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ICU associated weakness

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https://www.readbyqxmd.com/read/28072705/posterior-only-vertebral-column-resection-for-revision-surgery-in-post-laminectomy-rotokyphoscoliosis-associated-with-late-onset-paraplegia-a-case-report-and-literature-review
#1
Youping Tao, Jigong Wu, Huasong Ma
RATIONALE: Severe post-laminectomy spinal deformity associated with late-onset paraplegia is a complex and rare disorder. Little is known about revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia treated by the single stage posterior-only vertebral column resection (VCR) procedure. PATIENT CONCERNS AND DIAGNOSES: The patient was a 14-year-old male diagnosed as post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28067712/muscle-weakness-and-5-year-survival-in-acute-respiratory-distress-syndrome-survivors
#2
Victor D Dinglas, Lisa Aronson Friedman, Elizabeth Colantuoni, Pedro A Mendez-Tellez, Carl B Shanholtz, Nancy D Ciesla, Peter J Pronovost, Dale M Needham
OBJECTIVES: To longitudinally evaluate the association of post-ICU muscle weakness and associated trajectories of weakness over time with 5-year survival. DESIGN: Longitudinal prospective cohort study over 5 years of follow-up. SETTING: Thirteen ICUs in four hospitals in Baltimore, MD. PATIENTS: One hundred fifty-six acute respiratory distress syndrome survivors. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Strength was evaluated with standardized manual muscle testing using the Medical Research Council sum score (range, 0-60; higher is better), with post-ICU weakness defined as sum score less than 48...
January 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28034871/how-i-evaluate-and-treat-thrombocytopenia-in-the-intensive-care-unit-patient
#3
REVIEW
Andreas Greinacher, Sixten Selleng
Multiple causes (pseudothrombocytopenia, hemodilution, increased consumption, decreased production, increased sequestration, and immune-mediated destruction of platelets) alone or in combination make thrombocytopenia very common in intensive care unit (ICU) patients. Persisting thrombocytopenia in critically ill patients is associated with, but not causative of, increased mortality. Identification of the underlying cause is key for management decisions in individual patients. While platelet transfusion might be indicated in patients with impaired platelet production or increased platelet destruction, it could be deleterious in patients with increased intravascular platelet activation...
December 29, 2016: Blood
https://www.readbyqxmd.com/read/28032261/identifying-congestion-levels-sources-and-determinants-on-intensive-care-units-the-portuguese-case
#4
Diogo Ferreira, Rui Cunha Marques
Healthcare systems are facing a resources scarcity so they must be efficiently managed. On the other hand, it is commonly accepted that the higher the consumed resources, the higher the hospital production, although this is not true in practice. Congestion on inputs is an economic concept dealing with such situation and it is defined as the decreasing of outputs due to some resources overuse. This scenario gets worse when inpatients' high severity requires a strict and effective resources management, as happens in Intensive Care Units (ICU)...
December 28, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27993157/early-phase-cumulative-hypotension-duration-and-severe-stage-progression-in-oliguric-acute-kidney-injury-with-and-without-sepsis-an-observational-study
#5
Junichi Izawa, Tetsuhisa Kitamura, Taku Iwami, Shigehiko Uchino, Masanori Takinami, John A Kellum, Takashi Kawamura
BACKGROUND: Managing blood pressure in patients with acute kidney injury (AKI) could effectively prevent severe-stage progression. However, the effect of hypotension duration in the early phase of AKI remains poorly understood. This study investigated the association between early-phase cumulative duration of hypotension below threshold mean arterial pressure (MAP) and severe-stage progression of oliguric AKI in critically ill patients, and assessed the difference in association with presence of sepsis...
December 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27984278/guidelines-for-family-centered-care-in-the-neonatal-pediatric-and-adult-icu
#6
Judy E Davidson, Rebecca A Aslakson, Ann C Long, Kathleen A Puntillo, Erin K Kross, Joanna Hart, Christopher E Cox, Hannah Wunsch, Mary A Wickline, Mark E Nunnally, Giora Netzer, Nancy Kentish-Barnes, Charles L Sprung, Christiane S Hartog, Maureen Coombs, Rik T Gerritsen, Ramona O Hopkins, Linda S Franck, Yoanna Skrobik, Alexander A Kon, Elizabeth A Scruth, Maurene A Harvey, Mithya Lewis-Newby, Douglas B White, Sandra M Swoboda, Colin R Cooke, Mitchell M Levy, Elie Azoulay, J Randall Curtis
OBJECTIVE: To provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU. METHODS: We used the Council of Medical Specialty Societies principles for the development of clinical guidelines as the framework for guideline development. We assembled an international multidisciplinary team of 29 members with expertise in guideline development, evidence analysis, and family-centered care to revise the 2007 Clinical Practice Guidelines for support of the family in the patient-centered ICU...
