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https://www.readbyqxmd.com/read/29214175/what-healthcare-workers-should-know-about-environmental-bacterial-contamination-in-the-intensive-care-unit
#1
REVIEW
Vincenzo Russotto, Andrea Cortegiani, Teresa Fasciana, Pasquale Iozzo, Santi Maurizio Raineri, Cesare Gregoretti, Anna Giammanco, Antonino Giarratano
Intensive care unit- (ICU-) acquired infections are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk (odds ratio 2...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29214070/percutaneous-tracheostomy-a-comprehensive-review
#2
REVIEW
Ashraf O Rashid, Shaheen Islam
Tracheostomy is a common procedure. It can be done surgically or percutaneously by dilating the stoma using Seldinger technique. Percutaneous tracheostomy (PT) is now routinely performed by surgeons and non-surgeons such as intensivists and anesthesiologists in the intensive care units (ICU) all over the world. Although obesity, emergent tracheostomy, coagulopathy, inability to extend the neck and high ventilator demand (HVD) were initially thought to be a relative contraindication, recent data suggest safety of PT in these patient population...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29210925/frequency-of-desaturation-and-association-with-hemodynamic-adverse-events-during-tracheal-intubations-in-picus
#3
Simon Li, Ting-Chang Hsieh, Kyle J Rehder, Sholeen Nett, Pradip Kamat, Natalie Napolitano, David A Turner, Michelle Adu-Darko, J Dean Jarvis, Conrad Krawiec, Ashley T Derbyshire, Keith Meyer, John S Giuliano, Joana Tala, Keiko Tarquinio, Michael D Ruppe, Ronald C Sanders, Matthew Pinto, Joy D Howell, Margaret M Parker, Gabrielle Nuthall, Michael Shepherd, Guillaume Emeriaud, Yuki Nagai, Osamu Saito, Jan Hau Lee, Dennis W Simon, Alberto Orioles, Karen Walson, Paula Vanderford, Asha Shenoi, Anthony Lee, Geoffrey L Bird, Michael Miksa, Ana Lia Graciano, Jesse Bain, Peter W Skippen, Lee A Polikoff, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: Oxygen desaturation during tracheal intubation is known to be associated with adverse ICU outcomes in critically ill children. We aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association with adverse hemodynamic tracheal intubation-associated events. DESIGN: Retrospective cohort study as a part of the National Emergency Airway Registry for Children Network's quality improvement project from January 2012 to December 2014...
November 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29206728/distributions-and-behavior-of-vital-signs-in-critically-ill-children-by-admission-diagnosis
#4
Danny Eytan, Andrew J Goodwin, Robert Greer, Anne-Marie Guerguerian, Mjaye Mazwi, Peter C Laussen
OBJECTIVES: Define the distributions of heart rate and intraarterial blood pressure in children at admission to an ICU based on admission diagnosis and examine trends in these physiologic signs over 72 hours from admission (or to discharge if earlier). DESIGN: A retrospective analysis of continuously acquired signals. SETTING: A quaternary and primary referral children's hospital with a general PICU and cardiac critical care unit. PATIENTS: One thousand two hundred eighty-nine patients less than 18 years old were analyzed...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29189705/validation-of-the-italian-version-of-the-critical-pain-observation-tool-in-brain-injured-critically-ill-adults
#5
Francesco Sulla, Nilson De Souza Ramos, Noemi Terzi, Tania Trenta, Mariella Uneddu, Melanny Alessandra Zaldivar Cruces, Leopoldo Sarli
BACKGROUND AND AIM: Pain in intensive care units (ICUs) is a frequent and often undermanaged problem. Brain-injured patients are often unable to reliably self-report their pain, calling forth the need to use behavioural scales such as the Critical-Care Pain Observation Tool (CPOT). This study aimed to test the reliability and validity of the Italian CPOT use with brain-injured ICU adults. METHOD: A sample of 50 adults critical care patients was included. Each patient was assessed by two independent observers at three predefined times - at rest; during mobilization for hygiene; 20 minutes later - using the CPOT, PAINAD, and NRS...
