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https://www.readbyqxmd.com/read/28631452/the-impact-of-the-anaesthetic-conserving-device-on-occupational-exposure-to-isoflurane-among-intensive-care-healthcare-professionals
#1
Jennifer Herzog-Niescery, Heike Vogelsang, Philipp Gude, Hans-Martin Seipp, Horst Bartz, Waldemar Uhl, Thomas P Weber, Martin Bellgardt
BACKGROUND: Use of Anesthetic Conserving Devices (ACD) for inhalational isoflurane sedation in intensive care units (ICU) has grown in recent years, and healthcare professionals are concerned about isoflurane pollution and exposure-related health risks. Real-time measurements to determine isoflurane exposure in ICU personnel during short-term patient care procedures and ACD handling have not yet been performed. METHODS: Isoflurane concentrations in the breathing zones of ICU staff (25 cm around the nose and mouth) were measured, by photoacoustic gas monitoring, during daily practice including tracheal suctioning, oral hygiene, body care, and patient positioning...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28627291/early-complications-morbidity-and-mortality-in-octo-and-nonagenarians-undergoing-posterior-intraoperative-spinal-navigation-based-c1-2-fusion-for-type-ii-odontoid-process-fractures
#2
Basem Ishak, Till Schneider, Valerie Gimmy, Andreas W Unterberg, Karl L Kiening
Type II odontoid fractures represent the most common cervical spine injury in the elderly. The decision for surgical treatment is still controversial, particularly with regard to the elevated perioperative risk attributed to frequent comorbidities and poor bone quality. Purpose of this study was to assess both short-term mortality and mid-term clinical and radiological outcome in the elderly. Between January 2007 and December 2015, 35 patients with type II odontoid process fractures who underwent posterior atlanto-axial instrumentation using a modified Goel-Harms technique were retrospectively analyzed and prospectively examined clinically and radiologically...
June 18, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28623434/-cost-analysis-as-a%C3%A2-tool-for-assessing-the-efficacy-of-intensive-care-units
#3
T Maierhofer, F Pfisterer, A Bender, H Küchenhoff, O Moerer, H Burchardi, W H Hartl
BACKGROUND: The German "Hospital Structure Act" intends to align the state hospital planning on quality criteria. Within this process cost-utility analyses (CUAs) shall be used to assess the efficacy of medical care. To be objective, CUAs of intensive care units (ICUs) require standardization (adjustment) of costs. The present study analyzed the extent to which treatment costs are related to patient-specific baseline variables (such as type and severity of the primary disease). METHODS: From 2000-2004, a bottom-up procedure was used to quantify total costs on 14 ICUs in nine German university hospitals...
June 16, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28612302/a-simplified-lung-ultrasound-approach-to-detect-increased-extravascular-lung-water-in-critically-ill-patients
#4
Antonio Anile, Jole Russo, Giacomo Castiglione, Giovanni Volpicelli
BACKGROUND: The quantification of B-lines at lung ultrasonography is a valid tool to estimate the extravascular lung water (EVLW) in patients after major cardiac surgery. However, there is still uncertainty about the correlation between B-lines and EVLW in a general population of critically ill. AIM: To evaluate a simplified lung ultrasonographic assessment as a tool to estimate the EVLW in critically ill patients admitted to a polyvalent intensive care unit (ICU)...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28607286/morbidity-analysis-in-minimally-invasive-esophagectomy-for-oesophageal-cancer-versus-conventional-over-the-last-10-years-a-single-institution-experience
#5
Misbah Khan, Muhammad Ijaz Ashraf, Aamir Ali Syed, Shahid Khattak, Namra Urooj, Anam Muzaffar
BACKGROUND: There has been an increasing inclination towards minimally invasive esophagectomies (MIEs) at our institute recently for resectable oesophageal cancer. OBJECTIVES: The purpose of the present study is to report peri-operative and long-term procedure specific outcomes of the two groups and analyse their changing pattern at our institute. METHODS: All adult patients with a diagnosis of oesophageal cancer managed at our institute from 2005 to 2015 were included in this retrospective study...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28605922/surgical-coronary-revascularization-on-pump-versus-off-pump-in-patients-with-stenosis-of-the-main-tree-of-the-left-coronary-artery-and-carotid-stenosis
#6
Edin Kabil, Bedrudin Banjanović, Emir Mujanović
OBJECTIVE: The aim of this study was to show perioperative complications of CABG procedure with and without cardiopulmonary bypass (CPB) in patients with combined coronary and carotid disease. PATIENTS AND METHODS: This retrospective survey included patients with left main stenosis greater than 50% and carotid stenosis over 50%, who had undergone CABG without carotid endarterectomy at the BH Heart Centre, from May 2009 to May 2014. The patients were divided into two groups according to the surgical method used...
