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ICU Excellence

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150 papers 25 to 100 followers Clínica Fundadores Bogotá Colombia
https://www.readbyqxmd.com/read/28441234/validation-of-an-administrative-definition-of-icu-admission-using-revenue-center-codes
#1
Gary E Weissman, Rebecca A Hubbard, Rachel Kohn, George L Anesi, Scott Manaker, Meeta Prasad Kerlin, Scott D Halpern
OBJECTIVES: Describe the operating characteristics of a proposed set of revenue center codes to correctly identify ICU stays among hospitalized patients. DESIGN: Retrospective cohort study. We report the operating characteristics of all ICU-related revenue center codes for intensive and coronary care, excluding nursery, intermediate, and incremental care, to identify ICU stays. We use a classification and regression tree model to further refine identification of ICU stays using administrative data...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28441237/noninvasive-ventilation-in-acute-hypoxemic-nonhypercapnic-respiratory-failure-a-systematic-review-and-meta-analysis
#2
Xiu-Ping Xu, Xin-Chang Zhang, Shu-Ling Hu, Jing-Yuan Xu, Jian-Feng Xie, Song-Qiao Liu, Ling Liu, Ying-Zi Huang, Feng-Mei Guo, Yi Yang, Hai-Bo Qiu
OBJECTIVE: To evaluate the effectiveness of noninvasive ventilation in patients with acute hypoxemic nonhypercapnic respiratory failure unrelated to exacerbation of chronic obstructive pulmonary disease and cardiogenic pulmonary edema. DATA SOURCES: PubMed, EMBASE, Cochrane library, Web of Science, and bibliographies of articles were retrieved inception until June 2016. STUDY SELECTION: Randomized controlled trials comparing application of noninvasive ventilation with standard oxygen therapy in adults with acute hypoxemic nonhypercapnic respiratory failure were included...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28445237/effects-of-polymyxin-b-hemoperfusion-on-mortality-in-patients-with-severe-sepsis-and-septic-shock-a-systemic-review-meta-analysis-update-and-disease-severity-subgroup-meta-analysis
#3
Tzu Chang, Yu-Kang Tu, Chen-Tse Lee, Anne Chao, Chi-Hsiang Huang, Ming-Jiuh Wang, Yu-Chang Yeh
OBJECTIVE: Several studies have reported a survival benefit for polymyxin B hemoperfusion treatment in patients with severe sepsis and septic shock. However, recently, a propensity-matched analysis and a randomized controlled trial reported no survival benefit for polymyxin B hemoperfusion treatment. We performed an up-to-date meta-analysis to determine the effect of polymyxin B hemoperfusion treatment on mortality in patients with severe sepsis and septic shock. DATA SOURCES: PubMed, Embase, and Cochrane Library were searched from inception to May 2016...
April 25, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28439646/critical-care-admission-following-elective-surgery-was-not-associated-with-survival-benefit-prospective-analysis-of-data-from-27-countries
#4
Brennan C Kahan, Desponia Koulenti, Kostoula Arvaniti, Vanessa Beavis, Douglas Campbell, Matthew Chan, Rui Moreno, Rupert M Pearse
PURPOSE: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. METHODS: Planned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality...
April 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28444409/diagnostic-work-up-and-specific-causes-of-acute-kidney-injury
#5
REVIEW
Michael Darmon, Marlies Ostermann, Jorge Cerda, Meletios A Dimopoulos, Lui Forni, Eric Hoste, Matthieu Legrand, Nicolas Lerolle, Eric Rondeau, Antoine Schneider, Bertrand Souweine, Miet Schetz
Acute kidney injury (AKI) is common in critically ill patients and associated with grim short- and long-term outcome. Although in the vast majority of cases AKI is multifactorial, with sepsis, shock and nephrotoxicity accounting for most episodes, specific causes of AKI are not uncommon. Despite remaining uncertainties regarding their prevalence in the ICU, prompt recognition of specific aetiologies of AKI is likely to ensure timely management, limit worsening of renal dysfunction, and ultimately limit renal and systemic consequences of AKI...
April 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28437531/applicability-of-the-improve-it-trial-to-current-patients-with-acute-coronary-syndrome-an-ncdr-research-to-practice-project
#6
Thomas M Maddox, Fengming Tang, John R Downs, Frederick A Masoudi, Salim S Virani, Stacie L Daugherty, John S Rumsfeld
No abstract text is available yet for this article.
