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https://www.readbyqxmd.com/read/29466956/outcome-and-prognostic-factors-of-patients-with-right-sided-infective-endocarditis-requiring-intensive-care-unit-admission
#1
Hugues Georges, Olivier Leroy, Norair Airapetian, Nicolas Lamblin, Elie Zogheib, Patrick Devos, Sebastien Preau
BACKGROUND: Right-sided infective endocarditis (RSIE) is an uncommon diagnosis accounting for less than 10% of cases of infective endocarditis. Optimal management for severely ill patients with RSIE remains challenging because few studies reported on management and outcome. The goal of our study was to determine outcome and associated prognostic factors in a population of ICU patients with a diagnosis of definite, active and severe RSIE. METHODS: We performed a retrospective study in 10 French ICUs between January 2002 and December 2012...
February 21, 2018: BMC Infectious Diseases
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
#2
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/29461368/safety-outcomes-in-endoscopic-versus-open-repair-of-metopic-craniosynostosis
#3
Tara L Braun, Bradley S Eisemann, Olushola Olorunnipa, Edward P Buchanan, Laura A Monson
BACKGROUND: Premature fusion of the metopic suture leads to a range of clinical presentations, with more severe patients presenting characteristically with trigonocephaly. Endoscopic-assisted correction of craniosynostosis is emerging as an alternative to the gold-standard open cranial vault remodeling. While there are several documented benefits of endoscopic correction, the management of craniosynostosis varies widely in the literature with little consensus as to the preferred timing and surgical technique for repair...
February 14, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29460874/-robot-assisted-atrial-septal-defect-closure-in-adults-first-experience-in-russia
#4
A N Arkhipov, A V Bogachev-Prokofiev, A V Zubritskiy, T S Khapaev, Yu N Gorbatykh, P M Pavlushin, A M Karaskov
AIM: To analyze immediate results of minimally invasive robot-assisted atrial septal defect (ASD) closure in adults. MATERIAL AND METHODS: For the period from March 2012 to November 2016 sixty patients with contraindications to endovascular procedure have undergone robot-assisted atrial septal defect closure at Meshalkin Siberian Federal Biomedical Research Center. Mean age was 34.5±11.3 years, body mass index - 24.6±4.0 kg/m2 . 48 (80%) patients had NYHA class II before surgery...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29458927/the-effect-of-pleasant-olfactory-mental-imagery-on-the-incidence-and-extent-of-atelectasis-in-patients-after-open-heart-surgery
#5
Masoud Rezaei-Nodehi, Seyed Afshin Shorofi, Masoumeh Bagheri-Nesami, Rahman Ghafari, Jamshid Yazdani-Charati, Manizheh Darbeheshti
BACKGROUND AND PURPOSE: Atelectasis is the most common pulmonary complication after open heart surgery. This study was intended to examine the effects of pleasant olfactory mental imagery on postoperative atelectasis in patients undergoing open heart surgery. MATERIALS AND METHODS: This is a randomized controlled clinical trial. The sample consisted of 80 patients who were randomly assigned to either practice olfactory mental imagery (test group) or receive routine care (control group)...
February 2018: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29458294/the-impact-of-implementing-an-intensivist-model-with-nighttime-in-hospital-nocturnist-and-effect-on-icu-outcomes
#6
Maged A Tanios, Daniel Teres, Hyunsoon Park, Antonio Beltran, Arunpal Sehgal, James D Leo
BACKGROUND: Various intensivist staffing models have been suggested, but the long-term sustainability and outcomes vary and may not be sustained. We examined the impact of implementing a high-intensity intensivist coverage model with a nighttime in-house nocturnist (non-intensivist) and its effect on intensive care unit (ICU) outcomes. METHODS: We obtained historical control baseline data from 2007 to 2011 and compared the same data from 2011 to 2015. The Acute Physiological and Chronic Health Evaluation outcomes system was utilized to collect clinical, physiological, and outcome data on all adult patients in the medical ICU and to provide severity-adjusted outcome predictions...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29456597/insertion-rates-and-complications-of-central-lines-in-the-uk-population-a-pilot-study
#7
Adrian Vk Wong, Nitin Arora, Olusegun Olusanya, Ben Sharif, Robert M Lundin, A Dhadda, S Clarke, R Siviter, M Argent, Gavin Denton, Anna Dennis, Angela Day, Tamas Szakmany
Background: Central venous catheters are inserted ubiquitously in critical care and have roles in drug administration, fluid management and renal replacement therapy. They are also associated with numerous complications. The true number of central venous catheters inserted per year and the proportion of them associated with complications are unknown in the UK. Methods: We performed a prospective audit at five hospitals, as a feasibility pilot for a larger, nationwide audit...
