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https://www.readbyqxmd.com/read/29474938/differential-family-experience-of-palliative-sedation-therapy-in-specialised-palliative-or-critical-care-units
#1
Hui-Shan Shen, Szu-Yin Chen, Denise Shuk Ting Cheung, Shu-Yi Wang, Lee Jung Jae, Chia-Chin Lin
CONTEXT: No study has examined the varying family experience of palliative sedation therapy (PST) for terminally ill patients in different settings. OBJECTIVES: To examine and compare family concerns about PST use and its effect on the grief suffered by terminally ill patients' families in palliative care units (PCU) or intensive care units (ICU). METHODS: A total of 154 family members of such patients were recruited in Taiwan, of whom 143 completed the study, with 81 from the PCU and 62 from the ICU...
February 20, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29474506/derivation-of-outcome-based-pediatric-critical-values
#2
Hao Du, Corey Markus, Michael Metz, Mengling Feng, Tze Ping Loh
Objectives: There is currently a lack of an outcomes-based definition of critical values for the pediatric population. This has contributed to a highly heterogeneous critical value reporting practice between laboratories. Methods: Anonymized results were extracted from a laboratory information system for 10 biochemistry tests. The probability of high-dependency/intensive care unit admission (as a proxy for adverse outcomes) for each individual laboratory concentration was calculated and adjusted to fit using a polynomial function to model the probability trend...
February 21, 2018: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/29474481/a-dual-boundary-classifier-for-predicting-acute-hypotensive-episodes-in-critical-care
#3
Sakyajit Bhattacharya, Vijay Huddar, Vaibhav Rajan, Chandan K Reddy
An Acute Hypotensive Episode (AHE) is the sudden onset of a sustained period of low blood pressure and is one among the most critical conditions in Intensive Care Units (ICU). Without timely medical care, it can lead to an irreversible organ damage and death. By identifying patients at risk for AHE early, adequate medical intervention can save lives and improve patient outcomes. In this paper, we design a novel dual-boundary classification based approach for identifying patients at risk for AHE. Our algorithm uses only simple summary statistics of past Blood Pressure measurements and can be used in an online environment facilitating real-time updates and prediction...
2018: PloS One
https://www.readbyqxmd.com/read/29473523/drug-induced-qt-interval-prolongation-in-the-intensive-care-unit
#4
Cecilia Villa Etchegoyen, Guillermo Alberto Keller, Sebastian Mrad, Sixuan Cheng, Guillermo DiGirolamo
Drug-induced QT interval prolongation is the most frequent cause of Long QT syndrome (LQTS) in the clinical practice. This electrophysiological entity, produced by an extended duration of the myocardial repolarization and reflected as a prolonged QT interval in the superficial electrocardiogram (EKG), increases the risk of polymorphic ventricular tachycardia (Torsades de Pointes) appearance and sudden death. Certain antiarrhythmic drugs such as amiodarone, sotalol, quinidine, procainamide, verapamil and diltiazem are known as drugs that, due to their mechanism of action, prolong the QT interval, demanding constant monitorization...
February 23, 2018: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29473174/variation-in-red-cell-transfusion-decisions-in-the-intensive-care-unit-a-nationwide-survey-in-the-netherlands
#5
F J Kranenburg, S A Willems, S Le Cessie, P J Marang-van de Mheen, J G van der Bom, M S Arbous
BACKGROUND AND OBJECTIVES: Most guidelines recommend a restrictive transfusion trigger of 7 g/dl. It is unclear whether this resulted in more uniform transfusion practices. The primary objective was to uncover the extent of variation in transfusion decisions within four scenarios of critically ill patients among critical care physicians in the Netherlands. MATERIALS AND METHODS: An online survey comprising four different hypothetical clinical scenarios was sent to all members of the Dutch Society of Intensive Care...
February 23, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29472708/no-question-too-small-development-of-a-question-prompt-list-for-parents-of-critically-ill-infants
#6
Monica E Lemmon, Pamela K Donohue, Erin P Williams, Debra Brandon, Peter A Ubel, Renee D Boss
OBJECTIVE: To develop a question prompt list tailored to the needs of parents of critically ill infants at risk of neurodevelopmental impairment. STUDY DESIGN: Question content was derived from audio-recorded neonatal intensive care unit family meetings and interviews with parents of infants treated with therapeutic hypothermia. Question content was refined using clinician focus groups. Acceptability testing was performed with parents and clinicians caring for infants in the neonatal intensive care unit...
