collection
MENU ▼
Read by QxMD icon Read
search

Critical care

shared collection
48 papers 25 to 100 followers
https://www.readbyqxmd.com/read/27853091/tetanus-in-the-elderly-the-management-of-intensive-care-and-prolonged-hospitalization
#1
Hiroki Isono, Taiju Miyagami, Kohta Katayama, Momoko Isono, Ryuichi Hasegawa, Harumi Gomi, Hiroyuki Kobayashi
Tetanus is a potentially fatal infection. Approximately 100 cases are reported in Japan each year; however, little is known about its clinical course and outcomes in the current era of treatment. We herein report three cases of tetanus in elderly patients who survived after mechanical ventilation and intensive care. These patients, together with six other similar cases, had a median weaning period of 31 days and median length of stay of 77 days. In elderly patients, severe systemic forms of tetanus require prolonged mechanical ventilation and hospitalization...
2016: Internal Medicine
https://www.readbyqxmd.com/read/26304276/novel-uses-of-targeted-temperature-management
#2
REVIEW
John McGinniss, Peter Marshall, Shyoko Honiden
Targeted temperature management has an established role in treating the post-cardiac arrest syndrome after out-of-hospital cardiac arrest with an initial rhythm of ventricular tachycardia/ventricular fibrillation. There is less certain benefit if the initial rhythm is pulseless electrical activity/asystole or for in-hospital cardiac arrest. Targeted temperature management may have a role as salvage modality for conditions causing intracranial hypertension, such as traumatic brain injury, hepatic encephalopathy, intracerebral hemorrhage, and acute stroke...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/26304277/icu-telemedicine-solutions
#3
REVIEW
Steven A Fuhrman, Craig M Lilly
During the last 15 years, critical care services provided via telemedicine have expanded to now be incorporated into the care of 13% of patients in intensive care units (ICUs) in the United States. A response to shortfalls in the availability of critical care-trained providers has evolved into integrated programs of ICU care with contributions to improved outcomes through proactive management, population oversight, and standardization of care processes. The most impactful characteristics of successful ICU telemedicine programs are now better understood with more than a decade of national experience and the accrued benefits to health care systems...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/26304278/controversies-and-misconceptions-in-intensive-care-unit-nutrition
#4
REVIEW
Michael H Hooper, Paul E Marik
The early initiation of enteral nutrition remains a fundamental component of the management of critically ill and injured patients in the intensive care unit. Trophic feeding is equivalent, if not superior, to full-dose feeding. Parenteral nutrition has no proved benefit over enteral nutrition, which is the preferred route of nutritional support in intensive care unit patients with a functional gastrointestinal tract. Continuous enteral and parental nutrition inhibits the release of important enterohormones...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/26304279/sleep-loss-and-circadian-rhythm-disruption-in-the-intensive-care-unit
#5
REVIEW
Melissa P Knauert, Jeffrey A Haspel, Margaret A Pisani
Critical illness is associated with profound sleep disruption. Causality is diverse and includes physiologic, psychological, and environmental factors. There are limited pharmacologic interventions available to treat sleep disturbances in critical illness; however, multidisciplinary strategies that alter the intensive care unit (ICU) environment and cluster care delivery have shown promise in sleep and circadian promotion and delirium reduction. With the appropriate administrative support and involvement of diverse ICU stakeholders, effective strategies could be created, implemented, and maintained to improve sleep disruption in critically ill patients...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/26304280/barriers-and-challenges-to-the-successful-implementation-of-an-intensive-care-unit-mobility-program-understanding-systems-and-human-factors-in-search-for-practical-solutions
#6
REVIEW
Shyoko Honiden, Geoffrey R Connors
ICU-acquired weakness is a common problem and carries significant morbidity. Despite evidence that early mobility can mitigate this, implementation outside of the research setting is lagging. Understanding barriers at the systems as well as individual level is a crucial step in successful implementation of an ICU mobility program. This includes taking inventory of waste, overburden and inconsistencies in the work environment. Appreciating regulative, normative as well as cultural forces at work is critical...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/26304281/integration-of-palliative-care-services-in-the-intensive-care-unit-a-roadmap-for-overcoming-barriers
#7
REVIEW
Mary Baker, Jim Luce, Gabriel T Bosslet
