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https://www.readbyqxmd.com/read/27903931/comparison-of-perioperative-outcomes-in-endovascular-versus-open-repair-for-juxtarenal-and-pararenal-aortic-aneurysms-a-propensity-matched-analysis
#1
Nathan T Orr, Daniel L Davenport, David J Minion, Eleftherios S Xenos
OBJECTIVE: Endoluminal aortic aneurysm repair is suitable within certain anatomic specifications. This study aims to compare 30-day outcomes of endovascular versus open repairs for juxtarenal and pararenal aortic aneurysms (JAA/PAAs). METHODS: The ACS-NSQIP database was queried from 2012 to 2015 for JAA/PAA repairs. Procedures characterized as emergent were included in the study; however, failed prior repairs and ruptured aneurysms were excluded. The preoperative and perioperative patient characteristics, operative techniques, and outcome variables were compared between the open aortic repair and the endovascular aortic repair groups...
November 30, 2016: Vascular
https://www.readbyqxmd.com/read/27902412/the-staff-education-to-reducing-ventilator-associated-pneumonia
#2
Gurdal Yilmaz, Hava Aydin, Mustafa Aydin, Sedat Saylan, Hulya Ulusoy, Iftihar Koksal
Mechanical ventilation (MV) is a life-saving invasive procedure performed in intensive care units (ICUs) where critical patients are given advanced support. The purpose of this study was to assess the effect of personnel training on the incidence of ventilator-associated pneumonia (VAP). The study, performed prospectively in the ICU, was planned in two periods. In both periods, patient's characteristics were recorded on patient data forms. In the second period, ICU physicians and assistant health personnel were given regular theoretical and practical training...
October 17, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27895441/a-retrospective-analysis-of-postoperative-patients-admitted-to-the-intensive-care-unit
#3
S Uzman, Y Yilmaz, M Toptas, I Akkoc, Y G Gul, H Daskaya, Y Toptas
BACKGROUND: The aim of this retrospective study was to evaluate postoperative patients admitted to the intensive care unit (ICU) and to describe their characteristics and outcomes. METHODS: We performed a retrospective chart review of 1,756 postoperative patients admitted to the ICU of a tertiary referral hospital from January 2008 to December 2012. For each patient we recorded: demographic data, reason for admission to the ICU, duration of mechanical ventilation, elective versus emergency surgery, type of anaesthesia, American Society of Anesthesiologists (ASA) physical status, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Glasgow Coma Score (GCS), and outcome...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27880819/risk-assessment-of-patients-undergoing-transfemoral-aortic-valve-implantation-upon-admission-for-post-interventional-intensive-care-and-surveillance-implications-on-short-and-midterm-outcomes
#4
Fadi Al-Rashid, Philipp Kahlert, Friederike Selge, Heike Hildebrandt, Polycarpos-Christos Patsalis, Matthias Totzeck, Petra Mummel, Tienush Rassaf, Rolf Alexander Jánosi
BACKGROUND: Several studies have found that standard risk scores inaccurately reflect risk in TAVI cohorts. The assessment of mortality risk upon post-interventional ICU admission is important to optimizing clinical management. This study sought to determine outcomes and factors affecting mortality in patients admitted to the intensive care unit (ICU) after transcatheter aortic valve implantation (TAVI), and to analyze and compare the predictive values of SAPS II and EuroSCORE. METHODS AND FINDINGS: 214 consecutive patients treated with transfemoral TAVI (2006-2012) admitted to the ICU in an academic tertiary-care university hospital, were included in this retrospective data analysis...
2016: PloS One
https://www.readbyqxmd.com/read/27879954/comparison-of-terminal-extubation-and-terminal-weaning-as-mechanical-ventilation-withdrawal-in-icu-patients
#5
Damien Thellier, Pierre Y Delannoy, Olivier Robineau, Agnès Meybeck, Nicolas Boussekey, Arnaud Chiche, Olivier Leroy, Hugues Georges
BACKGROUND: Terminal extubation (TE) is applied in some intensive care unit (ICU) patients when a decision of withdrawal of mechanical ventilation is decided. Other units prefer terminal weaning (TW) with no removal of the endotracheal tube. We report our experience with these two procedures. METHODS: We conducted a retrospective study analyzing patients deceased in our ICU after a decision of life sustained therapy (LST) during the year 2013. TE was proposed to family members for patients presenting with two medical conditions: lack of vasoactive drugs (VAD) and SaO2 > 95% with a FIO2 < 50%...
