acute-on-chronic-liver-failure-and-without-liver-disease
#18
Andreas Drolz, Thomas Horvatits, Kevin Roedl, Karoline Rutter, Richard Brunner, Christian Zauner, Peter Schellongowski, Gottfried Heinz, Georg-Christian Funk, Michael Trauner, Bruno Schneeweiss, Valentin Fuhrmann
BACKGROUND: Acid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease. RESULTS: One hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29673409/worldwide-audit-of-blood-transfusion-practice-in-critically-ill-patients
#19
Jean-Louis Vincent, Ulrich Jaschinski, Xavier Wittebole, Jean-Yves Lefrant, Stephan M Jakob, Ghaleb A Almekhlafi, Tommaso Pellis, Swagata Tripathy, Paolo N Rubatto Birri, Yasser Sakr
BACKGROUND: The aim was to describe transfusion practice in critically ill patients at an international level and evaluate the effects of red blood cell (RBC) transfusion on outcomes in these patients. METHODS: This was a pre-planned sub-study of the Intensive Care Over Nations audit, which involved 730 ICUs in 84 countries and included all adult patients admitted between 8 May and 18 May 2012, except admissions for routine postoperative surveillance. RESULTS: ICU and hospital outcomes were recorded...
April 19, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29671764/evaluation-of-factors-associated-with-hypermetabolism-and-hypometabolism-in-critically-ill-aki-patients
#20
Cassiana R de Góes, André Luis Balbi, Daniela Ponce
Acute kidney injury (AKI) is a frequent and serious condition with high mortality. The presence of hypermetabolism may be a factor related to poorer prognosis. This study evaluated the resting energy expenditure (REE) of intensive care unit (ICU) patients with severe AKI using indirect calorimetry (IC) and identified factors associated with metabolism categories. Patients were evaluated through measurement of REE and estimation of basal energy expenditure (BEE) using the Harris⁻Benedict equation. Metabolism categories were as follows: hypermetabolism (REE/BEE > 1...
April 19, 2018: Nutrients
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