January 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27832023/rbc-distribution-width-biomarker-for-red-cell-dysfunction-and-critical-illness-outcome
#7
Ahmed S Said, Philip C Spinella, Mary E Hartman, Katherine M Steffen, Ronald Jackups, Richard Holubkov, Mike Wallendorf, Allan Doctor
OBJECTIVES: RBC distribution width is reported to be an independent predictor of outcome in adults with a variety of conditions. We sought to determine if RBC distribution width is associated with morbidity or mortality in critically ill children. DESIGN: Retrospective observational study. SETTING: Tertiary PICU. PATIENTS: All admissions to St. Louis Children's Hospital PICU between January 1, 2005, and December 31, 2012...
November 9, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27778318/oral-hygiene-care-for-critically-ill-patients-to-prevent-ventilator-associated-pneumonia
#8
REVIEW
Fang Hua, Huixu Xie, Helen V Worthington, Susan Furness, Qi Zhang, Chunjie Li
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of VAP in these patients. OBJECTIVES: To assess the effects of oral hygiene care on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs)...
October 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27745753/the-sara-combilizer-%C3%A2-as-an-early-mobilisation-aid-for-critically-ill-patients-a-prospective-before-and-after-study
#9
David McWilliams, Gemma Atkins, James Hodson, Catherine Snelson
BACKGROUND: Early mobility within the ICU is associated with a number of positive outcomes including reductions in ICU and hospital length of stay and better functional recovery. The exact definition of 'early' mobility is still not defined, with the actual ability to mobilise limited by a number of perceived factors. The Sara Combilizer is a combined tilt table and stretcher chair, which allows passive transfer of patients out of bed. This study aimed to assess whether the introduction of the Sara Combilizer reduced time taken to first mobilise for patients mechanically ventilated for at least five days and at risk of ICU acquired weakness...
October 10, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27716370/near-infrared-spectroscopy-for-assessing-tissue-oxygenation-and-microvascular-reactivity-in-critically-ill-patients-a-prospective-observational-study
#10
Abele Donati, Elisa Damiani, Roberta Domizi, Claudia Scorcella, Andrea Carsetti, Stefania Tondi, Valentina Monaldi, Erica Adrario, Rocco Romano, Paolo Pelaia, Mervyn Singer
BACKGROUND: Impaired microcirculatory perfusion and tissue oxygenation during critical illness are associated with adverse outcome. The aim of this study was to detect alterations in tissue oxygenation or microvascular reactivity and their ability to predict outcome in critically ill patients using thenar near-infrared spectroscopy (NIRS) with a vascular occlusion test (VOT). METHODS: Prospective observational study in critically ill adults admitted to a 12-bed intensive care unit (ICU) of a University Hospital...
October 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27703296/rhabdomyolysis-in-critically-ill-surgical-patients
#11
Biljana Kuzmanovska, Emilija Cvetkovska, Igor Kuzmanovski, Nikola Jankulovski, Mirjana Shosholcheva, Andrijan Kartalov, Tatjana Spirovska
INTRODUCTION: Rhabdomyolysis is a syndrome of injury of skeletal muscles associated with myoglobinuria, muscle weakness, electrolyte imbalance and often, acute kidney injury as severe complication. THE AIM: of this study is to detect the incidence of rhabdomyolysis in critically ill patients in the surgical intensive care unit (ICU), and to raise awareness of this medical condition and its treatment among the clinicians. MATERIAL AND METHODS: A retrospective review of all surgical and trauma patients admitted to surgical ICU of the University Surgical Clinic "Mother Teresa" in Skopje, Macedonia, from January 1(st) till December 31(st) 2015 was performed...
July 27, 2016: Medical Archives
https://www.readbyqxmd.com/read/27676408/lung-transplanation-after-125-days-on-ecmo-for-severe-refractory-hypoxemia-with-no-prior-lung-disease
#12
Shameen Salam, Robert Kotloff, Puneet Garcha, Sudhir Krishnan, Dhruv Joshi, Patrick Grady, Abhijit Duggal
Veno-venous extracorporeal membrane oxygenation (ECMO) has become a viable and increasingly utilized option for the treatment of refractory hypoxemia in severe acute respiratory distress syndrome (ARDS). However, options are limited for ARDS patients who fail to wean from ECMO. The high rates of infection, presence of extrapulmonary end organ damage, ICU-acquired weakness, and high short-term mortality associated with ARDS are all significant hurdles that make lung transplantation a difficult prospect to consider...
September 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27676204/time-to-decannulation-and-associated-risk-factors-in-the-post-acute-rehabilitation-of-critically-ill-patients-with-intensive-care-unit-acquired-weakness-a-cohort-study
#13
Simone Thomas, Wolfgang Sauter, Ulrike Starrost, Marcus Pohl, Jan Mehrholz
BACKGROUND: Treatment of critical illness on intensive-care-units (ICU) results often in persistent invasive endotracheal intubation which might delay rehabilitation and increases the risk of mortality. Recent longitudinal studies have described the recovery of critically ill people, but the detailed time course of decannulation in patients with chronic critical illness with ICU- acquired muscle weakness (ICUAW) is not well known. AIM: The aim of our study was therefore to describe the decannulation times and associated risk factors in patients who are chronic critically ill with ICU acquired weakness...