November 23, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27876075/chlorhexidine-bathing-and-health-care-associated-infections-among-adult-intensive-care-patients-a-systematic-review-and-meta-analysis
#6
Steven A Frost, Mari-Cris Alogso, Lauren Metcalfe, Joan M Lynch, Leanne Hunt, Ritesh Sanghavi, Evan Alexandrou, Kenneth M Hillman
BACKGROUND: Health care-associated infections (HAI) have been shown to increase length of stay, the cost of care, and rates of hospital deaths (Kaye and Marchaim, J Am Geriatr Soc 62(2):306-11, 2014; Roberts and Scott, Med Care 48(11):1026-35, 2010; Warren and Quadir, Crit Care Med 34(8):2084-9, 2006; Zimlichman and Henderson, JAMA Intern Med 173(22):2039-46, 2013). Importantly, infections acquired during a hospital stay have been shown to be preventable (Loveday and Wilson, J Hosp Infect 86:S1-70, 2014)...
November 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27862901/does-minimalist-transfemoral-transcatheter-aortic-valve-replacement-produce-better-survival-in-patients-with-severe-chronic-obstructive-pulmonary-disease
#7
Jose F Condado, Moosa N Haider, Stamatios Lerakis, Patricia Keegan, Hope Caughron, Vinod H Thourani, Chandan Devireddy, Bradley Leshnower, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert Guyton, Jessica Forcillo, Ateet Patel, Amy Simone, Peter C Block, Vasilis Babaliaros
OBJECTIVES: To compare outcomes after minimalist and standard transfemoral transcatheter aortic valve replacement (TF-TAVR) in patients with severe chronic obstructive pulmonary disease (COPD). BACKGROUND: TF-TAVR is increasingly performed with conscious sedation and transthoracic echocardiography guidance (minimalist). The safety/efficacy of this technique in patients with severe COPD is unknown. METHODS: We compared demographics, 30-day outcomes and 1-year survival of patients with severe COPD (FEV1% ≤50) who underwent minimalist vs...
November 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27861136/a-prospective-descriptive-quality-improvement-study-to-investigate-the-impact-of-a-turn-and-position-device-on-the-incidence-of-hospital-acquired-sacral-pressure-ulcers-and-nursing-staff-time-needed-for-repositioning-patients
#8
Kimberly D Hall, Rebecca C Clark
Patients in critical care areas are at risk for developing hospital-acquired pressure ulcers (HAPUs) due to their physical conditions and limited ability to reposition themselves. A prospective, 2-phase quality improvement study was conducted from September to November 2011 and from February to April 2012 in 1 medical and 1 surgical ICU to investigate the impact of a turn-and-assist device on the incidence of HAPUs and the time and personnel required to reposition patients reported as person/minutes (staff x minutes)...
