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https://www.readbyqxmd.com/read/28944590/effect-of-the-use-of-earplugs-and-eye-mask-on-the-quality-of-sleep-in-intensive-care-patients-a-systematic-review
#1
REVIEW
Hana Locihová, Karel Axmann, Hana Padyšáková, Jakub Fejfar
Intensive care unit (ICU) environment has a very strong and unavoidable negative impact on patients' sleep. Sleep deprivation in ICU patients has been already studied and negative effects on their outcome (prolonged ICU stay, decreased recovery) and complication rates (incidence of delirium, neuropsychological sequels of critical illness) discussed. Several interventions potentially improving the sleep disturbance in ICU (sleep-promotion strategies) have been assumed and tested for clinical practice. We present a review of recent literature focused on chosen types of non-pharmacological interventions (earplugs and eye mask) analysing their effect on sleep quality/quantity...
September 25, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28944163/weathering-the-storm-improving-therapeutic-interventions-for-cytokine-storm-syndromes-by-targeting-disease-pathogenesis
#2
Lehn K Weaver, Edward M Behrens
Cytokine storm syndromes require rapid diagnosis and treatment to limit the morbidity and mortality caused by the hyperinflammatory state that characterizes these devastating conditions. Herein, we discuss the current knowledge that guides our therapeutic decision-making and personalization of treatment for patients with cytokine storm syndromes. Firstly, ICU-level supportive care is often required to stabilize patients with fulminant disease while additional diagnostic evaluations proceed to determine the underlying cause of cytokine storm...
March 2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/28935438/lipids-in-the-intensive-care-unit-recommendations-from-the-espen-expert-group
#3
REVIEW
Philip C Calder, Michael Adolph, Nicolaas E Deutz, Teodoro Grau, Jacqueline K Innes, Stanislaw Klek, Shaul Lev, Konstantin Mayer, Adina T Michael-Titus, Lorenzo Pradelli, Mark Puder, Hester Vlaardingerbroek, Pierre Singer
This article summarizes the presentations given at an ESPEN Workshop on "Lipids in the ICU" held in Tel Aviv, Israel in November 2014 and subsequent discussions and updates. Lipids are an important component of enteral and parenteral nutrition support and provide essential fatty acids, a concentrated source of calories and building blocks for cell membranes. Whilst linoleic acid-rich vegetable oil-based enteral and parenteral nutrition is still widely used, newer lipid components such as medium-chain triglycerides and olive oil are safe and well tolerated...
September 7, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28929392/preventing-early-bouncebacks-to-the-neurointensive-care-unit-a-retrospective-analysis-and-quality-improvement-pilot
#4
David G Coughlin, Monisha A Kumar, Neha N Patel, Rebecca L Hoffman, Scott E Kasner
BACKGROUND: Early unplanned readmissions of "bouncebacks" to intensive care units are a healthcare quality metric and result in higher mortality and greater cost. Few studies have examined bouncebacks to the neurointensive care unit (neuro-ICU), and we sought to design and implement a quality improvement pilot to reduce that rate. METHODS: First, we performed a retrospective chart review of 504 transfers to identify potential bounceback risk factors. Risk factors were assessed on the day of transfer by the transferring physician identifying patients as "high risk" or "low risk" for bounceback...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28927475/impact-of-discontinuing-contact-precautions-for-mrsa-and-esble-in-an-intensive-care-unit-a-prospective-noninferiority-before-and-after-study
#5
Laurie Renaudin, Mathieu Llorens, Christophe Goetz, Sébastien Gette, Vincente Citro, Sylvia Poulain, Marie-Laure Vanson, Jocelyne Sellies
OBJECTIVE To compare incidence densities of methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLE) acquisition in the intensive care unit (ICU) before and after discontinuation of contact precautions (CP) and application of standard precautions (SP). DESIGN Prospective noninferiority before-and-after study comparing 2 periods: January 1, 2012, to January 31, 2014 (the CP period) and February 1, 2014, to February 29, 2016 (the SP period). SETTING A 16-bed polyvalent ICU in France with only single-bed rooms with dedicated equipment and reusable medical devices...
September 20, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28919718/extended-infusion-versus-intermittent-infusion-of-imipenem-in-the-treatment-of-ventilator-associated-pneumonia
#6
Mohamed M Ibrahim, Tarek Fouad Tammam, Mohy El Deen Ebaed, Hatem A Sarhan, Gamal F Gad, Amal K Hussein
BACKGROUND: Mechanical ventilation support can be the main source of ventilator-associated pneumonia (VAP). VAP is a serious infection that may be associated with dangerous gram-negative bacteria mainly, and it leads to an increase in the mortality in the intensive care unit (ICU). Imipenem is one of the strongest antibiotics now available for treating VAP which is associated with gram-negative and gram-positive bacteria, and it belongs to beta-lactam antibiotic group (carbapenem). OBJECTIVE: This study tried to investigate the efficacy of imipenem against VAP when it was infused within 180 min versus the efficacy when it was infused within 30-60 min...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28912057/apnoeic-oxygenation-during-intubation-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#7
REVIEW
Matthew J Binks, Rhys S Holyoak, Thomas M Melhuish, Ruan Vlok, Anthony Hodge, Thomas Ryan, Leigh D White
Hypoxaemia increases the risk of cardiac arrest and mortality during intubation. The reduced physiological reserve and reduced efficacy of pre-oxygenation in intensive care patients makes their intubation particularly dangerous. Apnoeic oxygenation is a promising means of preventing hypoxaemia in this setting. We sought to ascertain whether apnoeic oxygenation reduces the incidence of hypoxaemia when used during endotracheal intubation in the intensive care unit (ICU). A systematic review of five databases for all relevant studies published up to November 2016 was performed...