February 22, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29471722/outcomes-and-resource-use-among-overweight-and-obese-children-with-sepsis-in-the-pediatric-intensive-care-unit
#7
Laura S Peterson, Cecilia Gállego Suárez, Hannah E Segaloff, Cameron Griffin, Emily T Martin, Folafoluwa O Odetola, Kanakadurga Singer
OBJECTIVE: To evaluate the effect of overweight and obesity on outcomes and resource use among patients with sepsis in the pediatric intensive care unit (PICU). DESIGN: Retrospective analysis of clinical characteristics, resource use, and mortality among children 0 to 20 years of age admitted to the C.S. MottChildren's Hospital PICU (University of Michigan) between January 2009 and December 2015, with a diagnostic code for sepsis at admission (based on International Classification of Diseases, Ninth Revision- Clinical Modification codes) and with weight and height measurements at PICU admission...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29471111/mortality-prediction-in-intensive-care-units-icus-using-a-deep-rule-based-fuzzy-classifier
#8
Raheleh Davoodi, Mohammad Hassan Moradi
Electronic health records (EHRs) contain critical information useful for clinical studies. Early assessment of patients' mortality in intensive care units is of great importance. In this paper, a Deep Rule-Based Fuzzy System (DRBFS) was proposed to develop an accurate in-hospital mortality prediction in the intensive care unit (ICU) patients employing a large number of input variables. Our main contribution is proposing a system, which is capable of dealing with big data with heterogeneous mixed categorical and numeric attributes...
February 19, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29469010/effect-of-blood-thiamine-concentrations-on-mortality-influence-of-nutritional-status
#9
Heitor Pons Leite, Lúcio Flávio Peixoto de Lima, José Augusto de A C Taddei, Ângela Tavares Paes
OBJECTIVE: To test the hypothesis that low blood thiamine concentrations in malnourished critically ill children are associated with higher risk of 30-d mortality. METHODS: Prospective cohort study in 202 consecutively admitted children who had whole blood thiamine concentrations assessed on admission and on days 5 and 10 of intensive care unit (ICU) stay. The primary outcome variable was 30-d mortality. Mean blood thiamine concentrations within the first 10 d of ICU stay, age, sex, malnutrition, C-reactive protein concentration, Pediatric Index of Mortality 2 score, and severe sepsis/septic shock were the main potential exposure variables for outcome...
December 7, 2017: Nutrition
https://www.readbyqxmd.com/read/29468765/outcomes-of-paediatric-critical-care-asthma-patients
#10
Neeta Rampersad, Barry Wilkins, Jonathan R Egan
AIM: The aim of this study was to characterise patients with asthma admitted to an Australian paediatric intensive care unit (PICU). METHODS: This was a retrospective review of patients with asthma admitted to a university-affiliated, 23-bed, tertiary PICU between January 2000 and December 2011, with a subset of pharmacotherapy and biochemical data from patients admitted between July 2007 and December 2011. RESULTS: A total of 589 admissions (501 patients) with asthma over 12 years constituted 4...
February 22, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29468417/eliciting-the-experiences-of-the-adolescent-parent-dyad-following-critical-care-admission-a-pilot-study
#11
Dora Wood, Sophie Geoghegan, Padmanabhan Ramnarayan, Peter J Davis, John V Pappachan, Sarah Goodwin, Jo Wray
Critically ill adolescents are usually treated on intensive care units optimised for much older adults or younger children. The way they access and experience health services may be very different to most adolescent service users, and existing quality criteria may not apply to them. The objectives of this pilot study were, firstly, to determine whether adolescents and their families were able to articulate their experiences of their critical care admission and secondly, to identify the factors that are important to them during their intensive care unit (ICU) or high dependency unit (HDU) stay...
February 21, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29468335/use-of-speckle-tracking-strain-in-preload-dependent-patients-need-for-cautious-interpretation
#12
C Nafati, M Gardette, M Leone, L Reydellet, V Blasco, A Lannelongue, F Sayagh, S Wiramus, F Antonini, J Albanèse, L Zieleskiewicz
BACKGROUND: In critical patients, left ventricular ejection fraction and fractional shortening are used to reflect left ventricular systolic function. An emerging technique, two-dimensional-strain echocardiography, allows assessment of the left ventricle systolic longitudinal deformation (global longitudinal strain) and the speed at which this deformation occurs (systolic strain rate). This technique is of increasing use in critical patients in intensive care units and in the peri-operative period where preload constantly varies...
February 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29467082/national-survey-on-airway-and-difficult-airway-management-in-intensive-care-units
#13
M G Gómez-Prieto, M R Míguez-Crespo, J R Jiménez-Del-Valle, M D González-Caro, I Marmesat-Ríos, J Garnacho-Montero
OBJECTIVE: To know organization, management and training in airway (AW) in Spanish Intensive Care Units (ICUs), with special interest in difficult airway (DAW). DESIGN: Descriptive cross-sectional study and χ2 subanalysis, conducted through a national survey from november 1th to december 15th, 2016. With the SEMICYUC's support, an online questionnaire of 27 items was sent to 179 ICUs. SETTING: ICUs of public, private centers, and consortia...
February 18, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29467023/protracted-immune-disorders-at-one-year-after-icu-discharge-in-patients-with-septic-shock
#14
Florence Riché, Benjamin G Chousterman, Patrice Valleur, Alexandre Mebazaa, Jean-Marie Launay, Etienne Gayat
BACKGROUND: Sepsis is a leading cause of mortality and critical illness worldwide and is associated with an increased mortality rate in the months following hospital discharge. The occurrence of persistent or new organ dysfunction(s) after septic shock raises questions about the mechanisms involved in the post-sepsis status. The present study aimed to explore the immune profiles of patients one year after being discharged from the intensive care unit (ICU) following treatment for abdominal septic shock...
