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https://www.readbyqxmd.com/read/29344048/the-impact-of-normal-saline-on-the-incidence-of-exposure-keratopathy-in-patients-hospitalized-in-intensive-care-units
#1
Zohreh Davoodabady, Korosh Rezaei, Reza Rezaei
Background: Patients in the intensive care unit (ICU) have impaired ocular protective mechanisms that lead to an increased risk of ocular surface diseases including exposure keratopathy (EK). This study was designed to evaluate the effect of normal saline (NS) on the incidence and severity of EK in critically ill patients. Materials and Methods: This single-blind randomized controlled trial was conducted on 50 patients admitted to ICUs. The participants were selected through purposive sampling...
January 2018: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#2
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29340945/electromagnetic-induction-sensor-for-dynamic-testing-of-coagulation-process
#3
Zhe Wang, Yuanhua Yu, Zhanjiang Yu, Qimeng Chen
With the increasing demand for coagulation POCT for patients in the surgery department or the ICU, rapid coagulation testing techniques and methods have drawn widespread attention from scholars and businessmen. This paper proposes the use of electromagnetic induction sensor probe for detection of dynamic process causing changes in the blood viscosity and density before and after coagulation based on the damped vibration principle, in order to evaluate the coagulation status. Utilizing the dynamic principle, the differential equation of vibration system comprising elastic support and electromagnetic induction device is established through sensor dynamic modeling...
January 16, 2018: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/29340148/reducing-unnecessary-culturing-a-systems-approach-to-evaluating-urine-culture-ordering-and-collection-practices-among-nurses-in-two-acute-care-settings
#4
Robert Redwood, Mary Jo Knobloch, Daniela C Pellegrini, Matthew J Ziegler, Michael Pulia, Nasia Safdar
Background: Inappropriate ordering and acquisition of urine cultures leads to unnecessary treatment of asymptomatic bacteriuria (ASB). Treatment of ASB contributes to antimicrobial resistance particularly among hospital-acquired organisms. Our objective was to investigate urine culture ordering and collection practices among nurses to identify key system-level and human factor barriers and facilitators that affect optimal ordering and collection practices. Methods: We conducted two focus groups, one with ED nurses and the other with ICU nurses...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29338720/manual-exchange-transfusion-for-severe-imported-falciparum-malaria-a-retrospective-study
#5
Jinfeng Lin, Xiaoying Huang, Gang Qin, Suyan Zhang, Weiwei Sun, Yadong Wang, Ke Ren, Junxian Xu, Xudong Han
BACKGROUND: This study was designed to evaluate the efficacy of exchange transfusion in patients with severe imported falciparum malaria. Twelve patients who met the diagnostic criteria for severe malaria were treated with exchange transfusion 14 times according to a conventional anti-malarial treatment. This study evaluated the efficacy of exchange transfusion for severe imported falciparum malaria. METHODS: Clinical data of severe imported falciparum malaria patients admitted to the intensive care unit (ICU) of Nantong Third People's Hospital from January 2007 to December 2016 were investigated in this retrospective study...
January 16, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29337171/is-early-tracheostomy-better-for-severe-traumatic-brain-injury-a-meta-analysis
#6
Qin Lu, Yonglin Xie, Xunchen Qi, Xinwei Li, Shuxu Yang, Yirong Wang
OBJECTIVE: Tracheotomy have been proven to be benefit for the patients requiring prolonged mechanical ventilation. However, whether early tracheotomy (less than 10 days) could also improve the outcome of severe traumatic brain injury (TBI) patient (GCS≤8) remains controversial. The aim of this study was trying to clarify this question. METHODS: We searched four databases (PubMed, Web of Science, Elsevier and Cochrane Library) for articles comparing the outcome of early tracheostomy with late tracheostomy or prolonged intubation on the severe TBI patients...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29336389/a-randomized-controlled-trial-comparing-the-myocardial-protective-effects-of-isoflurane-with-propofol-in-patients-undergoing-elective-coronary-artery-bypass-surgery-on-cardiopulmonary-bypass-assessed-by-changes-in-n-terminal-brain-natriuretic-peptide
#7
Balaji Kuppuswamy, Kirubakaran Davis, Raj Sahajanandan, Manickam Ponniah
OBJECTIVE: The objective of the study is to compare the myocardial protective effects of isoflurane with propofol in patients undergoing elective coronary artery bypass surgery on cardiopulmonary bypass (CPB), the cardio protection been assessed by changes in N-terminal brain natriuretic peptide (NT proBNP). Methodology and Design: This study is designed as a participant blinded, prospective randomized clinical trial. SETTING: Christian Medical College Hospital, Vellore, India...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29320830/-a-multi-center-retrospective-study-of-clinical-characteristics-and-hospitalization-costs-of-patients-hospitalized-for-asthma-exacerbation-in-china-during-2013-2014
#8
J T Lin, B Xing, H P Tang, L Yang, Y D Yuan, Y H Gu, P Chen, X J Liu, J Zhang, H G Liu, C Z Wang, W Zhou, D J Sun, Y Q Chen, Z C Chen, M Huang, Q C Lin, C P Hu, X H Yang, J M Huo, X W Ye, X Zhou, P Jiang, W Zhang, Y J Huang, L M Dai, R Y Liu, S X Cai, J Y Xu, J Y Zhou
Objective: To study the characteristics of patients hospitalized for asthma exacerbation in 29 teaching hospitals in China and to evaluate the hospitalization costs of these patients. Methods: This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during 2013-2014. Information about the demographic features, conditions before the admission, the outcome, the complications, and the costs was collected using the pre-designed case report form. The influencing factors of the hospitalization costs were analyzed...