September 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28899584/evaluating-the-past-to-improve-the-future-a-qualitative-study-of-icu-patients-experiences
#8
Kristin Dahle Olsen, Marit Nester, Britt Sætre Hansen
BACKGROUND: The recovery period for patients who have been in an intensive care unitis often prolonged and suboptimal. Anxiety, depression and post-traumatic stress disorder are common psychological problems. Intensive care staff offer various types of intensive aftercare. Intensive care follow-up aftercare services are not standard clinical practice in Norway. OBJECTIVE: The overall aim of this study is to investigate how adult patients experience theirintensive care stay their recovery period, and the usefulness of an information pamphlet...
September 9, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28894481/respiratory-research-networks-in-europe-and-beyond-aims-achievements-and-aspirations-for-the-21st-century
#9
Ignacio Martin-Loeches, Fernando Zampieri, Pedro Povoa, Otavio Ranzani, Lieuwe D Bos, Stefano Aliberti, Antoni Torres
Healthcare-associated infection, such as intensive care unit (ICU)-related respiratory infections, remain the most frequently encountered morbidity of ICU admission, prolonging hospital stay and increasing mortality rates. The epidemiology of ICU-related respiratory infections, particularly nonventilated ICU-associated pneumonia and ventilator-associated tracheobronchitis, appears to be quite different among different countries. European countries have different prevalence, patterns and mechanism of resistance, as well as different treatments chosen by different attending physicians...
September 2017: Breathe
https://www.readbyqxmd.com/read/28891977/polytrauma-defined-by-the-new-berlin-definition-a-validation-test-based-on-propensity-score-matching-approach
#10
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. This study was designed to investigate the outcome of patients with polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS) ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension [systolic blood pressure ≤ 90 mmHg], unconsciousness [Glasgow Coma Scale score ≤ 8], acidosis [base excess ≤ -6...
September 11, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28889833/acute-kidney-injury-following-first-stage-palliation-in-hypoplastic-left-heart-syndrome-hybrid-versus-norwood-palliation
#11
Richard U Garcia, Girija Natarajan, Henry L Walters, Ralph E Delius, Sanjeev Aggarwal
OBJECTIVE: The aim of this study was to evaluate the prevalence of acute kidney injury after first-stage surgical palliation in patients with a single ventricle and to explore associated risk factors and outcomes. Design and patients This single-centre retrospective study included neonates who underwent either Norwood or Hybrid procedure from 2008 to 2015 for a single ventricle. Postoperative acute kidney injury was defined using the paediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE), criteria within 72 hours of the procedure...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28888275/mean-arterial-pressure-of-65-mm-hg-versus-85-100-mm-hg-in-comatose-survivors-after-cardiac-arrest-rationale-and-study-design-of-the-neuroprotect-post-cardiac-arrest-trial
#12
RANDOMIZED CONTROLLED TRIAL
Koen Ameloot, Cathy De Deyne, Bert Ferdinande, Matthias Dupont, Pieter-Jan Palmers, Thibault Petit, Ward Eertmans, Clara Moonen, Ann Belmans, Robin Lemmens, Joseph Dens, Stefan Janssens
BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO2) in a specific range (MAP 85-100 mm Hg, SVO2 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28887643/clinical-predictors-of-methicillin-resistant-staphylococcus-aureus-in-nosocomial-and-healthcare-associated-pneumonia-a-multicenter-matched-case-control-study
#13
J Torre-Cisneros, C Natera, F Mesa, M Trikic, J Rodríguez-Baño
The situations in which coverage for methicillin-resistant Staphylococcus aureus (MRSA) in the empirical treatment of nosocomial pneumonia (NP) or severe healthcare-associated pneumonia (HCAP) is needed are poorly defined, particularly outside intensive care units (ICUs). Our aim was to characterize if the risk of MRSA NP/HCAP can be defined by clinical variables. We designed an observational, retrospective, multicenter, case-control study to analyze the association between defined clinical variables and risk of MRSA NP/HCAP in non-ICU patients using conditional multivariable logistic regression...
