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https://www.readbyqxmd.com/read/28443388/utilization-of-thoracic-ultrasound-for-confirmation-of-central-venous-catheter-placement-and-exclusion-of-pneumothorax-a-novel-technique-in-real-time-application
#1
Dileep Raman, Manish Sharma, Ajit Moghekar, Xiaofeng Wang, Umur Hatipoğlu
AIM: To evaluate the safety and utility of ultrasonography as a tool to confirm central venous catheter (CVC) position and to exclude insertion-related pneumothorax in place of chest radiography (CXR) in a tertiary medical intensive care unit (ICU). METHODS: We randomized 60 consecutive medical ICU patients to conventional or ultrasound groups for CVC placement. Both groups had CVCs inserted under ultrasound guidance. The intervention group underwent real-time transthoracic echocardiography to assist in catheter positioning and chest ultrasonography for exclusion of pneumothorax...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28442204/out-of-hospital-thoracotomy-for-cardiac-arrest-after-penetrating-thoracic-trauma
#2
Mark G Van Vledder, Oscar J F Van Waes, Fabian O Kooij, Joost H Peters, Esther M M Van Lieshout, Michael H J Verhofstad
INTRODUCTION: Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and thoracotomy, some have advocated thoracotomy on the accident scene. The aim of this study was to determine the proportion of patients with return of spontaneous circulation and subsequent survival after out of hospital thoracotomy in the Netherlands...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28439517/incidence-and-risk-factors-for-organ-space-infection-after-radiofrequency-assisted-hepatectomy-or-ablation-of-liver-tumors-in-a-single-center-more-than-meets-the-eye
#3
Ioannis Karavokyros, Stamatios Orfanos, Anastasios Angelou, Antonia Meropouli, Dimitrios Schizas, John Griniatsos, Emmanouil Pikoulis
INTRODUCTION: Surgical site infections (SSIs) and especially organ/space infection (O/SI) after resection or ablation of liver tumors are associated with increased morbidity and mortality. A secondary blood stream infection (BSI) is considered an O/SI but the exact prevalence is unknown. We aimed to investigate the incidence of O/SI and BSIs in a cohort of consecutive patients after liver resection or ablation, to seek for a possible connection between them and to search for potential risk factors...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28438186/mortality-and-infectious-complications-of-therapeutic-endovascular-interventional-radiology-a-systematic-and-meta-analysis-protocol
#4
Kaoutar Mellouk Aid, Hervé Tchala Vignon Zomahoun, Abdelmajid Soulaymani, Karin Lebascle, Stephane Silvera, Pascal Astagneau, Benoit Misset
BACKGROUND: Endovascular interventional radiology (EIR) is an increasingly popular, mini invasive treatment option for patient with symptomatic vascular disease. The EIR practiced by qualified hands is an effective, well-tolerated procedure that offers relief of patient's symptoms with a low risk of complications. During acute post procedural period, immediate complications may relate to vascular access, restenosis, thromboembolic events, uterine ischemia, infection, necrosis, sepsis, ICU stay, surgical recovery, pain management, treatment failure, and death...
