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Critical care

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89 papers 100 to 500 followers
By M KKhan Pediatric Intensivist
https://www.readbyqxmd.com/read/29201914/acute-right-ventricular-dysfunction-in-intensive-care-unit
#1
REVIEW
Juan C Grignola, Enric Domingo
The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29171247/care-of-patients-undergoing-weaning-from-mechanical-ventilation-in-critical-care
#2
Susan Elliott, Nicola Morrell-Scott
There are several reasons why mechanical ventilation - the use of an artificial device to assist a patient to breathe - may be initiated, for example to enable general anaesthesia for patients undergoing surgery, and for those with a compromised airway or respiratory failure. It is important that critical care nurses have the skills and knowledge to care for patients who are undergoing weaning from mechanical ventilation. This is to ensure that patients are weaned safely and as soon as possible, to improve their outcomes and avoid an increase in patient mortality and morbidity through complications that can arise such as airway trauma and ventilator-associated pneumonia...
November 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/29173683/evolving-strategies-in-cardiac-arrest-management
#3
REVIEW
Bram J Geller, Benjamin S Abella
Cardiac arrest is a leading cause of death in the United States, with a hospital discharge rate of approximately 10%. International resuscitation guidelines offer standardized cardiac arrest management approaches, but beyond the guidelines, are promising innovations to improve resuscitative care. Although clinical data do not yet support the routine use of mechanical chest compressions, corticosteroids, thrombolytics, and adjunctive ventilation devices during arrest, these therapies may have an important role in select patients...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29174462/critical-care-and-personalized-or-precision-medicine-who-needs-whom
#4
Shihab Sugeir, Stephen Naylor
The current paradigm of modern healthcare is a reactive response to patient symptoms, subsequent diagnosis and corresponding treatment of the specific disease(s). This approach is predicated on methodologies first espoused by the Cnidean School of Medicine approximately 2500years ago. More recently escalating healthcare costs and relatively poor disease treatment outcomes have fermented a rethink in how we carry out medical practices. This has led to the emergence of "P-Medicine" in the form of Personalized and Precision Medicine...
November 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29169388/vitamin-d-deficiency-in-critically-ill-children-a-systematic-review-and-meta-analysis
#5
James Dayre McNally, Nassr Nama, Katie O'Hearn, Margaret Sampson, Karin Amrein, Klevis Iliriani, Lauralyn McIntyre, Dean Fergusson, Kusum Menon
BACKGROUND: Vitamin D deficiency (VDD) has been hypothesized not only to be common but also to represent a potentially modifiable risk factor for greater illness severity and clinical outcome during critical illness. The objective of this systematic review was to determine the frequency of VDD in pediatric critical illness and its association with clinical outcomes. METHODS: MEDLINE, Embase, and CENTRAL were searched through December 12, 2016, with no date or language restrictions...
November 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29105540/mechanically-ventilating-the-severe-asthmatic
#6
Abdullah E Laher, Sean K Buchanan
The management of the critically ill patients with asthma can be rather challenging. Potentially devastating complications relating to this presentation include hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and seizures. In contrast to various other pathologies requiring mechanical ventilation, acute asthma is generally associated with better outcomes. This review serves as a practical guide to the physician managing patients with severe acute asthma requiring mechanical ventilation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29069261/caring-for-critically-ill-patients-outside-intensive-care-units-due-to-full-units-a-cohort-study
#7
Fabiane Urizzi, Marcos T Tanita, Josiane Festti, Lucienne T Q Cardoso, Tiemi Matsuo, Cintia M C Grion
OBJECTIVES: This study sought to analyze the clinical and epidemiologic characteristics of critically ill patients who were denied intensive care unit admission due to the unavailability of beds and to estimate the direct costs of treatment. METHODS: A prospective cohort study was performed with critically ill patients treated in a university hospital. All consecutive patients denied intensive care unit beds due to a full unit from February 2012 to February 2013 were included...
