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ICU Excellence

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969 papers 100 to 500 followers Clínica Fundadores Bogotá Colombia
https://www.readbyqxmd.com/read/29571595/-sedation-is-tricky-a-qualitative-content-analysis-of-nurses-perceptions-of-sedation-administration-in-mechanically-ventilated-intensive-care-unit-patients
#1
Breanna Hetland, Jill Guttormson, Mary Fran Tracy, Linda Chlan
INTRODUCTION: Critical care nurses are responsible for administering sedative medications to mechanically ventilated patients. With significant advancements in the understanding of the impact of sedative exposure on physiological and psychological outcomes of ventilated patients, updated practice guidelines for assessment and management of pain, agitation, and delirium in the intensive care unit were released in 2013. The primary aim of this qualitative study was to identify and describe themes derived from critical care nurses' comments regarding sedation administration practices with mechanically ventilated patients...
March 20, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29580965/designing-a-nurse-delivered-delirium-bundle-what-intensive-care-unit-staff-survivors-and-their-families-think
#2
Leona Bannon, Jennifer McGaughey, Mike Clarke, Daniel F McAuley, Bronagh Blackwood
BACKGROUND: Implementation of quality improvement interventions can be enhanced by exploring the perspectives of those who will deliver and receive them. We designed a non-pharmacological bundle for delirium management for a feasibility trial, and we sought to obtain the views of intensive care unit (ICU) staff, survivors, and families on the barriers and facilitators to its implementation. OBJECTIVE: The objective of this study is to determine the barriers and facilitators to a multicomponent bundle for delirium management in critically ill patients comprising (1) education and family participation, (2) sedation minimisation and pain, agitation, and delirium protocol, (3) early mobilisation, and (4) environmental interventions for sleep, orientation, communication, and cognitive stimulation...
May 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29603206/critiquing-the-cdc-opioid-guideline-some-light-from-the-heat
#3
David N Juurlink
Released in 2016, the Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain has been met with both praise and criticism. In this issue of the Journal, two commentaries address the guideline's strengths and limitations. While the authors differ in their assessment of the guideline, they share a common objective: safer opioid prescribing. Followed carefully, the CDC guideline will facilitate this, but followed carelessly it has the potential to cause harm.
March 30, 2018: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29605589/patients-perceptions-of-sleep-in-a-critical-care-unit
#4
L Carrera-Hernández, E Aizpitarte-Pejenaute, N Zugazagoitia-Ciarrusta, R Goñi-Viguria
INTRODUCTION AND OBJECTIVES: Patients' sleep can be disturbed during their stay in an Intensive Care Unit. Many factors can explain this disturbance, both within the ICU environment and caused by patients' illnesses. There is evidence that patients' sleep can be improved within ICUs. The aim of this study is to describe patientś perceptions of a night's sleep and develop a care plan that promotes a night's sleep. METHODOLOGY: A prospective descriptive study was performed in the ICU of a training hospital...
April 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29618079/effects-of-massage-in-reducing-the-pain-and-anxiety-of-the-cardiac-surgery-critically-ill-a-randomized-controlled-trial
#5
Madalina Boitor, Géraldine Martorella, Christine Maheu, Andréa Maria Laizner, Céline Gélinas
Objective: To evaluate the effectiveness of hand massage on the pain and anxiety of the cardiac surgery critically ill. Design: A three-arm randomized controlled trial. Setting: This study was conducted in a medical-surgical intensive care unit in Canada. Subjects: Adult patients who underwent elective cardiac surgery, who were able to speak French/English and to self-report symptoms, without a high risk of postoperative complications were eligible...