May 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/28602752/analysis-of-complications-of-prone-position-in-acute-respiratory-distress-syndrome-quality-standard-incidence-and-related-factors
#7
E Jové Ponseti, A Villarrasa Millán, D Ortiz Chinchilla
INTRODUCTION: The monitoring system based on standards of quality allows clinicians to evaluate and improve the patient's care. According to the quality indicators recommended by Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias, and due to the importance of prone position (PP) as a treatment in patients with acute respiratory distress syndrome, it is fundamental to keep accurate record of serious adverse events occurring during the prone position procedure and its posterior analysis...
June 8, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28598866/using-qualitative-research-to-inform-development-of-professional-guidelines-a-case-study-of-the-society-of-critical-care-medicine-family-centered-care-guidelines
#8
Maureen A Coombs, Judy E Davidson, Mark E Nunnally, Mary A Wickline, J Randall Curtis
OBJECTIVES: To explore the importance, challenges, and opportunities using qualitative research to enhance development of clinical practice guidelines, using recent guidelines for family-centered care in the ICU as an example. METHODS: In developing the Society of Critical Care Medicine guidelines for family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptation of the Grading of Recommendations, Assessments, Development and Evaluations approach to explicitly incorporate qualitative research...
June 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28597281/gangrenous-cholecystitis-innovative-laparoscopic-techniques-to-facilitate-subtotal-fenestrating-cholecystectomy-when-a-critical-view-of-safety-cannot-be-achieved
#9
Rebekah Kirkwood, Lauren Damon, Jennifer Wang, Esther Hong, Kimberly Kirkwood
BACKGROUND: Gangrenous cholecystitis is associated with a higher conversion rate of conversion from laparoscopic to open than acute non-gangrenous cholecystitis. New strategies and techniques are needed to decrease conversion rates and improve outcomes. METHODS: In this article, we provide a richly detailed, illustrated description of a modified fundus-first technique that we have developed over the last 15 years and now use routinely with rare conversions. We also compared outcomes of laparoscopic (LC) and open (OC) approaches for pathologically confirmed gangrenous cholecystitis in 146 patients during 1995-2005, the first 10 years during which these two approaches were performed contemporaneously at our institution on comparable patients...