November 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29302597/ethical-challenges-involved-in-obtaining-consent-for-research-from-patients-hospitalized-in-the-intensive-care-unit
#9
Fiona Ecarnot, Jean-Pierre Quenot, Guillaume Besch, Gaël Piton
Clinical research remains a vital contributor to medical knowledge, and is an established and integral part of the practice of medicine worldwide. Respect for patient autonomy and ethical principles dictate that informed consent must be obtained from subjects before they can be enrolled into clinical research, yet these conditions may be difficult to apply in real practice in the intensive care unit (ICU). A number of factors serve to complexify the consent process in critically ill patients, notably decisional incapacity of the patient due to illness or sedation...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29302114/the-influence-of-intraoperative-autotransfusion-on-postoperative-hematocrit-after-cardiac-surgery-a-cross-sectional-study
#10
Andrew J Stasko, Alfred H Stammers, Linda B Mongero, Eric A Tesdahl, Samuel Weinstein
Utilization of intraoperative autotransfusion (IAT) during cardiac surgery with cardiopulmonary bypass (CPB) has been shown to reduce allogeneic red blood cell transfusion. Previous research has emphasized the benefits of using IAT in the intraoperative period. The present study was designed to evaluate the effects of using IAT on overall hematocrit (Hct) drift between initiation of CPB and the immediate postoperative period. We reviewed 3,225 adult cardiac procedures occurring between February 2016 and January 2017 at 84 hospitals throughout the United States...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29300728/intensive-insulin-therapy-increases-glutathione-synthesis-rate-in-surgical-icu-patients-with-stress-hyperglycemia
#11
Gianni Biolo, Benedetta Massolino, Filippo Giorgio Di Girolamo, Nicola Fiotti, Filippo Mearelli, Sara Mazzucco, Carlos Bertuzzi, Renzo Lazzarini, Alfonso Colombatti, Marcello De Cicco
OBJECTIVE: The glutathione system plays an essential role in antioxidant defense after surgery. We assessed the effects of intensive insulin treatment (IIT) on glutathione synthesis rate and redox balance in cancer patients, who had developed stress hyperglycemia after major surgery. METHODS: We evaluated 10 non-diabetic cancer patients the day after radical abdominal surgery combined with intra-operative radiation therapy. In each patient, a 24-hr period of IIT, aimed at tight euglycemic control, was preceded, or followed, by a 24-hr period of conventional insulin treatment (CIT) (control regimen)...
2018: PloS One
https://www.readbyqxmd.com/read/29300237/dedicated-afternoon-rounds-for-icu-patients-families-and-family-satisfaction-with-care
#12
Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kevin B Huang, Muhammad Hamza, Jessica White, Anna Coppola, Kathleen M Akgün, David M Greer, Evie G Marcolini, Emily J Gilmore, Nils H Petersen, Nona Timario, Kelly Poskus, Kevin N Sheth, David Y Hwang
OBJECTIVE: It was hypothesized that adding dedicated afternoon rounds for patients' families to supplement standard family support would improve overall family satisfaction with care in a neuroscience ICU. DESIGN: Pre- and postimplementation (pre-I and post-I) design. SETTING: Single academic neuroscience ICU. PATIENTS: Patients in the neuroscience ICU admitted for longer than 72 hours or made comfort measures only at any point during neuroscience ICU admission...
January 3, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29300217/development-of-an-rn-champion-model-to-improve-the-outcomes-of-ventilator-associated-pneumonia-patients-in-the-intensive-care-unit
#13
Carol Robinson, Marci Hoze, Stacy Hevener, Amy A Nichols
Healthcare-associated infections are costly. Methods to prevent infections must be effective and provide a return on investment to be sustainable. A funded project supported the design and implementation of a unique quality and safety model, using unit-based quality and safety RN champions. The goal was to create and sustain a hospital-wide safety culture focused on preventing ventilator-associated pneumonia (VAP) by adopting the Institute for Healthcare Improvement's VAP bundle. The program began with a pilot in 7 ICUs...