April 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28437376/organizational-issues-structure-and-processes-of-care-in-257-icus-in-latin-america-a-study-from-the-latin-america-intensive-care-network
#5
Elisa Estenssoro, Leyla Alegría, Gastón Murias, Gilberto Friedman, Ricardo Castro, Nicolas Nin Vaeza, Cecilia Loudet, Alejandro Bruhn, Manuel Jibaja, Gustavo Ospina-Tascon, Fernando Ríos, Flavia R Machado, Alexandre Biasi Cavalcanti, Arnaldo Dubin, F Javier Hurtado, Arturo Briva, Carlos Romero, Guillermo Bugedo, Jan Bakker, Maurizio Cecconi, Luciano Azevedo, Glenn Hernandez
OBJECTIVE: Latin America bears an important burden of critical care disease, yet the information about it is scarce. Our objective was to describe structure, organization, processes of care, and research activities in Latin-American ICUs. DESIGN: Web-based survey submitted to ICU directors. SETTINGS: ICUs located in nine Latin-American countries. SUBJECTS: Individual ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred fifty-seven of 498 (52%) of submitted surveys responded: 51% from Brazil, 17% Chile, 13% Argentina, 6% Ecuador, 5% Uruguay, 3% Colombia, and 5% between Mexico, Peru, and Paraguay...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437365/a-method-to-account-for-variation-in-congenital-heart-surgery-length-of-stay
#6
Andrew Brennan, Kimberlee Gauvreau, Jean Connor, Melvin Almodovar, James DiNardo, Puja Banka, Meena Nathan, Derek Mathieu, Aditya Kaza, John E Mayer, Lisa Bergersen
OBJECTIVES: We sought to develop a risk-adjustment methodology for length of stay in congenital heart surgery, as none exist. DESIGN: Prospective cohort analysis combined with previously obtained retrospective cohort analysis of a Department of Cardiovascular Surgery clinical database. PATIENTS: Patients discharged from Boston Children's Hospital between October 1, 2006, and May 31, 2014, that underwent a congenital heart surgery procedure(s) linked to one of 103 surgical procedure types...
April 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28427403/preoperative-carbohydrate-load-and-intraoperatively-infused-omega-3-polyunsaturated-fatty-acids-positively-impact-nosocomial-morbidity-after-coronary-artery-bypass-grafting-a-double-blind-controlled-randomized-trial
#7
Gibran Roder Feguri, Paulo Ruiz Lúcio de Lima, Danilo de Cerqueira Borges, Laura Ramos Toledo, Larissa Nadaf Batista, Thaís Carvalho E Silva, Neuber José Segri, José Eduardo de Aguilar-Nascimento
BACKGROUND: A strategy of limited preoperative fasting, with carbohydrate (CHO) loading and intraoperative infusion of omega-3 polyunsaturated fatty acids (ω-3 PUFA), has seldom been tried in cardiovascular surgery. Brief fasting, followed by CHO intake 2 h before anesthesia, may improve recovery from CABG procedures and lower perioperative vasoactive drug requirements. Infusion of ω-3 PUFA may reduce occurrences of postoperative atrial fibrillation (POAF) and shorten hospital stays...
April 20, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28417506/the-effect-of-intraoperative-hypothermia-upon-blood-transfusion-needs-and-length-of-stay-among-gastrointestinal-system-cancer-surgery
#8
V B Poveda, A S Nascimento
This cross-sectional study was performed to evaluate the relationship between intraoperative body temperature and the need for blood transfusion and length of stay in the post-anaesthetic care unit (PACU) or in the intensive care unit (ICU) among 79 patients undergoing elective oncology surgery of the digestive system. There was a statistically significant correlation between a lower temperature during surgery and medical diagnosis (p = .009), the use of bupivacaine anaesthesia (p = .016), anaesthesia time (p = ...
April 18, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28412131/screening-nasal-swabs-for-methicillin-resistant-staphylococcus-aureus-a-regional-burn-center-s-experience
#9
Shawn Tejiram, Laura S Johnson, Mihriye Mete, Sameer Desale, Kimberly Johnson, Jenny Zhang, Lauren T Moffatt, Jeffrey W Shupp
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen that can result in substantial morbidity and mortality. Early detection of MRSA colonization by screening nasal swabs may be important in the management of burn-injured patients. However, studies examining its use in this population are limited. The aim of this study was to study the utility of admission MRSA screening nasal swabs and determine if being positive for MRSA on admission impacted outcomes. MATERIALS AND METHODS: A retrospective review was conducted of burn patients who presented to a single regional burn center between June 2012 and December 2014...
