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Critical care; intensive care

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https://www.readbyqxmd.com/read/28542632/evaluation-of-a-strategy-for-enrolling-the-families-of-critically-ill-patients-in-research-using-limited-human-resources
#1
Alison E Turnbull, Mohamed D Hashem, Anahita Rabiee, An To, Caroline M Chessare, Dale M Needham
RATIONALE: Clinical trials of interventions aimed at the families of intensive care unit (ICU) patients have proliferated but recruitment for these trials can be challenging. OBJECTIVES: To evaluate a strategy for recruiting families of patients currently being treated in an ICU using limited human resources and time-varying daily screening over 7 consecutive days. METHODS: We screened the Johns Hopkins Hospital medical ICU census 7 days per week to identify eligible family members...
2017: PloS One
https://www.readbyqxmd.com/read/28542440/plasma-kallistatin-in-critically-ill-patients-with-severe-sepsis-and-septic-shock
#2
Wei-Chieh Lin, Chang-Wen Chen, Lee Chao, Julie Chao, Yee-Shin Lin
Kallistatin, an endogenous serine proteinase inhibitor, is protective against sepsis in animal models. The aim of this study was to determine the plasma concentration of kallistatin in intensive care unit (ICU) patients with severe sepsis and septic shock and to determine their potential correlation with disease severity and outcomes. We enrolled 86 ICU patients with severe sepsis and septic shock. Their plasma concentrations of kallistatin, kallikrein, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-8 were measured by enzyme-linked immunosorbent assay...
2017: PloS One
https://www.readbyqxmd.com/read/28542272/factors-associated-with-poor-outcomes-of-continuous-renal-replacement-therapy
#3
Chih-Chin Kao, Ju-Yeh Yang, Likwang Chen, Chia-Ter Chao, Yu-Sen Peng, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Continuous renal replacement therapy (CRRT) is one of the dialysis modalities for critically ill patients. Despite intensive dialysis care, a high mortality rate is found in these patients. Our objective was to investigate the factors associated with poor outcomes in these patients. We conducted a retrospective cohort study using the National Health Insurance Research Database. Records of critically ill patients who received CRRT between 2007 and 2011 were retrieved, and the patients were categorized into two groups: those with acute kidney injury (AKI) and those with history of end-stage renal disease (ESRD)...
2017: PloS One
https://www.readbyqxmd.com/read/28539958/cognitive-impairment-and-psychological-distress-at-discharge-from-intensive-care-unit
#4
Chi Ryang Chung, Hye Jin Yoo, Jinkyeong Park, Seunghyong Ryu
This study aimed to investigate cognitive impairment and psychological distress of critically ill patients at discharge from intensive care unit (ICU). This study included 30 critically ill patients who had neither pre-existing dementia nor ongoing delirium. At ICU discharge, they performed a screening test for cognitive impairment (Mini-Cog test) and completed questionnaires for depression (Patient Health Questionnaire-2, PHQ-2) and for 4 stressful experiences during ICU stay including nightmares, severe anxiety or panic, severe pain, and trouble to breathe or feeling of suffocation (Post-Traumatic Stress Syndrome 14-Question Inventory, PTSS-14 Part A)...
May 2017: Psychiatry Investigation
https://www.readbyqxmd.com/read/28539205/patient-participation-in-the-intensive-care-unit
#5
Anna Schandl, Ann-Charlotte Falk, Catharina Frank
OBJECTIVE: Patient participation in healthcare is important for optimizing treatment outcomes and for ensuring satisfaction with care. The purpose of the study wasto explore critical care nurses' perceptions of patient participation for critically ill patients. DESIGN AND SETTINGS: Qualitative data were collected in four separate focus group interviews with 17 nurses from two hospitals. The interviews were analyzed using qualitative content analysis. FINDINGS: Initially, the nurses stated that patient participation in the intensive care unit (ICU) was dependent on the patient's health condition and consciousness...
May 20, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28539083/patient-length-of-stay-and-mortality-prediction-a-survey
#6
Aya Awad, Mohamed Bader-El-Den, James McNicholas
Over the past few years, there has been increased interest in data mining and machine learning methods to improve hospital performance, in particular hospitals want to improve their intensive care unit statistics by reducing the number of patients dying inside the intensive care unit. Research has focused on prediction of measurable outcomes, including risk of complications, mortality and length of hospital stay. The length of stay is an important metric both for healthcare providers and patients, influenced by numerous factors...