January 4, 2018: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29297400/seven-unconfirmed-ideas-to-improve-future-icu-practice
#14
REVIEW
John J Marini, Daniel De Backer, Can Ince, Mervyn Singer, Frank Van Haren, Martin Westphal, Paul Wischmeyer
With imprecise definitions, inexact measurement tools, and flawed study execution, our clinical science often lags behind bedside experience and simply documents what appear to be the apparent faults or validity of ongoing practices. These impressions are later confirmed, modified, or overturned by the results of the next trial. On the other hand, insights that stem from the intuitions of experienced clinicians, scientists and educators-while often neglected-help place current thinking into proper perspective and occasionally point the way toward formulating novel hypotheses that direct future research...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29297387/personalised-fluid-resuscitation-in-the-icu-still-a-fluid-concept
#15
REVIEW
Frank van Haren
The administration of intravenous fluid to critically ill patients is one of the most common, but also one of the most fiercely debated, interventions in intensive care medicine. Even though many thousands of patients have been enrolled in large trials of alternative fluid strategies, consensus remains elusive and practice is widely variable. Critically ill patients are significantly heterogeneous, making a one size fits all approach unlikely to be successful.New data from basic, animal, and clinical research suggest that fluid resuscitation could be associated with significant harm...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29295760/the-contents-of-a-patient-diary-and-its-significance-for-persons-cared-for-in-an-icu-a-qualitative-study
#16
Sandra Strandberg, Lisa Vesterlund, Åsa Engström
OBJECTIVES: The aim of this study was to describe the contents of a patient diary and its significance for persons cared for in an ICU. RESEARCH METHODOLOGY: An empirical study with a qualitative design. Eight telephone interviews and one face-to-face interview were conducted with nine persons previously been treated in an ICU and been given a patient diary. In addition, the person would have read his/her diary. The data have been analysed with qualitative content analysis...
December 30, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29282724/the-impact-of-enhanced-critical-care-training-and-24-7-tele-icu-support-on-medicare-spending-and-postdischarge-utilization-patterns
#17
Matthew J Trombley, Andrea Hassol, Jennifer T Lloyd, Timothy G Buchman, Allison F Marier, Alan White, Erin Colligan
OBJECTIVE: To estimate the effect of implementing a tele-ICU and a critical care residency training program for advanced practice providers on service utilization and total Medicare episode spending. DATA SOURCES/STUDY SETTINGS: Medicare claims data for fee-for-service beneficiaries at 12 large, inpatient hospitals in the Atlanta Hospital Referral Region. STUDY DESIGN: Difference-in-differences design where changes in spending and utilization for Medicare beneficiaries eligible for treatment in participating ICUs was compared to changes in a comparison group of clinically similar beneficiaries treated at similar hospitals' ICUs in the same hospital referral region...
December 27, 2017: Health Services Research
https://www.readbyqxmd.com/read/29282098/the-impact-of-maintaining-serum-potassium-%C3%A2-3-6-meq-l-vs-%C3%A2-4-5-meq-l-on-the-incidence-of-new-onset-atrial-fibrillation-in-the-first-120-hours-after-isolated-elective-coronary-artery-bypass-grafting-study-protocol-for-a-randomised-feasibility-trial-for-the-proposed
#18
Niall G Campbell, Elizabeth Allen, Julie Sanders, Rebecca Swinson, Sophie Birch, Joanna Sturgess, Nawaf Al-Subaie, Diana Elbourne, Hugh Montgomery, Ben O'Brien
BACKGROUND: Atrial fibrillation (AF) occurs in approximately one in three patients after cardiac surgery, and is associated with increased short-term and long-term mortality, intensive care unit (ICU) and hospital stay, and increased cost of care. In an attempt to reduce AF incidence in these patients, serum potassium (K+) levels are commonly maintained at the high end of normal (4.5-5.5 mEq/L). However, such potassium supplementation is without proven benefit, and is not without negative consequences...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29282093/timing-of-renal-replacement-therapy-and-long-term-risk-of-chronic-kidney-disease-and-death-in-intensive-care-patients-with-acute-kidney-injury
#19
Søren Christiansen, Steffen Christensen, Lars Pedersen, Henrik Gammelager, J Bradley Layton, M Alan Brookhart, Christian Fynbo Christiansen
BACKGROUND: The optimal time to initiate renal replacement therapy (RRT) in intensive care unit (ICU) patients with acute kidney injury (AKI) is unclear. We examined the impact of early RRT on long-term mortality, risk of chronic kidney disease (CKD), and end-stage renal disease (ESRD). METHODS: This cohort study included all adult patients treated with continuous RRT in the ICU at Aarhus University Hospital, Skejby, Denmark (2005-2015). Data were obtained from a clinical information system and population-based registries...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29277137/effects-of-stress-on-critical-care-nurses-a-national-cross-sectional-study
#20
Amir Vahedian-Azimi, Mohammadreza Hajiesmaeili, Mari Kangasniemi, Joana Fornés-Vives, Rita L Hunsucker, Farshid Rahimibashar, Mohammad A Pourhoseingholi, Leily Farrokhvar, Andrew C Miller
BACKGROUND: Health care is a demanding field, with a high level of responsibility and exposure to emotional and physical danger. High levels of stress may result in depression, anxiety, burnout syndrome, and in extreme cases, post-traumatic stress disorder. The aim of this study was to determine which personal, professional, and organizational variables are associated with greater perceived stress among critical care nurses for purposes of developing integrative solutions to decrease stress in the future...
January 1, 2017: Journal of Intensive Care Medicine
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