October 2017: Clinics
https://www.readbyqxmd.com/read/29073462/implementing-early-mobilisation-in-the-intensive-care-unit-an-integrative-review
#8
REVIEW
Sonja Phelan, Frances Lin, Marion Mitchell, Wendy Chaboyer
BACKGROUND: The intensive care unit provides complex care for critically ill patients. Consequently, due to the nature of critical illness and the therapies administered in intensive care, patients are often on prolonged periods of bed rest with limited mobility. It has been recognised that mobilising critically ill patients is beneficial to patients' recovery, however implementing early mobility as a standard of care remains challenging in practice. OBJECTIVES: To identify the key factors that underpin successful implementation and sustainability of early mobilisation in adult intensive care units...
October 2, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29028761/the-value-of-24-7-in-house-icu-staffing-24-7-intensivist-in-the-icu
#9
Moldovan Sabov, Craig E Daniels
No abstract text is available yet for this article.
January 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/28882190/traversing-the-valley-of-glycemic-control-despair
#10
EDITORIAL
J Geoffrey Chase, Jennifer L Dickson
No abstract text is available yet for this article.
September 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28668925/perceptions-of-workload-burden-and-adherence-to-abcde-bundle-among-intensive-care-providers
#11
Leanne M Boehm, Mary S Dietrich, Eduard E Vasilevskis, Nancy Wells, Pratik Pandharipande, E Wesley Ely, Lorraine C Mion
BACKGROUND: Use of the interprofessional Awakening and Breathing Coordination, Delirium Monitoring and Management, and Early Mobility (ABCDE) bundle is recommended practice in intensive care, but its adoption remains limited. OBJECTIVE: To examine the relationship between intensive care unit provider attitudes regarding the ABCDE bundle and ABCDE bundle adherence. METHODS: A 1-time survey of 268 care providers in 10 intensive care units across the country who had worked at least 4 shifts per month to examine their attitudes toward workload burden, difficulty carrying out the bundle, perceived safety, confidence, and perceived strength of evidence...
July 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28864439/post-intensive-care-syndrome-in-family-decision-makers-of-long-term-acute-care-hospital-patients
#12
Amy Petrinec
BACKGROUND: Family members of critically ill patients experience indications of post-intensive care syndrome, including anxiety, depression, and posttraumatic stress disorder. Despite increased use of long-term acute care hospitals for critically ill patients, little is known about the impact of long-term hospitalization on patients' family members. OBJECTIVES: To examine indications of post-intensive care syndrome, coping strategies, and health-related quality of life among family decision makers during and after patients' long-term hospitalization...
September 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28887062/diaphragm-dysfunction-in-critical-illness
#13
REVIEW
Gerald S Supinski, Peter E Morris, Sanjay Dhar, Leigh Ann Callahan
The diaphragm is the major muscle of inspiration, and its function is critical for optimal respiration. Diaphragmatic failure has long been recognized as a major contributor to death in a variety of systemic neuromuscular disorders. More recently, it is increasingly apparent that diaphragm dysfunction is present in a high percentage of critically ill patients and is associated with increased morbidity and mortality. In these patients, diaphragm weakness is thought to develop from disuse secondary to ventilator-induced diaphragm inactivity and as a consequence of the effects of systemic inflammation, including sepsis...
September 5, 2017: Chest
https://www.readbyqxmd.com/read/28816838/executive-summary-clinical-practice-guideline-safe-medication-use-in-the-icu
#14
Sandra L Kane-Gill, Joseph F Dasta, Mitchell S Buckley, Sandeep Devabhakthuni, Michael Liu, Henry Cohen, Elizabeth L George, Anne S Pohlman, Swati Agarwal, Elizabeth A Henneman, Sharon M Bejian, Sean M Berenholtz, Jodie L Pepin, Mathew C Scanlon, Brian S Smith
No abstract text is available yet for this article.