April 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28409489/cost-of-trauma-care-in-secondary-and-tertiary-care-public-sector-hospitals-in-north-india
#10
Ankur Sangwan, Shankar Prinja, Sameer Aggarwal, Jagnoor Jagnoor, Pankaj Bahuguna, Rebecca Ivers
BACKGROUND: Several initiatives to provide trauma care, including ambulance services, creation of a network of trauma hospitals and insurance schemes for cashless treatment, are currently being implemented in India. However, lack of information on the cost of trauma care is an impediment to the evidence-based planning for such initiatives. In this study, we aim to bridge this gap in evidence by estimating the unit cost of an outpatient consultation, inpatient bed-day of hospitalization, surgical procedure and diagnostics for providing trauma care through secondary- and tertiary-level hospitals in India...
April 13, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28403118/validation-of-intensive-care-and-mechanical-ventilation-codes-in-medicare-data
#11
Hannah Wunsch, Andrew Kramer, Hayley B Gershengorn
OBJECTIVES: To assess the reliability of codes relevant to critically ill patients in administrative data. DESIGN: Retrospective cohort study linking data from Acute Physiology and Chronic Health Evaluation Outcomes, a clinical database of ICU patients with data from Medicare Provider Analysis and Review. We linked data based on matching for sex, date of birth, hospital, and date of admission to hospital. SETTING: Forty-six hospitals in the United States participating in Acute Physiology and Chronic Health Evaluation Outcomes...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#12
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399954/using-benchmarking-to-identify-inter-centre-differences-in-persistent-ductus-arteriosus-treatment-can-we-improve-outcome
#13
Esther J S Jansen, Koen P Dijkman, Richard A van Lingen, Willem B de Vries, Daniel C Vijlbrief, Willem P de Boode, Peter Andriessen
OBJECTIVE: The aim of this study was to identify inter-centre differences in persistent ductus arteriosus treatment and their related outcomes. Materials and methods We carried out a retrospective, multicentre study including infants between 24+0 and 27+6 weeks of gestation in the period between 2010 and 2011. In all centres, echocardiography was used as the standard procedure to diagnose a patent ductus arteriosus and to document ductal closure. RESULTS: In total, 367 preterm infants were included...
April 12, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28398925/urgent-chemotherapy-for-life-threatening-complications-related-to-solid-neoplasms
#14
Yoann Zerbib, Antoine Rabbat, Muriel Fartoukh, Naïke Bigé, Claire Andréjak, Julien Mayaux, Nicolas De Prost, Benoît Misset, Virginie Lemiale, Fabrice Bruneel, Julien Maizel, Sylvie Ricome, Frédéric Jacobs, Caroline Bornstain, Hervé Dupont, François Baudin, Elie Azoulay, Frédéric Pène
OBJECTIVES: Solid neoplasms can be directly responsible for organ failures at the time of diagnosis or relapse. The management of such specific complications relies on urgent chemotherapy and eventual instrumental or surgical procedures, combined with advanced life support. We conducted a multicenter study to address the prognosis of this condition. DESIGN: A multicenter retrospective (2001-2015) chart review. SETTING: Medical and respiratory ICUs...
April 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28396900/multidisciplinary-team-approach-to-traumatic-spinal-cord-injuries-a-single-institution-s-quality-improvement-project
#15
Georgina Alizo, Jason D Sciarretta, Stefanie Gibson, Keely Muertos, Sharon Holmes, Felicia Denittis, Joseph Cheatle, John Davis, Antonio Pepe
BACKGROUND: A stepwise multidisciplinary team (MDT) approach to the injured trauma patient has been reported to have an overall benefit, with reduction in mortality and improved morbidity. Based on clinical experience, we hypothesized that implementation of a dedicated Spinal Cord Injury Service (SCIS) would impact outcomes of a patient specific population on the trauma service. METHODS: The trauma center registry was retrospectively queried, from January 2011 through December 2015, for patients presenting with a spinal cord injury...