September 27, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27571047/the-utility-of-clinical-features-for-the-diagnosis-of-seizures-in-the-intensive-care-unit
#14
Sarah E Schmitt
INTRODUCTION: Seizures in the intensive care unit (ICU) are often subtle, and may have little or no clinical correlate. This study attempts to determine what clinical features are most strongly associated with the presence of electrographic seizures on continuous EEG (cEEG) monitoring. METHODS: A retrospective review for all patients who underwent cEEG monitoring between Jan. 2003 and Mar. 2009 for either characterization of clinical events or altered mental status was performed...
August 26, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27555696/the-incidence-of-deep-venous-thrombosis-in-high-risk-indian-neurosurgical-patients-need-for-early-chemoprophylaxis
#15
Ajith John George, Shalini Nair, Jayanthi Chinnaiya Karthic, Mathew Joseph
INTRODUCTION: Deep venous thrombosis (DVT) is thought to be less common in Asians than in Caucasian population. The incidence of DVT in high-risk groups, especially the neurosurgical (NS) patients, has not been well studied. This leaves no firm basis for the start of early prophylactic anticoagulation within first 5 postoperative days in Indian NS patients. This is a prospective observational study to determine the early occurrence of DVT in the NS patients. PATIENTS AND METHODS: We screened 137 consecutive high-risk NS patients based on inclusion and exclusion criteria...
July 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27532030/prolonged-glucocorticoid-treatment-in-ards-impact-on-intensive-care-unit-acquired-weakness
#16
REVIEW
Gianfranco Umberto Meduri, Andreas Schwingshackl, Greet Hermans
Systemic inflammation and duration of immobilization are strong independent risk factors for the development of intensive care unit-acquired weakness (ICUAW). Activation of the pro-inflammatory transcription factor nuclear factor-κB (NF-κB) results in muscle wasting during disuse-induced skeletal muscle atrophy (ICU bed rest) and septic shock. In addition, NF-κB-mediated signaling plays a significant role in mechanical ventilation-induced diaphragmatic atrophy and contractile dysfunction. Older trials investigating high dose glucocorticoid treatment reported a lack of a sustained anti-inflammatory effects and an association with ICUAW...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27513545/neuromuscular-blocking-agents-and-neuromuscular-dysfunction-acquired-in-critical-illness-a-systematic-review-and-meta-analysis
#17
David R Price, Mark E Mikkelsen, Craig A Umscheid, Ehrin J Armstrong
OBJECTIVE: The relationship between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness remains unclear. We examined the association between neuromuscular blocking agents and ICU-acquired weakness, critical illness polyneuropathy, and critical illness myopathy. DATA SOURCES: PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, and bibliographies of included studies were searched from database inception until September 24, 2015...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27475524/respiratory-weakness-after-mechanical-ventilation-is-associated-with-one-year-mortality-a-prospective-study
#18
Clément Medrinal, Guillaume Prieur, Éric Frenoy, Aurora Robledo Quesada, Antoine Poncet, Tristan Bonnevie, Francis-Edouard Gravier, Bouchra Lamia, Olivier Contal
BACKGROUND: Diaphragm dysfunction in mechanically ventilated patients is associated with poor outcome. Maximal inspiratory pressure (MIP) can be used to evaluate inspiratory muscle function. However, it is unclear whether respiratory weakness is independently associated with long-term mortality. The aim of this study was to determine if low MIP is independently associated with one-year mortality. METHODS: We conducted a prospective observational cohort study in an 18-bed ICU...
July 31, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27411715/transcriptomic-analysis-reveals-abnormal-muscle-repair-and-remodeling-in-survivors-of-critical-illness-with-sustained-weakness
#19
Christopher J Walsh, Jane Batt, Margaret S Herridge, Sunita Mathur, Gary D Bader, Pingzhao Hu, Claudia C Dos Santos
ICU acquired weakness (ICUAW) is a common complication of critical illness characterized by structural and functional impairment of skeletal muscle. The resulting physical impairment may persist for years after ICU discharge, with few patients regaining functional independence. Elucidating molecular mechanisms underscoring sustained ICUAW is crucial to understanding outcomes linked to different morbidity trajectories as well as for the development of novel therapies. Quadriceps muscle biopsies and functional measures of muscle strength and mass were obtained at 7 days and 6 months post-ICU discharge from a cohort of ICUAW patients...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27369026/engaging-critically-ill-patients-in-symptom-management-thinking-outside-the-box
#20
Linda L Chlan
Caring for critically ill patients receiving mechanical ventilation in the intensive care unit (ICU) is an immense challenge for clinicians. Interventions to maintain physiological stability and life itself can cause a number of adverse effects that have a marked impact on patients beyond the period of critical illness or injury. These ICU-acquired conditions include but are not limited to weakness, depression, and post-intensive care syndrome, all of which markedly affect patients' quality of life after they leave the unit...
July 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
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