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28820753/prevention-of-exposure-keratopathy-in-critically-ill-patients-a-single-center-randomized-pilot-trial-comparing-ocular-lubrication-with-bandage-contact-lenses-and-punctal-plugs
#15
RANDOMIZED CONTROLLED TRIAL
Itai Bendavid, Inbal Avisar, Irena Serov Volach, Amir Sternfeld, Idit Dan Brazis, Lewaa Umar, Yiftach Yassur, Pierre Singer, Jonathan David Cohen
OBJECTIVES: To compare the effectiveness of bandage contact lenses and punctal plugs with ocular lubricants in preventing corneal damage in mechanically ventilated and sedated critically ill patients. DESIGN: Single-center, prospective, randomized, pilot study. SETTING: Sixteen-bed, general ICU at a tertiary academic medical center. PATIENTS: Adults admitted to the ICU and anticipated to require mechanical ventilation and continuous sedation for greater than or equal to 4 days...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28837429/severe-burnout-is-common-among-critical-care-physician-assistants
#16
Muneer Bhatt, Danny Lizano, Anthony Carlese, Vladimir Kvetan, Hayley Beth Gershengorn
OBJECTIVES: To determine the prevalence of and risk factors for burnout among critical care medicine physician assistants. DESIGN: Online survey. SETTINGS: U.S. ICUs. SUBJECTS: Critical care medicine physician assistant members of the Society of Critical Care Medicine coupled with personal contacts. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used SurveyMonkey to query critical care medicine physician assistants on demographics and the full 22-question Maslach Burnout Inventory, a validated tool comprised of three subscales-emotional exhaustion, depersonalization, and achievement...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28857850/interventions-to-improve-hand-hygiene-compliance-in-the-icu-a-systematic-review
#17
REVIEW
Sinéad Lydon, Michael Power, Jennifer McSharry, Molly Byrne, Caoimhe Madden, Janet Elaine Squires, Paul O'Connor
OBJECTIVES: To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. DATA SOURCES: Systematic searches were conducted in November 2016 using five electronic databases: Medline, CINAHL, PsycInfo, Embase, and Web of Science. Additionally, the reference lists of included studies and existing review papers were screened. STUDY SELECTION: English language, peer-reviewed studies that evaluated an intervention to improve hand hygiene in an adult ICU setting, and reported hand hygiene compliance rates collected via observation, were included...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28915199/the-overlap-between-burnout-and-depression-in-icu-staff
#18
Gillian A Colville, Jared G Smith
No abstract text is available yet for this article.
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28366166/a-path-to-precision-in-the-icu
#19
REVIEW
David M Maslove, Francois Lamontagne, John C Marshall, Daren K Heyland
Precision medicine is increasingly touted as a groundbreaking new paradigm in biomedicine. In the ICU, the complexity and ambiguity of critical illness syndromes have been identified as fundamental justifications for the adoption of a precision approach to research and practice. Inherently protean diseases states such as sepsis and acute respiratory distress syndrome have manifestations that are physiologically and anatomically diffuse, and that fluctuate over short periods of time. This leads to considerable heterogeneity among patients, and conditions in which a "one size fits all" approach to therapy can lead to widely divergent results...
April 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28552074/heat-and-moisture-exchangers-hmes-and-heated-humidifiers-hhs-in-adult-critically-ill-patients-a-systematic-review-meta-analysis-and-meta-regression-of-randomized-controlled-trials
#20
Maria Vargas, Davide Chiumello, Yuda Sutherasan, Lorenzo Ball, Antonio M Esquinas, Paolo Pelosi, Giuseppe Servillo
BACKGROUND: The aims of this systematic review and meta-analysis of randomized controlled trials are to evaluate the effects of active heated humidifiers (HHs) and moisture exchangers (HMEs) in preventing artificial airway occlusion and pneumonia, and on mortality in adult critically ill patients. In addition, we planned to perform a meta-regression analysis to evaluate the relationship between the incidence of artificial airway occlusion, pneumonia and mortality and clinical features of adult critically ill patients...
May 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
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