June 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28594588/impact-of-bedside-tracheostomy-on-procalcitonin-kinetics-in-critically-ill-patients
#10
Koji Sato, Masaki Okajima, Toru Noda, Takumi Taniguchi
BACKGROUND: Critically ill patients are particularly vulnerable to invasive procedures and complications; however, tracheostomy is frequently performed in the intensive care unit (ICU). We analyzed the effects of tracheostomy on procalcitonin (PCT) kinetics and investigated whether PCT could reliably predict septic complications after tracheostomy. METHODS: We retrospectively identified 134 patients who underwent bedside tracheostomy during their ICU stay at a Japanese university hospital from October 2010 to December 2015...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28592080/-complete-revascularization-for-multi-vessel-coronary-diseases-through-lower-ministernotomy-on-beating-heart-off-pump-surgery
#11
Z B Xiao, Y Zhang, J Z Guo, Y Y Li, Y P Zhang
Objective: To discuss a novel method of complete revascularization for multi-vessel coronary diseases on beating heart off-pump surgery through lower ministernotomy. Methods: Clinical data of 79 patients underwent ministernotomy off-pump coronary artery bypass from January 2015 to May 2016 at Department of Cardiac Surgery, Heart Center, Beijing Friendship Hospital, Capital Medical University were analyzed retrospectively. There were 62 male and 17 female patients, with an average age of (65±9) years. All the patients were multi-vessel coronary diseases and planned to receive coronary artery bypass grafting...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28589534/noninvasive-ventilation-with-helium-oxygen-mixture-in-hypercapnic-copd-exacerbation-aggregate-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Fekri Abroug, Lamia Ouanes-Besbes, Zeineb Hammouda, Saoussen Benabidallah, Fahmi Dachraoui, Islem Ouanes, Philippe Jolliet
When used as a driving gas during NIV in hypercapnic COPD exacerbation, a helium-oxygen (He/O2) mixture reduces the work of breathing and gas trapping. The potential for He/O2 to reduce the rate of NIV failure leading to intubation and invasive mechanical ventilation has been evaluated in several RCTs. The goal of this meta-analysis is to assess the effect of NIV driven by He/O2 compared to air/O2 on patient-centered outcomes in hypercapnic COPD exacerbation. Relevant RCTs were searched using standard procedures...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28580563/-new-treatment-for-vascular-thrombosis-prevention-in-patients-with-atrial-fibrillation-left-atrial-appendage-occlusion
#13
Chen-Wei Lin, Shiao-Pei Wang
Atrial fibrillation (AF) is a common type of arrhythmia that increases significantly the risk of blood clots in the heart and of stroke. Therefore, stroke prevention is a key goal of AF treatment. In the past, patients were required to take anticoagulants for the remainder of their life, to regularly the monitor international normalized ratio (INR) of prothrombin time (PT), and to avoid possible negative interactions with various drugs and foods. Left atrial appendage occlusion (LAAO), a novel device and technique, was thus developed for AF patients with contraindications to anticoagulants and a high risk of bleeding...
June 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28576517/retrieval-of-tracheobronchial-foreign-bodies-by-short-flexible-endoscopy-in-children
#14
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: Flexible endoscopy (FE) is frequently used to diagnose tracheobronchial foreign bodies (TBFB). However, it is still controversial for retrieval of TBFB in pediatric field. This study aims at reporting and evaluating our experiences of using short-length FE with a non-invasive ventilation (NIV) technique and intensive care unit (ICU) support in retrieving pediatric TBFB. METHODS: A retrospective review of the hospital database and FE videos of pediatric patients aged less than 18 year-old who were diagnosed of TBFB and managed in our hospital over a 17-year period (1999-2015)...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28575079/comparison-of-forced-air-and-water-circulating-warming-for-prevention-of-hypothermia-during-transcatheter-aortic-valve-replacement
#15
Benjamin Rohrer, Emily Penick, Farhad Zahedi, Hocine Tighiouart, Brian Kelly, Frederick Cobey, Stefan Ianchulev
INTRODUCTION: Transcatheter Aortic Valve Replacement (TAVR) procedures at our institution were complicated by perioperative hypothermia despite use of the standard of care forced-air convective warming device (the BairHugger, Augustine Medical Inc, Eden Prairie, MN, USA). To remedy this problem, we initiated a quality improvement process that investigated the use of a conductive warm water-circulating device (the Allon ThermoWrap, Menen Medical Corporation, Trevose, PA, USA), and hypothesized that it would decrease the incidence of perioperative hypothermia...