May 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28538609/critical-care-interventions-for-asthmatic-patients-admitted-from-the-emergency-department-to-the-pediatric-intensive-care-unit
#7
Kristen Michelle Cundiff, James M Gerard, Robert G Flood
OBJECTIVES: The aim of this study was to assess the frequency and predictors of critical interventions in asthmatic patients admitted to the pediatric intensive care unit (PICU) at a tertiary-care pediatric hospital. METHODS: We conducted a retrospective chart review of patients admitted from our emergency department (ED) to the PICU for treatment of status asthmaticus between January 1, 2008, and March 31, 2013. Patients with concomitant medical conditions and those who received a critical intervention, other than continuously aerosolized albuterol, in the ED before admission were excluded...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28537973/identifying-variability-in-mental-models-within-and-between-disciplines-caring-for-the-cardiac-surgical-patient
#8
Evans K H Brown, Kathleen A Harder, Ioanna Apostolidou, Joyce A Wahr, Douglas C Shook, R Saeid Farivar, Tjorvi E Perry, Mojca R Konia
BACKGROUND: The cardiac operating room is a complex environment requiring efficient and effective communication between multiple disciplines. The objectives of this study were to identify and rank critical time points during the perioperative care of cardiac surgical patients, and to assess variability in responses, as a correlate of a shared mental model, regarding the importance of these time points between and within disciplines. METHODS: Using Delphi technique methodology, panelists from 3 institutions were tasked with developing a list of critical time points, which were subsequently assigned to pause point (PP) categories...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537808/dose-intense-dose-dense-and-tailored-dose-adjuvant-chemotherapy-for-early-breast-cancer-an-evolution-of-concepts
#9
Alexios Matikas, Theodoros Foukakis, Jonas Bergh
BACKGROUND: The introduction of adjuvant chemotherapy following surgery for early breast cancer (BC) and its integration into routine clinical practice has consistently improved clinical outcomes. Since the addition of other agents to the contemporary standard of care containing an anthracycline, cyclophosphamide and a taxane has not lead to further prolongation of survival, subsequent efforts concentrated on escalating the administered doses and reducing the time interval between chemotherapy cycles...
May 24, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28537519/burden-and-outcome-of-vitamin-d-deficiency-among-critically-ill-patients-a-prospective-study
#10
Enas Anwar, Gehan Hamdy, Eman Taher, Esmat Fawzy, Sherif Abdulattif, Mohamed H Attia
BACKGROUND: Vitamin D deficiency is a prevalent condition among critically ill patients. Information about the relationship between vitamin D levels and outcomes in the intensive care unit (ICU) is sparse. PURPOSE: To evaluate vitamin D status among critically ill patients and its relevance to severity of illness, ICU stay period, and mortality. METHODS: This prospective multicenter study was conducted in the ICUs of Fayoum, Cairo, Alazhar, and Ain Shams university hospitals...
June 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28537514/novel-family-centered-intervention-to-improve-nutrition-in-patients-recovering-from-critical-illness-a-feasibility-study
#11
Andrea P Marshall, Margot Lemieux, Rupinder Dhaliwal, Hilda Seyler, Kristen N MacEachern, Daren K Heyland
BACKGROUND: Critically ill patients are at increased risk of developing malnutrition-related complications because of physiological changes, suboptimal delivery, and reduced intake. Strategies to improve nutrition during critical illness recovery are required to prevent iatrogenic underfeeding and risk of malnutrition. The purpose of this study was to assess the feasibility and acceptability of a novel family-centered intervention to improve nutrition in critically ill patients. MATERIALS AND METHODS: A 3-phase, prospective cohort feasibility study was conducted in 4 intensive care units (ICUs) across 2 countries...