November 30, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29189393/acute-pancreatitis-in-the-elderly-a-cause-for-increased-concern
#6
Joana R Carvalho, Samuel R Fernandes, Patrícia Santos, Carlos M Moura, Teresa Antunes, José Velosa
BACKGROUND: Acute pancreatitis (AP) is an aggressive and potentially fatal clinical condition. Although all age groups are at risk, the elderly may be a group of special concern. We aimed at evaluating clinical outcomes of patients with elderly-onset AP. MATERIALS AND METHODS: Using a single-center retrospective database, treatment and follow-up records of 550 patients admitted with AP were reviewed. Outcomes included mortality, admission to the ICU, need for interventional procedures, nutritional support, and length of hospital and ICU stay...
November 17, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29187048/multitargeted-feeding-strategies-improve-nutrition-outcome-and-are-associated-with-reduced-pneumonia-in-a-level-1-trauma-intensive-care-unit
#7
Jenny C Lee, George W Williams, Rosemary A Kozar, Lillian S Kao, Krislynn M Mueck, Andrew D Emerald, Natacha C Villegas, Laura J Moore
BACKGROUND: Factors impeding delivery of adequate enteral nutrition (EN) to trauma patients include delayed EN initiation, frequent surgeries and procedures, and postoperative ileus. We employed 3 feeding strategies to optimize EN delivery: (1) early EN initiation, (2) preoperative no nil per os feeding protocol, and (3) a catch-up feeding protocol. This study compared nutrition adequacy and clinical outcomes before and after implementation of these feeding strategies. METHODS: All trauma patients aged ≥18 years requiring mechanical ventilation for ≥7 days and receiving EN were included...
March 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29184730/outcomes-comparison-for-microsurgical-breast-reconstruction-in-specialty-surgery-hospitals-versus-tertiary-care-facilities
#8
Rahul Vemula, Matthew J Bartow, Matt Freeman, Cameron Callaghan, Tim Matatov, David Jansen, Bob Allen, Hugo St Hilaire, Oren Tessler
Background: Postoperative monitoring is crucial in the care of free flap breast reconstruction patients. Tertiary care facilities (TCFs) provide postoperative monitoring in an ICU after surgery. Specialty surgery hospitals (SSHs) do not have ICUs, but these facilities perform free flap breast reconstruction as well. Are outcomes comparable between the 2 facilities in terms of flap reexploration times and overall success? Methods: Retrospective study including 163 SSH and 157 TCF patients...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29182729/effects-of-opioids-given-to-facilitate-mechanical-ventilation-on-sleep-apnea-after-extubation-in-the-intensive-care-unit
#9
Fanny P Timm, Sebastian Zaremba, Stephanie D Grabitz, Hassan N Farhan, Stefanie Zaremba, Elizabeth Siliski, Christina H Shin, Sandra Muse, Sabine Friedrich, James E Mojica, Tobias Kurth, Satya-Krishna Ramachandran, Matthias Eikermann
Study Objectives: Following extubation in the intensive care unit (ICU), upper airway (UA) edema and respiratory depressants may promote UA dysfunction. We tested the hypothesis that opioids increase the risk of sleep apnea early after extubation. Methods: 56 ICU patients underwent polysomnography the night after extubation. Airflow limitation during wakefulness was identified using bedside spirometry. Correlation and ordinal regression analyses were used to quantify effects of pre-extubation opioid dose on post-extubation Apnea-Hypopnea-Index (AHI) and severity of sleep apnea and whether or not inspiratory airway obstruction (ratio of maximum expiratory and inspiratory flow at 50% of vital capacity (MEF50/MIF50)≥1) during wakefulness predicts airway obstruction during sleep...