September 8, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28883166/standards-based-procedural-phenotyping-the-arden-syntax-on-i2b2
#14
Sebastian Mate, Ixchel Castellanos, Thomas Ganslandt, Hans-Ulrich Prokosch, Stefan Kraus
Phenotyping, or the identification of patient cohorts, is a recurring challenge in medical informatics. While there are open source tools such as i2b2 that address this problem by providing user-friendly querying interfaces, these platforms lack semantic expressiveness to model complex phenotyping algorithms. The Arden Syntax provides procedural programming language construct, designed specifically for medical decision support and knowledge transfer. In this work, we investigate how language constructs of the Arden Syntax can be used for generic phenotyping...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28881078/the-effects-of-nurse-led-clinical-pathway-in-coronary-artery-bypass-graft-surgery-a-quasi-experimental-study
#15
Ayda Kebapçı, Nevin Kanan
AIMS AND OBJECTIVE: Develop and evaluate the effects of a nurse-led clinical pathway (CP) for patients undergoing CABG (Coronary Artery Bypass Graft Surgery). BACKGROUND: A CP is a multidisciplinary care plan, based on evidence and guidelines to provide consistent, quality care to patients and improve outcomes. DESIGN: Prospective, quasi-experimental design. METHODS: Patients hospitalized for CABG between April 2014 and November 2015 in a hospital in Turkey were studied...
September 7, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28877171/preventable-proportion-of-intubation-associated-pneumonia-role-of-adherence-to-a-care-bundle
#16
Antonella Agodi, Martina Barchitta, Annalisa Quattrocchi, Emiliano Spera, Giovanni Gallo, Francesco Auxilia, Silvio Brusaferro, Marcello Mario D'Errico, Maria Teresa Montagna, Cesira Pasquarella, Stefano Tardivo, Ida Mura
OBJECTIVE: The aim of the present study was to estimate the preventable proportion of Intubation-Associated Pneumonia (IAP) in the Intensive Care Units (ICUs) participating in the Italian Nosocomial Infections Surveillance in ICUs (SPIN-UTI) network, taking into account differences in intrinsic patients' risk factors, and additionally considering the compliance with the European bundle for IAP prevention. METHODS: A prospective patient-based survey was conducted and all patients staying in ICU for more than 2 days were enrolled in the surveillance...
2017: PloS One
https://www.readbyqxmd.com/read/28876686/management-of-failed-mitral-valve-replacement-the-durban-experience
#17
D Kistan, M Booysen, G Alexander, T E Madiba
BACKGROUND: Mitral valve replacement is the procedure of choice in patients with severe mitral valve disease. However, these patients are surviving longer and are thus at an increased risk of prosthesis failure or valve-related complications. METHOD: Study setting: Inkosi Albert Luthuli Central Hospital, a tertiary referral Hospital in Durban. Study population: All patients undergoing redo mechanical mitral valve replacement surgery between January 2005 and December 2014...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28875123/costs-and-perioperative-outcomes-associated-with-open-versus-endoscopic-resection-of-sinonasal-malignancies-with-skull-base-involvement
#18
Terence S Fu, Eric Monteiro, Ian Witterick, Allan Vescan, Gelareh Zadeh, Fred Gentili, John R de Almeida
Objective  To compare financial and perioperative outcomes between endoscopic and open surgical approaches in the surgical management of sinonasal malignancies. Design  Retrospective chart review. Setting  Tertiary care hospital. Participants  Patients undergoing surgical resection of a sinonasal malignancy from January 2000 to December 2014. Main Outcome Measures  In-hospital costs, complications, and length of stay (LOS). Results  Of 106 patients, 91 received open surgery (19 free flap and 72 non-free flap) and 15 were treated with purely endoscopic approaches...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28864157/basal-insulin-for-the-management-of-diabetic-ketoacidosis
#19
REVIEW
Leonid Barski, Evgenia Brandstaetter, Iftach Sagy, Alan Jotkowitz
Due to its pharmacokinetic properties, it has been suggested that long-acting insulin analogues may have a role in facilitating the transition from continuous intravenous insulin infusion to subcutaneous maintenance therapy in patients with DKA for prevention of rebound hyperglycemia, particularly if there are high insulin requirements. Concomitant administration of basal insulin analogues with regular insulin infusion accelerates ketoacidosis resolution and prevents rebound hyperglycemia. Several studies have investigated the use of basal insulin in the management of DKA...
August 30, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28864056/classification-of-patients-with-sepsis-according-to-blood-genomic-endotype-a-prospective-cohort-study
#20
Brendon P Scicluna, Lonneke A van Vught, Aeilko H Zwinderman, Maryse A Wiewel, Emma E Davenport, Katie L Burnham, Peter Nürnberg, Marcus J Schultz, Janneke Horn, Olaf L Cremer, Marc J Bonten, Charles J Hinds, Hector R Wong, Julian C Knight, Tom van der Poll
BACKGROUND: Host responses during sepsis are highly heterogeneous, which hampers the identification of patients at high risk of mortality and their selection for targeted therapies. In this study, we aimed to identify biologically relevant molecular endotypes in patients with sepsis. METHODS: This was a prospective observational cohort study that included consecutive patients admitted for sepsis to two intensive care units (ICUs) in the Netherlands between Jan 1, 2011, and July 20, 2012 (discovery and first validation cohorts) and patients admitted with sepsis due to community-acquired pneumonia to 29 ICUs in the UK (second validation cohort)...
August 29, 2017: Lancet Respiratory Medicine
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