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https://www.readbyqxmd.com/read/28918202/implementation-of-a-risk-stratified-opioid-weaning-protocol-in-a-pediatric-intensive-care-unit
#1
L Nelson Sanchez-Pinto, Lara P Nelson, Phuong Lieu, Joyce Y Koh, John W Rodgers, Krichelle A Larson, Jennifer M Huson, Rambod Amirnovin
PURPOSE: Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. METHODS: A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol...
September 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28917604/the-needs-of-the-relatives-in-the-adult-intensive-care-unit-cultural-adaptation-and-psychometric-properties-of-the-chilean-spanish-version-of-the-critical-care-family-needs-inventory
#2
Noelia Rojas Silva, Cristobal Padilla Fortunatti, Yerko Molina Muñoz, Macarena Amthauer Rojas
INTRODUCTION: The admission of a patient to an intensive care unit is an extraordinary event for their family. Although the Critical Care Family Needs Inventory is the most commonly used questionnaire for understanding the needs of relatives of critically ill patients, no Spanish-language version is available. The aim of this study was to culturally adapt and validate theCritical Care Family Needs Inventory in a sample of Chilean relatives of intensive care patients. METHODS: The back-translated version of the inventory was culturally adapted following input from 12 intensive care and family experts...
September 13, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28917603/development-of-the-nurses-care-coordination-competency-scale-for-mechanically-ventilated-patients-in-critical-care-settings-in-japan-part-1-development-of-a-measuring-instrument
#3
Chie Takiguchi, Yumiko Yatomi, Tomoko Inoue
OBJECTIVES: To develop a draft scale measuring nurses' care coordination competency for care of mechanically ventilated patients in critical care settings. METHOD: The scale items and concepts were derived from semi-structured interviews with 28 professionals (14 nurses, eight physicians, three physical therapists, three clinical engineers) who are managing mechanically ventilated critical care patients. A grounded theory approach was used. After content validation by experts, two pilot tests were used to identify and correct non-discriminating items and vague items...
September 13, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28917226/energy-intake-in-the-first-week-in-an-emergency-intensive-care-unit-may-not-influence-clinical-outcomes-in-critically-ill-overweight-japanese-patients
#4
Satomi Ichimaru, Maren Sono, Ryutaro Seo, Koichi Ariyoshi, Teruyoshi Amagai
BACKGROUND AND OBJECTIVES: The American Society for Parenteral and Enteral Nutrition recommends hypocaloric feeding for critically ill patients with a BMI of >=30.0 kg/m2. However, the cut-off value of obesity in Japan is BMI >25.0 kg/m2, due to the higher prevalence of type 2 diabetes mellitus, and cardiovascular risk factors, even at a lower BMI than in Western populations. Thus, the optimal energy intake for critically ill, overweight Asian patients is unknown. METHODS AND STUDY DESIGN: A retrospective chart review was conducted in patients with BMI of >=25...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28917221/determining-the-predictive-equation-for-height-from-ulnar-length-in-the-vietnamese-population
#5
Ana Bonell, Nguyen Nguyen Huyen, Vu Dinh Phu, Heiman Wertheim, Behzad Nadjm
BACKGROUND AND OBJECTIVES: Height is an essential measurement in clinical medicine. It allows the calculation of body mass index, ideal body weight, basic energy requirements and tidal volumes. In many patient groups, such as the critically ill, height cannot be measured easily and surrogate anthropometric measures are used. Regression equations estimating height are specific to ethnicity. We aimed to develop the regression equation for Vietnamese men and women to predict height from ulna length and so improve prescription of life-saving treatment in the intensive care units...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28917005/outcome-of-pediatric-acute-kidney-injury-a-multicenter-prospective-cohort-study
#6
Jameela A Kari, Khalid A Alhasan, Mohamed A Shalaby, Norah Khathlan, Osama Y Safdar, Suleman A Al Rezgan, Sherif El Desoky, Amr S Albanna
BACKGROUND: Acute kidney injury (AKI) is a common problem encountered in critically ill children with an increasing incidence and evolving epidemiology. AKI carries a serious morbidity and mortality in patients requiring admission to a pediatric intensive care unit (PICU). METHODS: We undertook a prospective cohort study of PICU admissions at three tertiary care hospitals in the Kingdom of Saudi Arabia over 2 years. The Kidney Disease Improving Global Outcomes (KDIGO) definition was used to diagnose AKI...