November 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27850846/1210-considerations-for-implementing-a-successful-or-icu-handover-procedure-in-a-large-trauma-centre
#9
Karolina Zjadewicz, Andrea Soo, Jennifer Coulthard, Paul Boucher, Paul Boiteau
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849665/practice-style-variation-in-medicaid-and-non-medicaid-children-with-complex-chronic-conditions-undergoing-surgery
#10
Jeffrey H Silber, Paul R Rosenbaum, Wei Wang, Shawna R Calhoun, Joseph G Reiter, Orit Even-Shoshan, William J Greeley
OBJECTIVES: With differential payment between Medicaid and Non-Medicaid services, we asked whether style-of-practice differs between similar Medicaid and Non-Medicaid children with complex chronic conditions (CCCs) undergoing surgery. SUMMARY OF BACKGROUND DATA: Surgery in children with CCCs accounts for a disproportionately large percentage of resource utilization at major children's hospitals. METHODS: A matched cohort design, studying 23,582 pairs of children with CCCs undergoing surgery (Medicaid matched to Non-Medicaid within the same hospital) from 2009 to 2013 in 41 Children's Hospitals...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27847697/comparison-of-the-effect-of-open-and-closed-endotracheal-suctioning-methods-on-pain-and-agitation-in-medical-icu-patients-a-clinical-trial
#11
Raziyeh Dastdadeh, Abbas Ebadi, Amir Vahedian-Azimi
BACKGROUND: Endotracheal suctioning is a necessary procedure practiced by nurses in intensive care units to remove lung secretions. This procedure leads to higher oxygenation levels and reduced breathing difficulties. It also prevents atelectasis, pulmonary infections, and the accumulation of secretions. OBJECTIVES: The present study aims to compare the effectiveness of open and closed endotracheal suction tube systems on pain and agitation in patients under mechanical ventilation...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27846248/elective-tracheotomy-practices-in-turkey
#12
Bulent Gucyetmez, Hakan Korkut Atalan, Nahit Cakar
OBJECTIVES: Elective tracheotomy (ET) procedures in intensive care units (ICU) might be different in accordance with countries and ICUs' features. The aim of the present study was to search the epidemiology of ET procedures in Turkey. METHODS: A questionnaire which consists of 43 questions was sent by e-mail to 238 ICUs which were officially recognized by The Turkish Ministry of Health. All answers were obtained between August 1, 2015 and August 31, 2015. RESULTS: Two hundred and three ICUs (85...
2016: PloS One
https://www.readbyqxmd.com/read/27843781/comparison-of-bispectral-index-monitoring-with-the-critical-care-pain-observation-tool-in-the-pain-assessment-of-intubated-adult-patients-after-cardiac-surgery
#13
Zahra Faritous, Arvin Barzanji, Rasoul Azarfarin, Behshid Ghadrdoost, Mohsen Ziyaeifard, Nahid Aghdaei, Mostafa Alavi
BACKGROUND: Detecting pain is crucial in sedated and mechanically ventilated patients, as they are unable to communicate verbally. OBJECTIVES: This study aimed to compare Bispectral index (BIS) monitoring with the Critical-care pain observation tool (CPOT) and vital signs for pain assessment during painful procedures in intubated adult patients after cardiac surgery. MATERIALS AND METHODS: Seventy consecutive patients who underwent cardiac surgery (coronary artery bypass graft or valvular surgery) were enrolled in the study...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27833752/accuracy-of-critical-care-pain-observation-tool-and-behavioral-pain-scale-to-assess-pain-in-critically-ill-conscious-and-unconscious-patients-prospective-observational-study
#14
Paolo Severgnini, Paolo Pelosi, Elena Contino, Elisa Serafinelli, Raffaele Novario, Maurizio Chiaranda
BACKGROUND: Critically ill patients admitted to intensive care unit (ICU) may suffer from different painful stimuli, but the assessment of pain is difficult because most of them are almost sedated and unable to self-report. Thus, it is important to optimize evaluation of pain in these patients. The main aim of this study was to compare two commonly used scales for pain evaluation: Critical Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS), in both conscious and unconscious patients...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27830281/a-family-information-brochure-and-dedicated-website-to-improve-the-icu-experience-for-patients-relatives-an-italian-multicenter-before-and-after-study
#15
Giovanni Mistraletti, Michele Umbrello, Elena Silvia Mantovani, Benedetta Moroni, Paolo Formenti, Paolo Spanu, Stefania Anania, Elisa Andrighi, Alessandra Di Carlo, Federica Martinetti, Irene Vecchi, Alessandra Palo, Cristina Pinna, Riccarda Russo, Silvia Francesconi, Federico Valdambrini, Enrica Ferretti, Giulio Radeschi, Edda Bosco, Paolo Malacarne, Gaetano Iapichino
PURPOSE: Good communication between ICU staff and patients' relatives may reduce the occurrence of post-traumatic stress disorder, anxiety or depression, and dissatisfaction with clinicians. An information brochure and website to meet relatives' needs were designed to explain in technical yet simple terms what happens during and after an ICU stay, to legitimize emotions such as fear, apprehension, and suffering, and to improve cooperation with relatives without increasing staff workload...