April 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28437539/safety-and-efficacy-of-antiviral-therapy-for-prevention-of-cytomegalovirus-reactivation-in-immunocompetent-critically-ill-patients-a-randomized-clinical-trial
#7
Nicholas J Cowley, Andrew Owen, Sarah C Shiels, Joanne Millar, Rebecca Woolley, Natalie Ives, Husam Osman, Paul Moss, Julian F Bion
Importance: Latent cytomegalovirus (CMV) infection is present in more than half the adult population, and a viral reactivation (ie, when the virus becomes measurable in body fluids such as blood) can occur in up to one-third of these individuals during episodes of critical illness. Objective: To determine whether antiviral therapy is safe and effective for preventing CMV reactivation in a general population of critically ill patients. Design, Setting, and Participants: A single-center, open-label, randomized, controlled clinical trial recruited 124 CMV-seropositive patients undergoing mechanical ventilation for at least 24 hours in the intensive care unit between January 1, 2012, and January 31, 2014...
April 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28437372/heart-rate-modification-of-cardiac-output-following-cardiac-surgery-the-importance-of-cardiac-time-intervals
#8
Guido Tavazzi, Andy Kontogeorgis, Fabio Guarracino, Niels Bergsland, Ana Martinez-Naharro, John Pepper, Susanna Price
OBJECTIVES: Inadequate cardiac output is associated with a poor outcome following cardiac surgery and is generally modified by the use of positive inotropic agents, volume resuscitation, and pacing. Echocardiography-guided pacemaker optimization is used in the outpatient setting, using different variables including total isovolumic time and the Tei index. We sought to determine the acute impact of heart rate on cardiac electromechanics, cardiac output, and stroke volume in the perioperative setting...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437374/icu-patients-requiring-renal-replacement-therapy-initiation-fewer-survivors-and-more-dialysis-dependents-from-80-years-old
#9
Morgane Commereuc, Emmanuel Guérot, Anais Charles-Nelson, Adrien Constan, Sandrine Katsahian, Frédérique Schortgen
OBJECTIVES: To assess the role of advanced age on survival and dialysis dependency after initiation of renal replacement therapy for acute kidney injury. DESIGN: Retrospective pooled analysis of prospectively collected data. SETTING: ICUs of two teaching hospitals in Paris area, France. SUBJECTS: One thousand five hundred thirty adult patients who required renal replacement therapy initiation in the ICU. INTERVENTIONS: None...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28432023/pulmonary-embolism-related-sudden-cardiac-arrest-admitted-alive-at-hospital-management-and-outcomes
#10
Wulfran Bougouin, Eloi Marijon, Benjamin Planquette, Nicole Karam, Florence Dumas, David S Celermajer, Daniel Jost, Lionel Lamhaut, Frankie Beganton, Alain Cariou, Guy Meyer, Xavier Jouven
AIM: Pulmonary Embolism (PE) is a relatively common cardiovascular condition, occasionally and tragically manifesting as Sudden Cardiac Arrest (SCA). The natural history of SCA complicating PE has been poorly evaluated.In this study, we described the management and outcome of PE-related SCA. METHODS: In this prospective population--based study, we included all patients admitted at hospital alive after out- of- hospital SCA, in Paris and suburbs, France (6.6 million inhabits), from May 2011 to September 2015...
April 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#11
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28431797/video-education-for-critical-care-nurses-to-assess-pain-with-a-behavioural-pain-assessment-tool-a-descriptive-comparative-study
#12
Annika Björn, Sanna-Mari Pudas-Tähkä, Sanna Salanterä, Anna Axelin
AIM: To evaluate the impact of video education on critical care nurses' knowledge and skills in using a behavioural pain assessment tool for intensive care patients and to explore the nurses' experiences with video education. METHODS: Forty-eight nurses in one intensive care unit watched an educational video on the use of the Critical-Care Pain Observation Tool, then assessed pain in two patients with the tool and took a knowledge test. The researcher made parallel pain assessments...