September 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28916175/early-sepsis-detection-in-critical-care-patients-using-multiscale-blood-pressure-and-heart-rate-dynamics
#7
Supreeth P Shashikumar, Matthew D Stanley, Ismail Sadiq, Qiao Li, Andre Holder, Gari D Clifford, Shamim Nemati
Sepsis remains a leading cause of morbidity and mortality among intensive care unit (ICU) patients. For each hour treatment initiation is delayed after diagnosis, sepsis-related mortality increases by approximately 8%. Therefore, maximizing effective care requires early recognition and initiation of treatment protocols. Antecedent signs and symptoms of sepsis can be subtle and unrecognizable (e.g., loss of autonomic regulation of vital signs), causing treatment delays and harm to the patient. In this work we investigated the utility of high-resolution blood pressure (BP) and heart rate (HR) times series dynamics for the early prediction of sepsis in patients from an urban, academic hospital, meeting the third international consensus definition of sepsis (sepsis-III) during their ICU admission...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28914626/secondary-traumatic-stress-in-nicu-nurses-a-mixed-methods-study
#8
Cheryl Tatano Beck, Regina M Cusson, Robert K Gable
BACKGROUND: Secondary traumatic stress is an occupational hazard for healthcare providers who care for patients who have been traumatized. This type of stress has been reported in various specialties of nursing, but no study to date had specifically focused on neonatal intensive care unit (NICU) nurses. PURPOSE: (1) To determine the prevalence and severity of secondary traumatic stress in NICU nurses and (2) to explore those quantitative findings in more depth through nurses' qualitative descriptions of their traumatic experiences caring for critically ill infants in the NICU...
September 13, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28914279/blood-products-provided-to-patients-receiving-futile-critical-care
#9
Thanh H Neville, Alyssa Ziman, Neil S Wenger
The number of hospitalized patients receiving treatment perceived to be futile is not insignificant. Blood products are valuable resources that are donated to help others in need. We aimed to quantify the amount of blood transfused into patients who were receiving treatment that the critical care physician treating them perceived to be futile. During a 3-month period, critical care physicians in 5 adult intensive care units completed a daily questionnaire to identify patients perceived as receiving futile treatment...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914277/antidepressant-use-and-depressive-symptoms-in-intensive-care-unit-survivors
#10
Sophia Wang, Chris Mosher, Sujuan Gao, Kayla Kirk, Sue Lasiter, Sikander Khan, You Na Kheir, Malaz Boustani, Babar Khan
Nearly 30% of intensive care unit (ICU) survivors have depressive symptoms 2-12 months after hospital discharge. We examined the prevalence of depressive symptoms and risk factors for depressive symptoms in 204 patients at their initial evaluation in the Critical Care Recovery Center (CCRC), an ICU survivor clinic based at Eskenazi Hospital in Indianapolis, Indiana. Thirty-two percent (N = 65) of patients had depressive symptoms on initial CCRC visit. For patients who are not on an antidepressant at their initial CCRC visit (N = 135), younger age and lower education level were associated with a higher likelihood of having depressive symptoms...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914111/analyzing-how-discursive-practices-affect-physicians-decision-making-processes-a-phenomenological-based-qualitative-study-in-critical-care-contexts
#11
Luigina Mortari, Roberta Silva
An intensive care unit (ICU) is a demanding environment, defined by significant complexity, in which physicians must make decisions in situations characterized by high levels of uncertainty. This study used a phenomenological approach to investigate the decision-making (DM) processes among ICU physicians' team with the aim of understanding what happens when ICU physicians must reach a decision about the infectious status of a patient. The focus was put on the identification of how the discursive practices influence physicians' DM processes and on how different ICU environments make different discursive profiles emerge, particularly when a key issue is at the center of the physicians' discussion...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28912978/anoxic-brain-injury-presenting-as-pseudosubarachnoid-hemorrhage-in-the-medical-intensive-care-unit
#12
O'Dene Lewis, Samina Afreen, Supo Folaranmi, Marie Fidelia-Lambert, Vishal Poddar, Alicia Thomas
Anoxic encephalopathy is frequently encountered in the medical intensive care unit (ICU). Cerebral edema as a result of anoxic brain injury can result in increased attenuation in the basal cisterns and subarachnoid spaces on computerized tomography (CT) scans of the head. These findings can mimic those seen in acute subarachnoid hemorrhage (SAH) and are referred to as pseudosubarachnoid hemorrhage (pseudo-SAH). Pseudo-SAH is a diagnosis critical care physicians should be aware of as they treat and evaluate their patients with presumed SAH, which is a medical emergency...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28912057/apnoeic-oxygenation-during-intubation-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#13
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/28911833/development-of-the-nurses-care-coordination-competency-scale-for-mechanically-ventilated-patients-in-critical-care-settings-in-japan-part-2%C3%A3-validation-of-the-scale
#14
Chie Takiguchi, Yumiko Yatomi, Tomoko Inoue
OBJECTIVES: To confirm the validity and reliability of the nurses' care coordination competency draft scale for mechanically ventilated patients in Japan. DESIGN/METHOD: In this cross sectional observational study, a draft scale measuring care coordination was distributed to 2189 nurses from 73 intensive care units in Japan from February-March 2016. Based on the valid 887 responses, we examined construct validity including structural validity (exploratory and confirmatory factor analysis), convergent and discriminant validity and internal consistency reliability...