February 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29466591/effect-of-haloperidol-on-survival-among-critically-ill-adults-with-a-high-risk-of-delirium-the-reduce-randomized-clinical-trial
#15
Mark van den Boogaard, Arjen J C Slooter, Roger J M Brüggemann, Lisette Schoonhoven, Albertus Beishuizen, J Wytze Vermeijden, Danie Pretorius, Jan de Koning, Koen S Simons, Paul J W Dennesen, Peter H J Van der Voort, Saskia Houterman, J G van der Hoeven, Peter Pickkers
Importance: Results of studies on use of prophylactic haloperidol in critically ill adults are inconclusive, especially in patients at high risk of delirium. Objective: To determine whether prophylactic use of haloperidol improves survival among critically ill adults at high risk of delirium, which was defined as an anticipated intensive care unit (ICU) stay of at least 2 days. Design, Setting, and Participants: Randomized, double-blind, placebo-controlled investigator-driven study involving 1789 critically ill adults treated at 21 ICUs, at which nonpharmacological interventions for delirium prevention are routinely used in the Netherlands...
February 20, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29466493/preventable-adverse-drug-events-in-critically-ill-hiv-patients-is-the-detection-of-potential-drug-drug-interactions-a-useful-tool
#16
Grazielle Viana Ramos, André Miguel Japiassú, Fernando Augusto Bozza, Lusiele Guaraldo
OBJECTIVES: The aim of this study was to develop a strategy to identify adverse drug events associated with drug-drug interactions by analyzing the prescriptions of critically ill patients. METHODS: This retrospective study included HIV/AIDS patients who were admitted to an intensive care unit between November 2006 and September 2008. Data were collected in two stages. In the first stage, three prescriptions administered throughout the entire duration of these patients' hospitalization were reviewed, with the Micromedex database used to search for potential drug-drug interactions...
February 19, 2018: Clinics
https://www.readbyqxmd.com/read/29465895/-clinical-neurophysiological-methods-in-diagnosis-and-treatment-of-cerebrovascular-diseases
#17
REVIEW
Ildikó Nagy, Dániel Fabó
Neurophysiological methods are gaining ground in the diagnosis and therapy of cerebrovascular disease. While the role of the EEG (electroencephalography) in the diagnosis of post-stroke epilepsy is constant, quantitative EEG para-meters, as new indicators of early efficiency after thrombolysis or in prognosis of patient's condition have proved their effectiveness in several clinical studies. In intensive care units, continuous EEG monitoring of critically ill patients became part of neurointenzive care protocols...
January 30, 2018: Ideggyógyászati Szemle
https://www.readbyqxmd.com/read/29465177/end-of-life-care-in-the-icu-supporting-nurses-to-provide-high-quality-care
#18
Sarah Crowe
ICU care has traditionally focused on curative treatment, but making the decision to withdraw life-sustaining therapies, the there is an increasing awareness of the key role palliative and barriers to providing good end-of-life care, factors that support comfort care play. Through a review of recent literature on end- good end-of-life care, and specific guidelinesfor the withdrawal of-life care and withdrawal of life-sustaining therapies in the of life-sustaining therapies. Using this information, a checklist to intensive care unit, four themes have emerged: the challenges of support end-of-life care by critical care nurses was created...
May 2017: Canadian Journal of Critical Care Nursing
https://www.readbyqxmd.com/read/29464690/bis-monitoring-versus-clinical-assessment-for-sedation-in-mechanically-ventilated-adults-in-the-intensive-care-unit-and-its-impact-on-clinical-outcomes-and-resource-utilization
#19
REVIEW
Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29464581/urinary-neutrophil-gelatinase-associated-lipocalin-ngal-and-serum-cystatin-c-measurements-for-early-diagnosis-of-acute-kidney-injury-in-children-admitted-to-picu
#20
Jameela Abdulaziz Kari, Mohamed Ahmed Shalaby, Kholoud Sofyani, Ahmad Saleh Sanad, Albaraa Fuad Ossra, Rayan Smeer Halabi, Maha Hassan Aljuhani, Wael Mohammad Toffaha, Feras Aymen Moria, Samar Sabry, Hanan AbdelAziz Ahmed, Khalid Abdulaziz Alhasan, Sara Sharief, Osama Safdar
BACKGROUND: Acute kidney injury (AKI) is common in critically ill children with significant mortality and morbidity. Serum creatinine is an insensitive and late biomarker compared to newly proposed AKI biomarkers. METHODS: Prospective study in pediatric intensive care unit (PICU) over three months to compare between serum cystatin-C (s-Cys-C) and urinary neutrophil gelatinase-associated lipocalin (uNGAL) as AKI biomarkers at multiple time points with pediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE) classification in diagnosing AKI...
February 20, 2018: World Journal of Pediatrics: WJP
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