November 22, 2017: Sleep
https://www.readbyqxmd.com/read/29178274/lactate-%C3%A2-2-mmol-l-plus-qsofa-improves-utility-over-qsofa-alone-in-emergency-department-patients-presenting-with-suspected-sepsis
#10
Amith Shetty, Stephen Pj MacDonald, Julian M Williams, John van Bockxmeer, Bas de Groot, Laura M Esteve Cuevas, Annemieke Ansems, Malcolm Green, Kelly Thompson, Harvey Lander, Jaimi Greenslade, Simon Finfer, Jonathan Iredell
OBJECTIVE: The Sepsis-3 task force recommends the use of the quick Sequential Organ Failure Assessment (qSOFA) score to identify risk for adverse outcomes in patients presenting with suspected infection. Lactate has been shown to predict adverse outcomes in patients with suspected infection. The aim of the study is to investigate the utility of a post hoc lactate threshold (≥2 mmol/L) added qSOFA score (LqSOFA(2) score) to predict primary composite adverse outcomes (mortality and/or ICU stay ≥72 h) in patients presenting to ED with suspected sepsis...
December 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29174280/physician-staffing-needs-in-critical-care-departments
#11
V Gómez Tello, J Ruiz Moreno, M Weiss, E González Marín, P Merino de Cos, N Franco Garrobo, A Alonso Ovies, J C Montejo González, T Iber, G Marx, V Córcoles González, F Gordo Vidal, E Palencia Herrejón, J Roca Guiseris
Departments of Critical Care Medicine are characterized by high medical assistance costs and great complexity. Published recommendations on determining the needs of medical staff in the DCCM are based on low levels of evidence and attribute excessive significance to the structural/welfare approach (physician-to-beds ratio), thus generating incomplete and minimalistic information. The Spanish Society of Intensive Care Medicine and Coronary Units established a Technical Committee of experts, the purpose of which was to draft recommendations regarding requirements for medical professionals in the ICU...
November 21, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29162728/evaluating-the-value-of-the-respiratory-therapist-where-is-the-evidence-focus-on-the-barnes-jewish-hospital-experience
#12
Marin H Kollef
Currently, >20 million people in the United States have asthma, and approximately 15 million adults have been diagnosed with COPD, with approximately the same number not yet having been diagnosed with this condition. Moreover, the overall burden of respiratory diseases is still increasing, in part due to environmental factors, such as air pollution. At the same time, the number of patients requiring hospitalization as well as the number of individuals admitted to ICUs from emergency departments has been on the rise over the last decade...
December 2017: Respiratory Care
https://www.readbyqxmd.com/read/29153826/performance-evaluation-of-phase-angle-and-handgrip-strength-in-patients-undergoing-cardiac-surgery-prospective-cohort-study
#13
Taís Kereski da Silva, Ingrid Dalira Schweigert Perry, Janete Salles Brauner, Orlando Carlos Belmonte Weber, Gabriela Corrêa Souza, Sílvia Regina Rios Vieira
BACKGROUND AND AIMS: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), has been interpreted as a cell membrane integrity indicator, while handgrip strength (HGS) has been used as a prognostic indicator in certain clinical situations, such as in cardiac, oncologic patients with renal disease, hemodialysis patients, HIV-positive patients, and liver disease patients. In addition to prognostic scores, body changes due to surgical procedures indicate the importance of measuring muscle function and cell integrity...