September 11, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28911290/outcomes-of-telemedicine-intervention-in-a-regional-intensive-care-unit-a-before-and-after-study
#15
O M Panlaqui, E Broadfield, R Champion, J P Edington, S Kennedy
Telemedicine consultations in remote intensive care units (ICUs) overseas were found to be effective in reducing mortality and hospital length of stay (LOS). In Australia, there were anecdotal reports of these clinical outcomes. This retrospective before and after study assessed the improvement in patient outcomes with the implementation of a telemedicine program in a regional high dependency unit. Daily virtual consultations were conducted between the rural facility and the intensivists at the regional centre...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28911284/effect-of-nicotine-replacement-therapy-on-mortality-delirium-and-duration-of-therapy-in-critically-ill-smokers-a-systematic-review-and-meta-analysis
#16
K T Ng, M Gillies, D M Griffith
Nicotine replacement therapy is widely used in critically ill smokers and its effect on delirium, mortality and duration of intensive care unit (ICU) admission is unknown. The aims of this review were to determine whether the management of nicotine withdrawal with nicotine replacement therapy reduces delirium, mortality or length of stay in critically ill smokers in ICU. The primary outcome was incidence of author-defined ICU delirium. Secondary outcomes were ICU or hospital mortality, ICU-free days at day 28, and ICU or hospital length of stay...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28910303/the-influence-of-analgesic-based-sedation-protocols-on-delirium-and-outcomes-in-critically-ill-patients-a-randomized-controlled-trial
#17
Dan Liu, Jie Lyu, Huiying Zhao, Youzhong An
OBJECTIVE: To investigate the influence of analgesic-based midazolam sedation on delirium and outcomes in critically ill patients and to analyze the risk factors of delirium. DESIGN: Single center, prospective randomized controlled trial. SETTING: A surgical intensive care unit (ICU) in a tertiary care hospital in China. PATIENTS: Mechanically ventilated patients requiring sedation. MEASUREMENTS AND MAIN RESULTS: Patients admitted to the surgical intensive care unit who required sedation and were undergoing mechanical ventilation for longer than 24 hours were randomly divided into three groups: 1) the remifentanil group received remifentanil and midazolam, 2) the fentanyl group received fentanyl and midazolam, and 3) the control group received only midazolam...
2017: PloS One
https://www.readbyqxmd.com/read/28906423/empowering-parents-of-australian-infants-and-children-in-hospital-translation-cultural-adaptation-and-validation-of-the-empowerment-of-parents-in-the-intensive-care-30-aus-questionnaire
#18
Fenella J Gill, Sally Wilson, Laurene Aydon, Gavin D Leslie, Jos M Latour
OBJECTIVES: To translate, culturally adapt, and psychometrically test the EMpowerment of PArents in The Intensive Care-30 questionnaire in Australian pediatric critical care, neonatal, and pediatric ward settings. DESIGN: Cross-sectional, descriptive, multicenter study conducted in two phases; 1) translation and cultural adaptation and 2) validation of the EMpowerment of PArents in The Intensive Care-30 questionnaire. SETTINGS: Two Western Australian sites, the PICU and two pediatric wards of a children's hospital and the neonatal unit of a women's and newborn hospital...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28906137/treatment-of-achromobacter-ventilator-associated-pneumonia-in-critically-ill-trauma-patients
#19
G Christopher Wood, Brittany L Jonap, George O Maish, Louis J Magnotti, Joseph M Swanson, Bradley A Boucher, Martin A Croce, Timothy C Fabian
BACKGROUND: Achromobacter sp are nonfermenting Gram-negative bacilli (NFGNB) that rarely cause severe infections, including ventilator-associated pneumonia (VAP). Data on the treatment of Achromobacter pneumonia are very limited, and the organism has been associated with a high mortality rate. Thus, more data are needed on treating this organism. OBJECTIVE: To evaluate the treatment of Achromobacter VAP in critically ill trauma patients. METHODS: This retrospective, observational study evaluated critically ill trauma patients who developed Achromobacter VAP...
September 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28905701/outcomes-of-patients-with-severe-influenza-infection-admitted-to-intensive-care-units-a-retrospective-study-in-a-medical-centre
#20
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Kuo-Shu Yuan, Chin-Ming Chen
PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20...
September 14, 2017: Journal of Medical Microbiology
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