March 30, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29619627/new-advances-in-acute-postoperative-pain-management
#6
REVIEW
Sukanya Mitra, Daniel Carlyle, Gopal Kodumudi, Vijay Kodumudi, Nalini Vadivelu
PURPOSE OF REVIEW: Postoperative pain remains one of the most common challenges following inpatient and outpatient surgeries. With our advances in modern medicine, pain following surgical procedures still remains a challenge, though significant accomplishments have been made over the past few decades. This article highlights some of the promising new advances and approaches in postoperative pain management. RECENT FINDINGS: Over the last decade, Enhanced Recovery after Surgery (ERAS) pathways and protocols are becoming the benchmark standards for enhancing postoperative recovery...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29628828/pain-assessment-in-the-critically-ill-mechanically-ventilated-adult-patients-comparison-between-skin-conductance-algesimeter-index-and-physiologic-indicators
#7
Puneet Khanna, Chandralekha Chandralekha, Ravinder Kumar Pandey, Ankur Sharma
Background and Objectives: Critically ill patients are unable to communicate effectively, so it is difficult to assess their pain and analgesic requirement. Skin conductance algesimeter (SCA) index is a device that primarily measures changes in skin conductance real time to assess pain. Methods: We planned this quantitative prospective observational study to assess pain in the critically ill mechanically ventilated patients in comparison to physiologic indicators such as blood pressure and heart rate...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29624189/improving-the-safety-of-opioid-use-for-acute-noncancer-pain-in-hospitalized-adults-a-consensus-statement-from-the-society-of-hospital-medicine
#8
Shoshana J Herzig, Hilary J Mosher, Susan L Calcaterra, Anupam B Jena, Teryl K Nuckols
Hospital-based clinicians frequently treat acute, noncancer pain. Although opioids may be beneficial in this setting, the benefits must be balanced with the risks of adverse events, including inadvertent overdose and prolonged opioid use, physical dependence, or development of opioid use disorder. In an era of epidemic opioid use and related harms, the Society of Hospital Medicine (SHM) convened a working group to develop a consensus statement on opioid use for adults hospitalized with acute, noncancer pain, outside of the palliative, end-of-life, and intensive care settings...
April 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29523342/migraine
#9
REVIEW
David W Dodick
Migraine is a chronic paroxysmal neurological disorder characterised by multiphase attacks of head pain and a myriad of neurological symptoms. The underlying genetic and biological underpinnings and neural networks involved are coming sharply into focus. This progress in the fundamental understanding of migraine has led to novel, mechanism-based and disease-specific therapeutics. In this Seminar, the clinical features and neurobiology of migraine are reviewed, evidence to support available treatment options is provided, and emerging drug, device, and biological therapies are discussed...
March 31, 2018: Lancet
https://www.readbyqxmd.com/read/29519206/the-top-ten-websites-in-critical-care-medicine-education-today
#10
Traci A Wolbrink, Lucy Rubin, Jeffrey P Burns, Barry Markovitz
INTRODUCTION: The number of websites for the critical care provider is rapidly growing, including websites that are part of the Free Open Access Med(ical ed)ucation (FOAM) movement. With this rapidly expanding number of websites, critical appraisal is needed to identify quality websites. The last major review of critical care websites was published in 2011, and thus a new review of the websites relevant to the critical care clinician is necessary. METHODS: A new assessment tool for evaluating critical care medicine education websites, the Critical Care Medical Education Website Quality Evaluation Tool (CCMEWQET), was modified from existing tools...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29501369/acute-pancreatitis-guideline
#11
Seth Crockett, Yngve Falck-Ytter, Sachin Wani, Timothy B Gardner
No abstract text is available yet for this article.
March 2018: Gastroenterology
https://www.readbyqxmd.com/read/29461885/physiologic-basis-of-mechanical-ventilation
#12
Martin J Tobin
The primary purpose of mechanical ventilation is to decrease work of breathing. Achieving this goal requires that cycling of the ventilator be carefully aligned with the intrinsic rhythm of a patient's respiratory center output. Problems arise at the point of ventilator triggering, post-trigger inflation, and inspiration-expiration switchover. Careful, iterative adjustments of ventilator settings are required to minimize work of breathing. Use of protocols for the selection of ventilator settings can lead to complications (including alveolar overdistention) and risk of death...
February 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29496021/post-myocardial-infarction-heart-failure
#13
REVIEW
M Cecilia Bahit, Ajar Kochar, Christopher B Granger
Heart failure (HF) complicating myocardial infarction (MI) is common and may be present at admission or develop during the hospitalization. Among patients with MI, there is a strong relationship between degree of HF and mortality. The optimal management of the patient with HF complicating MI varies according to time since the onset of infarction. Medical therapy for HF after MI includes early (within 24 h) initiation of angiotensin-converting enzyme inhibitors and early (within 7 days) use of aldosterone antagonists...
March 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29226044/neuroanatomy-and-neuropsychology-of-pain
#14
REVIEW
Shehzad Khalid, R Shane Tubbs
We have reviewed here the neuroanatomical and neuropsychological literature of the human brain and have proposed the various pain mechanisms that we currently know of. Essentially when tissue is damaged, peripheral nociceptors are activated continuously and prostanoids are hence produced. Nonsteroidal anti-inflammatory drugs (NSAIDs) and medications aim to target these prostanoids to treat the inflammatory component of pain. Normal pain tends to have a protective response. It is important for the nervous system to learn and recognize this painful stimulus earlier and quicker with repeated exposure to avoid tissue damage...