February 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29455437/live-donor-liver-transplantation-for-acute-liver-failure-a-single-center-experience
#8
Siddharth Mehrotra, Naimish Mehta, Prashantha S Rao, Shailendra Lalwani, Vivek Mangla, Samiran Nundy
INTRODUCTION: Acute liver failure (ALF) is an indication for emergency liver transplantation (LT). Although centers performing only deceased donor liver transplants (DDLT) have shown improved outcomes in this situation, they still have relatively long waiting lists. An alternative would be living donor liver transplantation (LDLT), which has shown equivalent outcomes in the elective situation but there is limited evidence of its results in ALF. AIM: The purpose of this study was to assess the outcomes in patients with ALF undergoing emergency LDLT in our center in Delhi, India...
February 17, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29455034/preoperative-risk-factors-for-unexpected-postoperative-intensive-care-unit-admission-a-retrospective-case-analysis
#9
Joshua B Knight, Evan E Lebovitz, Theresa A Gelzinis, Ibtesam A Hilmi
INTRODUCTION: The purpose of this retrospective case-control study was to investigate preoperative risk factors for unexpected postoperative intensive care unit (ICU) admissions in patients undergoing non-emergent surgical procedures in a tertiary medical centre. METHODS: A medical record review of adult patients undergoing elective non-cardiac and non-transplant major surgical procedures during the period of January 2011 through December 2015 in the operating rooms of a large university hospital was carried out...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29433727/point-of-care-ultrasound-in-the-intensive-care-unit
#10
REVIEW
Steven J Campbell, Rabih Bechara, Shaheen Islam
Spreading beyond the realm of tertiary academic medical centers, point-of-care ultrasound in the intensive care unit is an important diagnostic tool. The real-time feedback garnered can lead to critical and clinically relevant changes in management and decrease potential complications. Bedside ultrasound evaluation in the intensive care setting with a small, portable equipment is well-suited for placement of central lines, lumbar puncture, thoracentesis or other bedside ICU procedures and in the evaluation of cardiac activity, pleural and abdominal cavity and the overall fluid volume...
March 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29423912/implementing-and-assessing-a-standardized-protocol-for-weaning-children-successfully-from-extracorporeal-life-support
#11
Rouven Kubicki, René Höhn, Jochen Grohmann, Thilo Fleck, Katja Reineker, Johannes Kroll, Matthias Siepe, Christoph Benk, Rolf Klemm, Frank Humburger, Brigitte Stiller
Extracorporeal life support (ECLS) weaning is a complex interdisciplinary process with no clear guidelines. To assess ventricular and pulmonary function as well as hemodynamics including end-organ recovery during ECLS weaning, we developed a standardized weaning protocol. We reviewed our experience 2 years later to assess its feasibility and efficacy. In 2015 we established an inter-professional, standardized, stepwise protocol for weaning from ECLS. If the patient did not require further surgery, weaning was conducted bedside in the intensive care unit (ICU)...
February 8, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29422729/outcome-of-patients-admitted-to-a-tertiary-referral-intensive-care-unit-with-urosepsis-needing-source-control
#12
Chaitra C Rao, Pradeep Rangappa, Karthik Rao, Ipe Jacob
Introduction: Urosepsis is one of the common causes of admission to the Intensive Care Unit (ICU). It has traditionally been treated with antibiotics, but surgical management with Double J [DJ] ureteral stents is gaining popularity. This study compares patients with complicated urosepsis who underwent surgical source control by ureteral stenting with those managed medically. Materials and Methods: The study enrolled patients admitted to a tertiary adult ICU with a diagnosis of urosepsis over a period of 2 years...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29416456/evaluation-of-safety-and-efficacy-of-regional-anesthesia-compared-with-general-anesthesia-in-thoracoscopic-lung-biopsy-procedure-on-patient-with-idiopathic-pulmonary-fibrosis
#13
Waseem M Hajjar, Sami A Al-Nassar, Ghaida S Al-Sugair, Alaa Al-Oqail, Shahd Al-Mansour, Rand Al-Haweel, Adnan W Hajjar
Background: Interstitial lung diseases are diseases that need histology diagnosis or obtaining a lung biopsy to establish the diagnosis. Surgical biopsies are performed usually using the thoracoscopy technique under general anesthesia (GA) although this procedure is still associated with morbidity rate. The aim of this study is to determine the effectiveness and safety of regional anesthesia (RA) compared with GA in thoracoscopic lung biopsy procedures done on patients with idiopathic pulmonary fibrosis (IPF)...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416148/assessment-of-malnutrition-and-enteral-feeding-practices-in-the-critically-ill-a-single-centre-observational-study
#14
Prashant P Verghese, Ashu Sara Mathai, Valsamma Abraham, Paramdeep Kaur
Background and Aims: Early identification of malnutrition among hospitalised patients is essential to institute appropriate patient-specific nutritional strategies. This study was conducted to evaluate the nutritional status of medical patients at admission to the adult intensive care unit (ICU) and to identify factors which prevent attainment of daily feeding goals in them. Methods: This was a 1 year prospective, observational study on 200 medical adult ICU patients...