November 16, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29149949/attitudes-toward-organ-donation-among-relatives-of-the-patients-who-are-being-followed-up-in-intensive-care-and-dialysis-units
#14
B Kahveci, K Topal, Ç Gereklioglu, H Aksoy
INTRODUCTION: This study sought to investigate attitudes toward organ donation (OD) among the relatives of patients who are being followed up in intensive care units (ICU) and dialysis units. MATERIALS AND METHODS: This cross-sectional study was conducted with relatives of the patients who were being followed up in hemodialysis (HD) and peritoneal dialysis (PD) units and Neurosurgery, Neurology, Anesthesia, and Reanimation ICUs of Adana Numune Research and Training Hospital...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#15
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29142747/clinical-characteristics-of-critically-ill-cancer-patients-who-are-undergoing-isolated-limb-perfusion
#16
Silvio A Ñamendys-Silva, Arturo M Ruiz-Beltran, Mireya Barragán-Dessavre, Andoreni R Bautista-Ocampo, Abelardo Meneses-García, Octavio González-Chon, Angel Herrera-Gómez
The aim of the present study was to investigate the incidence of organ dysfunction, and to describe the clinical characteristics and intensive care unit (ICU) outcomes of critically ill cancer patients who were admitted to an oncological ICU during the isolated limb perfusion post-operative period. The present study was an observational investigation of 42 critically ill cancer patients who were admitted to the ICU of the Instituto Nacional de Cancerología, during the isolated limb perfusion post-operative period, between July 2010 and February 2016...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29142372/mapping-the-characteristics-of-critical-care-facilities-assessment-distribution-and-level-of-critical-care-facilities-from-central-india
#17
Saurabh Saigal, Jai Prakash Sharma, Abhijit Pakhare, Santosh Bhaskar, Sanjay Dhanuka, Sanjay Kumar, Yogesh Sabde, Pradip Bhattacharya, Rajnish Joshi
Background: In low- and middle-income countries such as India, where health systems are weak, the number of available Critical Care Unit (Intensive Care Unit [ICU]) beds is expected to be low. There is no study from the Indian subcontinent that has reported the characteristics and distribution of existing ICUs. We performed this study to understand the characteristics and distribution of ICUs in Madhya Pradesh (MP) state of Central India. We also aimed to develop a consensus scoring system and internally validate it to define levels of care and to improve health system planning and to strengthen referral networks in the state...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29138878/higher-cost-of-hospitalizations-for-non-cardiac-diagnoses-in-adults-with-congenital-heart-disease
#18
Michael D Seckeler, Ian D Thomas, Jennifer Andrews, Omar Meziab, Tabitha Moe, Elissa Heller, Scott E Klewer
Adults with congenital heart disease (CHD) are a rapidly increasing population and their impact on healthcare resources is not fully understood. The purpose of this study was to describe the costs of hospitalizations for non-cardiac disease for adults with CHD. We conducted a retrospective review of hospital discharge data from the University HealthSystem Consortium Clinical Data Base/Resource Manager from January 2011 through December 2013. Patients were ≥ 18 years old at admission with any ICD-9 code for moderate or high severity CHD; cardiac surgical admissions were excluded...
November 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29124121/patients-comorbidities-reduce-the-clinical-value-of-emergency-colonoscopy-results-of-a-retrospective-cohort-study
#19
Cristiano Cremone, Anouk Esch, Charlotte Gagniere, Alessandro Fugazza, Faria Mesli, Michael Levy, Aurelien Amiot, Alexis Laurent, Yann LeBaleur, Francois Hemery, Nicolas De'Angelis, Francesco Brunetti, Iradj Sobhani
Background and study aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial. Patients and methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29123370/assessing-hand-hygiene-compliance-among-healthcare-workers-in-six-intensive-care-units
#20
REVIEW
M Musu, A Lai, N M Mereu, M Galletta, M Campagna, M Tidore, M F Piazza, L Spada, M V Massidda, S Colombo, P Mura, R C Coppola
Introduction: Healthcare associated infections (HAIs) are a cause of high morbidity, disability and reduced quality of life, as well as mortality and rising costs for health systems. Preventing the HAI risk by planning and implementing effective preventive strategies is important to safeguard patient health. Methods: The study aimed to evaluate the presence of procedures and protocols for infection control, to assess the adhesion to the different aspects of hand hygiene (HH) and hand washing technique by healthcare workers in six ICUs...
September 2017: Journal of Preventive Medicine and Hygiene
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