October 6, 2017: Curēus
https://www.readbyqxmd.com/read/29486908/update-of-pathophysiology-and-management-of-diabetic-kidney-disease
#15
REVIEW
Yi-Chih Lin, Yu-Hsing Chang, Shao-Yu Yang, Kwan-Dun Wu, Tzong-Shinn Chu
Diabetic kidney disease (DKD) is a major cause of morbidity and mortality in patients with diabetes mellitus and the leading cause of end-stage renal disease in the world. The most characteristic marker of DKD is albuminuria, which is associated with renal disease progression and cardiovascular events. Renal hemodynamics changes, oxidative stress, inflammation, hypoxia and overactive renin-angiotensin-aldosterone system (RAAS) are involved in the pathogenesis of DKD, and renal fibrosis plays the key role. Intensified multifactorial interventions, including RAAS blockades, blood pressure and glucose control, and quitting smoking, help to prevent DKD development and progression...
February 24, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29549932/chronic-critical-illness-the-limbo-between-life-and-death
#16
Rosechelle M Ruggiero
The entity of chronic critical illness (CCI) has shown a rise in the past decades for popularity and prevalence. CCI is loosely defined as the group of patients who require the intensive care setting for weeks to months; its hallmark is prolonged mechanical ventilation. The outcomes of chronically critically ill patients have been dismal and have not improved over time; 1-year survival hovers at approximately 50%. Given the high mortality, prognostic variables are important when making medical decisions. CCI encompasses a syndrome that includes altered pathophysiology across a variety of organ systems...
March 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29496762/aggressive-care-and-palliative-care
#17
EDITORIAL
Cindy L Munro, Richard H Savel
No abstract text is available yet for this article.
March 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29496764/validation-of-a-postextubation-dysphagia-screening-tool-for-patients-after-prolonged-endotracheal-intubation
#18
Karen L Johnson, Lauri Speirs, Anne Mitchell, Heather Przybyl, Diane Anderson, Brenda Manos, Amy T Schaenzer, Keri Winchester
BACKGROUND: Patients who receive prolonged endotracheal intubation (> 48 hours) are at risk for dysphagia. Nurses should conduct swallowing assessments after extubation because of the high likelihood of aspiration pneumonia developing. No valid and reliable postextubation dysphagia screening tools are available. OBJECTIVES: To establish content validity, analyze interrater reliability, and determine sensitivity and specificity of an evidence-based postextubation dysphagia screening tool developed by a multidisciplinary team...
March 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29496765/early-rehabilitation-and-in-hospital-mortality-in-intensive-care-patients-with-community-acquired-pneumonia
#19
Yusuke Sawada, Yusuke Sasabuchi, Yasuo Nakahara, Hiroki Matsui, Kiyohide Fushimi, Nobuhiko Haga, Hideo Yasunaga
BACKGROUND: Community-acquired pneumonia is one of the most common infectious diseases and can be fatal. The benefits of early rehabilitation in intensive care units are known, but the association between early rehabilitation and in-hospital mortality of patients with community-acquired pneumonia admitted to intensive care units has not been studied. OBJECTIVES: To study the association between early rehabilitation and the in-hospital mortality of patients with community- acquired pneumonia admitted to intensive care units, effects of early rehabilitation on unit and hospital lengths of stay, and total costs of hospitalization...
March 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29496767/attitudes-and-practices-related-to-clinical-alarms-a-follow-up-survey
#20
Halley Ruppel, Marjorie Funk, J Tobey Clark, Izabella Gieras, Yadin David, Thomas J Bauld, Paul Coss, Margaret L Holland
BACKGROUND: Alarm fatigue is a widely acknowledged patient safety concern in hospitals. In 2013, The Joint Commission issued a National Patient Safety Goal on Alarm Management, making addressing alarm management a priority. To capture changes in attitudes and practices related to alarms, the Healthcare Technology Foundation conducted and reported findings from national online surveys in 2006 and 2011 and completed a third survey in 2016. OBJECTIVES: The goal of the 2016 survey was to identify how hospital practices and clinicians' perceptions of alarms have changed since 2006...
March 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
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