January 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29410100/association-between-neurological-outcomes-related-to-aneurysmal-subarachnoid-haemorrhage-and-onsite-access-to-neurointerventional-radiology
#15
Jorge Pena Mogollon, Nicolas Roydon Smoll, Rakshit Panwar
OBJECTIVE: An onsite access to neurointerventional radiology (NIR) may be useful for managing patients with aneurysmal subarachnoid haemorrhage (aSAH) after the aneurysm-securing procedure. We aimed to assess the association between neurological outcomes related to aSAH and onsite access to NIR service. METHODS: This was a sequential period study of 47 patients with aSAH admitted consecutively during the pre-NIR period (Jan 2010 to Jun 2012) compared with 81 patients with aSAH admitted consecutively during the post-NIR period (Jan 2013 to Jun 2015) at an academic tertiary referral ICU...
February 1, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29409380/ultrasound-guided-percutaneous-dilational-tracheostomy-a-systematic-review-of-randomized-controlled-trials-and-meta-analysis
#16
André L N Gobatto, Bruno A M P Besen, Mino Cestari, Paolo Pelosi, Luiz M S Malbouisson
INTRODUCTION: Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related complications. OBJECTIVE: To investigate whether the ultrasound-guided PDT is equivalent or superior to the bronchoscopy-guided or anatomical landmarks-guided PDT with regard to procedural-related and clinical complications...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29408558/outcomes-of-endoscopic-intervention-for-overt-gastrointestinal-bleeding-in-severe-thrombocytopenia
#17
Guilherme Piovezani Ramos, Moritz Binder, Paul Hampel, Manuel Bonfim Braga Neto, Dharma Sunjaya, Badr Al Bawardy, Barham K Abu Dayyeh, Navtej S Buttar, David H Bruining, Nayantara Coelho-Prabhu, Mark V Larson, Louis M Wong Kee Song, Elizabeth Rajan
BACKGROUND AND AIMS: Gastrointestinal bleeding (GIB) in the setting of thrombocytopenia raises concerns about endoscopic procedure risk. We aimed to assess the safety and outcomes of endoscopy for overt GIB in the setting of severe thrombocytopenia in liver cirrhosis (LC) and non-liver cirrhosis (NLC). METHODS: Retrospective study on inpatients who underwent endoscopy within 24-hours of presentation for overt GIB with a platelet count (PC) of 20 to <50 x 103/mL...
February 1, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29401139/therapeutic-plasma-exchange-in-critically-ill-children-requiring-intensive-care
#18
Gerard Cortina, Rosemary McRae, Roberto Chiletti, Warwick Butt
OBJECTIVE: To characterize the clinical indications, procedural safety, and outcome of critically ill children requiring therapeutic plasma exchange. DESIGN: Retrospective observational study based on a prospective registry. SETTING: Tertiary and quaternary referral 30-bed PICU. PATIENTS: Forty-eight critically ill children who received therapeutic plasma exchange during an 8-year period (2007-2014) were included in the study...
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29398346/measuring-acute-pain-over-time-in-the-critically-ill-using-the-multidimensional-objective-pain-assessment-tool-mopat
#19
Debra L Wiegand, Tracey Wilson, Diane Pannullo, Marguerite M Russo, Karen Snow Kaiser, Karen Soeken, Deborah B McGuire
A valid and reliable instrument is needed to assess acute pain in critically ill patients unable to self-report and who may be transitioning between critical care and other settings. To examine the reliability, validity, and clinical utility of the Multidimensional Objective Pain Assessment Tool (MOPAT) when used over time by critical care nurses to assess acute pain in non-communicative critically ill patients. Twenty-seven patients had pain assessed at two time points (T1 and T2) surrounding a painful event for up to 3 days...
February 1, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29396757/epidemiology-of-open-tibia-fractures-in-a-population-based-database-update-on-current-risk-factors-and-clinical-implications
#20
Christian David Weber, Frank Hildebrand, Philipp Kobbe, Rolf Lefering, Richard M Sellei, Hans-Christoph Pape
BACKGROUND: Open tibia fractures usually occur in high-energy mechanisms and are commonly associated with multiple traumas. The purposes of this study were to define the epidemiology of open tibia fractures in severely injured patients and to evaluate risk factors for major complications. METHODS: A cohort from a nationwide population-based prospective database was analyzed (TraumaRegister DGU®). Inclusion criteria were: (1) open or closed tibia fracture, (2) Injury Severity Score (ISS) ≥ 16 points, (3) age ≥ 16 years, and (4) survival until primary admission...
February 2, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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