April 18, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28429310/the-protective-association-of-endogenous-immunoglobulins-against-sepsis-mortality-is-restricted-to-patients-with-moderate-organ-failure
#13
Ignacio Martin-Loeches, Arturo Muriel-Bombín, Ricard Ferrer, Antonio Artigas, Jordi Sole-Violan, Leonardo Lorente, David Andaluz-Ojeda, Adriele Prina-Mello, Ruben Herrán-Monge, Borja Suberviola, Ana Rodriguez-Fernandez, Pedro Merino, Ana M Loza, Pablo Garcia-Olivares, Eduardo Anton, Eduardo Tamayo, Wysali Trapiello, Jesús Blanco, Jesús F Bermejo-Martin
BACKGROUND: Pre-evaluation of endogenous immunoglobulin levels is a potential strategy to improve the results of intravenous immunoglobulins in sepsis, but more work has to be done to identify those patients who could benefit the most from this treatment. The objective of this study was to evaluate the impact of endogenous immunoglobulins on the mortality risk in sepsis depending on disease severity. METHODS: This was a retrospective observational study including 278 patients admitted to the ICU with sepsis fulfilling the SEPSIS-3 criteria, coming from the Spanish GRECIA and ABISS-EDUSEPSIS cohorts...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28427966/intravenous-immunoglobulin-for-treatment-of-severe-refractory-heparin-induced-thrombocytopenia
#14
Anand Padmanabhan, Curtis G Jones, Shannon M Pechauer, Brian R Curtis, Daniel W Bougie, Mehraboon S Irani, Barbara J Bryant, Jack B Alperin, Thomas G Deloughery, Kevin P Mulvey, Binod Dhakal, Renren Wen, Demin Wang, Richard H Aster
BACKGROUND: HIT complicated by severe thrombocytopenia and thrombosis can pose significant treatment challenges. Use of alternative anticoagulants in this setting may increase bleeding risks, especially in patients who have a protracted disease course. Additional therapies are lacking in this severely affected patient population. METHODS: We describe three HIT patients who had severe thromboembolism and prolonged thrombocytopenia refractory to standard treatment but achieved an immediate and sustained response to intravenous immunoglobulin G (IVIg) therapy...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28427967/mechanisms-underlying-hiv-associated-non-infectious-lung-disease
#15
REVIEW
Rachel M Presti, Sonia C Flores, Brent E Palmer, Jeffrey J Atkinson, Catherine R Lesko, Bryan Lau, Andrew P Fontenot, Jesse Roman, John F McDyer, Homer L Twigg
Pulmonary disease remains a primary source of morbidity and mortality in persons living with HIV (PLWH), although the advent of potent combination antiretroviral therapy (cART) has resulted in a shift from predominantly infectious to noninfectious pulmonary complications. PLWH are at high risk for chronic obstructive pulmonary disease, pulmonary hypertension, and lung cancer even in the era of cART. The underlying mechanisms of this are incompletely understood, but recent research in both human and animal models suggest that oxidative stress, expression of matrix metalloproteinases, and genetic instability may result in lung damage which predisposes PLWH to these conditions...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28429957/utility-of-simplicity-for-low-risk-chest-pain-patients
#16
Ezra A Amsterdam, Sandhya Venugopal
No abstract text is available yet for this article.
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28431343/measurement-of-physical-activity-levels-in-the-intensive-care-unit-and-functional-outcomes-an-observational-study
#17
Lisa J Beach, Kate Fetterplace, Lara Edbrooke, Selina M Parry, Rachel Curtis, Thomas Rechnitzer, Sue Berney, Linda Denehy
PURPOSE: Primary aims were: (1) objectively quantify levels of physical activity with the sensewear armband mini-fly motion sensor (SWA-MF), (2) evaluate the correlation of SWA-MF measurement of active and resting energy expenditure against the ICU Mobility scale (IMS) and indirect calorimetry respectively. MATERIALS AND METHODS: Adults mechanically ventilated ≥48h and anticipated to remain in ICU≥5days were included. Physical activity (PA) was measured using a SWA-MF (over the first five days); energy expenditure was measured with both the SWA-MF and the Deltatrac II metabolic cart on day three; highest level of mobility was assessed on the IMS...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28429603/effect-of-high-flow-nasal-cannula-oxygen-therapy-versus-conventional-oxygen-therapy-and-noninvasive-ventilation-on-reintubation-rate-in-adult-patients-after-extubation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
Hua-Wei Huang, Xiu-Mei Sun, Zhong-Hua Shi, Guang-Qiang Chen, Lu Chen, Jan O Friedrich, Jian-Xin Zhou
PURPOSE: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of high-flow nasal cannula (HFNC) on reintubation in adult patients. PROCEDURES: Ovid Medline, Embase, and Cochrane Database of Systematic Reviews were searched up to November 1, 2016, for RCTs comparing HFNC versus conventional oxygen therapy (COT) or noninvasive ventilation (NIV) in adult patients after extubation. The primary outcome was reintubation rate, and the secondary outcomes included complications, tolerance and comfort, time to reintubation, length of stay, and mortality...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#19
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28423283/reply-to-controlled-clinical-trials-and-real-life-experience-with-pulmonary-rehabilitation
#20
Maria-Rosa Güell, Bartolome Celli
No abstract text is available yet for this article.
April 19, 2017: American Journal of Respiratory and Critical Care Medicine
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