November 9, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27829093/postoperative-pulmonary-complications-early-mortality-and-hospital-stay-following-noncardiothoracic-surgery-a-multicenter-study-by-the-perioperative-research-network-investigators
#16
Ana Fernandez-Bustamante, Gyorgy Frendl, Juraj Sprung, Daryl J Kor, Bala Subramaniam, Ricardo Martinez Ruiz, Jae-Woo Lee, William G Henderson, Angela Moss, Nitin Mehdiratta, Megan M Colwell, Karsten Bartels, Kerstin Kolodzie, Jadelis Giquel, Marcos Francisco Vidal Melo
Importance: Postoperative pulmonary complications (PPCs), a leading cause of poor surgical outcomes, are heterogeneous in their pathophysiology, severity, and reporting accuracy. Objective: To prospectively study clinical and radiological PPCs and respiratory insufficiency therapies in a high-risk surgical population. Design, Setting, and Participants: We performed a multicenter prospective observational study in 7 US academic institutions...
November 9, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27826778/comparison-of-single-and-multi-incision-minimally-invasive-esophagectomy-mie-for-treating-esophageal-cancer-a-propensity-matched-study
#17
Jang-Ming Lee, Shang-Chi Chen, Shun-Mao Yang, Ying-Fan Tseng, Pei-Wen Yang, Pei-Ming Huang
OBJECTIVE: To compare the perioperative outcome of minimally invasive (MIE) esophagectomy performed with a single- or a multi-incision in treating esophageal cancer. METHOD: Patients with esophageal cancer who underwent MIE from 2006 to 2016 were evaluated. A 3-4-cm incision was created in both the thoracoscopic and the laparoscopic phases during the single-incision MIE procedures. A propensity-matched comparison was made between the two groups of patients. RESULTS: We analyzed a total of 48 pairs of patients with propensity-matched from the cohort of 360 patients undergoing MIE during 2006-2015...
November 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27822310/anaphylactic-shock-during-cement-implantation-of-a-total-hip-arthroplasty-in-a-patient-with-underlying-mastocytosis-case-report-of-a-rare-intraoperative-complication
#18
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27821662/malnutrition-at-intensive-care-unit-admission-predicts-mortality-in-emergency-general-surgery-patients
#19
Joaquim M Havens, Alexandra B Columbus, Anupamaa J Seshadri, Olubode A Olufajo, Kris M Mogensen, James D Rawn, Ali Salim, Kenneth B Christopher
BACKGROUND: Emergency general surgery (EGS) patients are at an increased risk for morbidity and mortality compared with non-EGS patients. Limited information exists regarding the contribution of malnutrition to the outcome of critically ill patients who undergo EGS. We hypothesized that malnutrition would be associated with increased risk of 90-day all-cause mortality following intensive care unit (ICU) admission in EGS patients. MATERIALS AND METHODS: We performed an observational study of patients treated in medical and surgical ICUs at a single institution in Boston...
November 7, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27815745/a-new-perspective-on-the-value-of-minimally-invasive-colorectal-surgery-payer-provider-and-patient-benefits
#20
Deborah S Keller, Anthony J Senagore, Kathryn Fitch, Andrew Bochner, Eric M Haas
BACKGROUND: The clinical benefits of minimally invasive surgery (MIS) are proven, but overall financial benefits are not fully explored. Our goal was to evaluate the financial benefits of MIS from the payer's perspective to demonstrate the value of minimally invasive colorectal surgery. METHODS: A Truven MarketScan(®) claim-based analysis identified all 2013 elective, inpatient colectomies. Cases were stratified into open or MIS approaches based on ICD-9 procedure codes; then costs were assessed using a similar distribution across diagnosis related groups (DRGs)...
November 4, 2016: Surgical Endoscopy
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