2017: PloS One
https://www.readbyqxmd.com/read/28569640/prevalence-of-serum-antibody-titers-against-canine-distemper-virus-and-canine-parvovirus-in-dogs-hospitalized-in-an-intensive-care-unit
#16
Jennifer L Mahon, Elizabeth A Rozanski, April L Paul
OBJECTIVE To determine the prevalence of dogs hospitalized in an intensive care unit (ICU) with serum antibody titers against canine distemper virus (CDV) and canine parvovirus (CPV). DESIGN Prospective observational study. ANIMALS 80 dogs. PROCEDURES Dogs hospitalized in an ICU for > 12 hours between February 1 and June 1, 2015, that had at least 0.25 mL of serum left over from diagnostic testing were eligible for study inclusion. Dogs with serum antibody titers > 1:32 (as determined by serum neutralization) and > 1:80 (as determined by hemagglutination inhibition) were considered seropositive for CDV and CPV, respectively...
June 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28569213/is-early-intervention-using-mansoura-vv-uterine-compression-sutures-an-effective-procedure-in-the-management-of-primary-atonic-postpartum-hemorrhage-a-prospective-study
#17
Abd Elaziz A El Refaeey, Hosam Abdelfattah, Alaa Mosbah, Anas M Gamal, Emad Fayla, Waleed Refaie, Abdelhady Zaied, Rafik I Barakat, Amal K Seleem, Mohammed Maher
BACKGROUND: Postpartum hemorrhage is the leading cause of maternal death, uterine atony accounts for 75-90% of primary postpartum hemorrhage. The efficacy of the Uterine compression suture in the treatment of atonic postpartum hemorrhage is time-tested and can be said to be almost established.The aim of this study was to assess the role of the Mansoura-VV uterine compression suture as an early intervention in the management of primary atonic postpartum hemorrhage. METHODS: This prospective observational study included 108 women with primary atonic PPH over a period of 44 months...
May 31, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28567237/level-of-headaches-after-surgical-aneurysm-clipping-decreases-significantly-faster-compared-to-endovascular-coiled-patients
#18
Athanasios K Petridis, Jan F Cornelius, Marcel A Kamp, Sina Falahati, Igor Fischer, Hans Jakob Steiger
In incidental aneurysms, endovascular treatment can lead to post-procedural headaches. We studied the difference of surgical clipping vs. endovascular coiling in concern to post-procedural headaches in patients with ruptured aneurysms. Sixty-seven patients with aneurysmal subarachnoidal haemorrhage were treated in our department from September 1(st) 2015 - September 1(st) 2016. 43 Patients were included in the study and the rest was excluded because of late recovery or high-grade subarachnoid bleedings. Twenty-two were surgical treated and twenty-one were interventionally treated...
April 6, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28567186/critical-evaluation-of-contemporary-management-in-a-new-pelvic-exenteration-unit-the-first-25-consecutive-cases
#19
Min Hoe Chew, Yu-Ting Yeh, Ee-Lin Toh, Stephen Aditya Sumarli, Ghee Kheng Chew, Lui Shiong Lee, Mann Hong Tan, Tiffany Priyanthi Hennedige, Shin Yi Ng, Say Kiat Lee, Tze Tec Chong, Hairil Rizal Abdullah, Terence Lin Hon Goh, Mohamed Zulfikar Rasheed, Kok Chai Tan, Choong Leong Tang
AIM: To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODS: This retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome...
May 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28562388/procedural-sedation-in-the-icu-and-emergency-department
#20
Nikhil Chawla, Adjoa Boateng, Ranjit Deshpande
PURPOSE OF REVIEW: Procedures are increasingly being performed in the acute care setting, outside of the operating rooms (OR). This article aims to review the current literature on out-of-OR procedural sedation with a focus on the ICU and emergency department, highlighting the following topics: multidisciplinary team approach, choice of pharmacologic agent, sedation scales, current safety guidelines, anticipating complications, appropriate monitoring and necessary resources. RECENT FINDINGS: Subjective assessment of sedation using sedation scales is controversial...
May 27, 2017: Current Opinion in Anaesthesiology
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