June 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28536944/fluid-responsiveness-predicted-by-transcutaneous-partial-pressure-of-oxygen-in-patients-with-circulatory-failure-a-prospective-study
#12
Jingyuan Xu, Xiao Peng, Chun Pan, Shixia Cai, Xiwen Zhang, Ming Xue, Yi Yang, Haibo Qiu
BACKGROUND: Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO2) in the critically ill patients. METHODS: This was a single-center prospective study conducted in the intensive care unit of a tertiary care teaching hospital. Shock patients who presented with at least one clinical sign of inadequate tissue perfusion, defined as systolic blood pressure <90 mmHg or a decrease >40 mmHg in previously hypertensive patients or the need for vasopressive drugs; urine output <0...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28535742/electrolyte-disturbances-in-critically-ill-cancer-patients-an-endocrine-perspective
#13
Maryam I Khan, R Phillip Dellinger, Steven G Waguespack
Electrolyte disturbances are frequently encountered in critically ill oncology patients. Hyponatremia and hypernatremia as well as hypocalcemia and hypercalcemia are among the most commonly encountered electrolyte abnormalities. In the intensive care unit, management of critical electrolyte disturbances is focused on initial evaluation and immediate treatment plan to prevent severe complications. A PubMed search was performed to identify best available evidence for evaluation and management of dysnatremias, hypocalcemia, and hypercalcemia...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28534557/-circuit-life-span-of-continuous-renal-replacement-therapy-in-critically-ill-patients-with-or-without-conventional-anticoa-gulation-an-observational-prospective-study
#14
M Sanz Ganuza, F Hidalgo Martínez, N García-Fernández
BACKGROUND: The aim of this study was to describe the efficacy, security and viability of an anticoagulation system with continuous infusion of unfractionated heparin (UFH) versus one without any type of anticoagulant using 0.9% physiological saline washings, in critically ill patients with continuous renal replacement therapy (CRRT) and different risks of bleeding. METHODS: From October 2013 to April 2015 we conducted an observational prospective study in the intensive care unit (ICU)...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28534110/the-impact-of-disability-in-survivors-of-critical-illness
#15
Carol L Hodgson, Andrew A Udy, Michael Bailey, Jonathan Barrett, Rinaldo Bellomo, Tracey Bucknall, Belinda J Gabbe, Alisa M Higgins, Theodore J Iwashyna, Julian Hunt-Smith, Lynne J Murray, Paul S Myles, Jennie Ponsford, David Pilcher, Craig Walker, Meredith Young, D J Cooper
PURPOSE: To use the World Health Organisation's International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. METHODS: A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been admitted to the ICU, received more than 24 h of mechanical ventilation and survived to hospital discharge. The primary outcome was measurement of disability using the World Health Organisation's Disability Assessment Schedule 2...
May 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28533916/pediatric-intensive-care-stress-ulcer-prevention-pic-up-a-protocol-for-a-pilot-randomized-trial
#16
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Nikhil Pai, Lehana Thabane, Deborah J Cook
BACKGROUND: Despite sparse pediatric data on effectiveness, the majority of critically ill children receive medications to prevent gastrointestinal (GI) bleeding. Stress ulcer prophylaxis may have unintended consequences-increasing the risk of nosocomial infections-which may be more serious and common than the bleeding which these drugs are prescribed to prevent. Randomized controlled trials (RCTs) in pediatric critical care are exceptionally challenging to complete, thus a rigorous pilot RCT is crucial...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#17
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531396/translation-and-adaptation-of-the-nutric-score-to-identify-critically-ill-patients-who-benefit-the-most-from-nutrition-therapy
#18
Mariane Rosa, Daren K Heyland, Daieni Fernandes, Estela I Rabito, Manoela L Oliveira, Aline Marcadenti
INTRODUCTION AND OBJECTIVES: Due to the scarcity of tools to assess the nutritional risk in critically ill patients, the NUTrition Risk in the Critically ill Score (NUTRIC Score) was developed and validated primarily in a limited population to quantify the risk of adverse events that may be modified by aggressive nutrition therapy. The objective of this study was to translate and adapt the NUTRIC Score into Portuguese language for further demonstrate its feasibility and clinical utility in Brazilian Intensive Care Units (ICUs)...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531322/evaluation-of-ifitm3-rs12252-association-with-severe-pediatric-influenza-infection
#19
Adrienne G Randolph, Wai-Ki Yip, E Kaitlyn Allen, Carrie M Rosenberger, Anna A Agan, Stephanie A Ash, Yu Zhang, Tushar R Bhangale, David Finkelstein, Natalie Cvijanovich, Peter M Mourani, Mark Hall, Helen C Su, Paul G Thomas
Background: Interferon inducible transmembrane protein 3 (IFITM3) restricts endocytic fusion of influenza virus. IFITM3 rs12252_C, a putative alternate splice site, has been associated with influenza severity in adults. IFITM3 has not been evaluated in pediatric influenza. Methods: The PICFLU Study enrolled children with suspected influenza infection across 38 pediatric intensive care units November 2008 to April 2016. IFITM3 was sequenced in patients and parents were genotyped for specific variants for family-based association testing...
May 20, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28531142/optimal-energy-delivery-rather-than-the-implementation-of-a-feeding-protocol-may-benefit-clinical-outcomes-in-critically-ill-patients
#20
Chen-Yu Wang, Chun-Te Huang, Chao-Hsiu Chen, Mei-Fen Chen, Shiu-Lan Ching, Yi-Chia Huang
Malnutrition is common in intensive care units (ICU), and volume based feeding protocols have been proposed to increase nutrient delivery. However, the volume based approach compared to trophic feeding has not been proven entirely successful in critically ill patients. Our study aimed to compare the clinical outcomes both before and after the implementation of the feeding protocol, and to also evaluate the effects of total energy delivery on outcomes in these patients. We retrospectively collected all patient data, one year before and after the implementation of the volume-based feeding protocol, in the ICU at Taichung Veterans General Hospital...
May 21, 2017: Nutrients
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