April 10, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28393502/-peripherally-inserted-central-catheters-savings-comfort-many-advantages
#16
A Y Molina Caballero, M Martínez Merino, A Pérez Martínez, L Ayuso González, S Hernández Martín, J Pisón Chacón
INTRODUCTION: Peripherally inserted central catheters are indicated when an intravenous treatment is expected for more than 6 days or less if phlebotoxic medication is used. We report our recent experience. METHODS: Retrospective study from 2014 to 2015 including patients to whom a catheter was placed either, in the operating room after surgery and before awakening the patient, or in the Pediatric ICU by direct or ultrasound guidance venipuncture. We reviewed patient characteristics, underlying disease, line catheterization procedure, type and duration of venous line, intravenous treatment and complications...
July 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28393444/bidirectional-glenn-on-cardiopulmonary-bypass-a-comparison-of-three-techniques
#17
Sachin Talwar, Manikala Vinod Kumar, Ashima Nehra, Poonam Malhotra Kapoor, Neeti Makhija, Vishnubhatla Sreenivas, Shiv Kumar Choudhary, Balram Airan
OBJECTIVE: To analyze the intraoperative and early results of the bidirectional Glenn (BDG) procedure performed on cardiopulmonary bypass (CPB) using three different techniques. METHODS: Between September 2013 and June 2015, 75 consecutive patients (mean age 42 ± 34.4 months) undergoing BDG were randomly assigned to either technique I: open anastomosis or technique II: superior vena cava (SVC) cannulation or technique III: intermittent SVC clamping. We monitored the cerebral near infrared spectrophotometry (NIRS), SVC pressure, CPB time, intensive care unit (ICU) stay, and neurocognitive function...
April 9, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28389026/national-survey-on-the-indicators-of-quality-in-bioethics-of-the-semicyuc-in-the-departments-of-intensive-care-medicine-in-spain
#18
V López Camps, M A García García, M C Martín Delgado, J M Añón Elizalde, N Masnou Burrallo, O Rubio Sanchiz, A Estella García, J L Monzón Marín
INTRODUCTION: Multiple interventions are performed in critical patients admitted to Intensive Care Units (ICUs). This study explores the presence in the daily practice of ICUs of elements related to the 6 bioethics quality indicators of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units, and the participation of their members in the hospital ethics committees. MATERIALS AND METHODS: A multicenter observational study was carried out, using a survey exploring descriptive aspects of the ICUs, with 25 questions related to bioethics quality indicators, and assessing the participation of ICU members in the hospital ethics committees...
April 4, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28388292/end-of-life-racial-and-ethnic-disparities-among-patients-with-ovarian-cancer
#19
Jolyn S Taylor, Suja S Rajan, Ning Zhang, Larissa A Meyer, Lois M Ramondetta, Diane C Bodurka, David R Lairson, Sharon H Giordano
Purpose To assess disparities in end-of-life care among patients with ovarian cancer. Patients and Methods Using Texas Cancer Registry-Medicare data, we assessed patients with ovarian cancer deceased in 2000 to 2012 with at least 13 months of continuous Medicare coverage before death. Descriptive statistics and multivariate logistic regressions were conducted to evaluate end-of-life care, including chemotherapy in the final 14 days of life, intensive care unit (ICU) admission in the final 30 days of life, more than one emergency room (ER) or hospital admission in the final 30 days of life, invasive or life-extending procedures in the final 30 days of life, enrollment in hospice, enrollment in hospice during the final 3 days of life, and enrollment in hospice while not hospitalized...
April 7, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28379981/improved-costs-and-outcomes-with-conscious-sedation-vs-general-anesthesia-in-tavr-patients-time-to-wake-up
#20
William Toppen, Daniel Johansen, Sohail Sareh, Josue Fernandez, Nancy Satou, Komal D Patel, Murray Kwon, William Suh, Olcay Aksoy, Richard J Shemin, Peyman Benharash
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become a commonplace procedure for the treatment of aortic stenosis in higher risk surgical patients. With the high cost and steadily increasing number of patients receiving TAVR, emphasis has been placed on optimizing outcomes as well as resource utilization. Recently, studies have demonstrated the feasibility of conscious sedation in lieu of general anesthesia for TAVR. This study aimed to investigate the clinical as well as cost outcomes associated with conscious sedation in comparison to general anesthesia in TAVR...
2017: PloS One
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