Clinicians working in the intensive care unit (ICU) confront death and dying daily. ICU care can be inconsistent with a patient's values, preferences, and previously expressed goals of care. Current evidence promotes the integration of palliative care services within the ICU setting. Palliative care bridges the gap between comfort and cure, and these services are growing in the United States. This article discusses the benefits and barriers to integration of ICU and palliative care services, and a stepwise approach to implementation of palliative care services...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/26304282/clinical-reasoning-and-risk-in-the-intensive-care-unit
#8
REVIEW
Geoffrey R Connors, Jonathan M Siner
Clinical reasoning in medicine describes the process whereby a clinician gathers, assimilates, and assesses information about a person and their illness to assign a diagnosis and institute therapy. Care of patients in the intensive care unit involves managing a substantial quantity of incomplete, novel, and rapidly changing data. A modified nine-step bayesian approach to clinical reasoning comports well with this complex environment and is useful for assisting and educating novice learners to apply clinical reasoning accurately and consistently...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/26304283/adverse-event-reporting-and-quality-improvement-in-the-intensive-care-unit
#9
REVIEW
Jason J Heavner, Jonathan M Siner
Patients in the intensive care unit are at high risk for experiencing adverse events and errors. The high-acuity health care needs of these vulnerable patients expose them to numerous medications, procedures, and health care providers. The occurrence of adverse events is associated with detriments to patient outcomes including increased mortality. Adverse event reporting is the most commonly used event-detection tool, but it should also be complimented with other tools such as trigger tools, chart review, and direct observation...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/26304284/five-questions-critical-care-educators-should-ask-about-simulation-based-medical-education
#10
REVIEW
Dominique Piquette, Vicki R LeBlanc
Simulation is now commonly used in health care education, and a growing body of evidence supports its positive impact on learning. However, simulation-based medical education (SBME) involves a range of modalities, instructional methods, and presentations associated with different advantages and limitations. This review aims at better understanding the nature of SBME, its theoretic and proven benefits, its delivery, and the challenges posed by SBME. Areas requiring further research and development are also discussed...
September 2015: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27845639/innovative-designs-for-the-smart-icu
#11
Neil A Halpern
Successfully designing a new ICU requires clarity of vision and purpose and the recognition that the patient room is the core of the ICU experience for patients, staff, and visitors. The ICU can be conceptualized into three components: the patient room, central areas, and universal support services. Each patient room should be designed for single patient use and be similarly configured and equipped. The design of the room should focus upon functionality, ease of use, healing, safety, infection control, communications, and connectivity...
March 2014: Chest
https://www.readbyqxmd.com/read/27815151/right-atrial-pressure-in-the-critically-ill-how-to-measure-what-is-the-value-what-are-the-limitations
#12
REVIEW
Sheldon Magder
Right atrial pressure (Pra) is determined by the interaction of the function of the heart as a pump, called cardiac function, and the factors that determine the return of blood to heart, called return function. Thus, monitoring Pra or its surrogate, central venous pressure (CVP), can give important insights into mechanisms behind changes in hemodynamic status, responses to interventions, and the likelihood of diagnoses. Examination of the components of the Pra tracing, especially during the ventilator cycle, also can give information about right heart diastolic function, status of the tricuspid valve, volume responsiveness and the cardiac rhythm...
November 1, 2016: Chest
https://www.readbyqxmd.com/read/27637676/stroke
#13
Graeme J Hankey
In the past decade, the definition of stroke has been revised and major advances have been made for its treatment and prevention. For acute ischaemic stroke, the addition of endovascular thrombectomy of proximal large artery occlusion to intravenous alteplase increases functional independence for a further fifth of patients. The benefits of aspirin in preventing early recurrent ischaemic stroke are greater than previously recognised. Other strategies to prevent recurrent stroke now include direct oral anticoagulants as an alternative to warfarin for atrial fibrillation, and carotid stenting as an alternative to endarterectomy for symptomatic carotid stenosis...
September 13, 2016: Lancet
https://www.readbyqxmd.com/read/26855894/prevention-of-stress-related-ulcer-bleeding-at-the-intensive-care-unit-risks-and-benefits-of-stress-ulcer-prophylaxis
#14
REVIEW
Lukas Buendgens, Alexander Koch, Frank Tacke
Stress-related mucosal disease is a typical complication of critically ill patients in the intensive care unit (ICU). It poses a risk of clinically relevant upper gastrointestinal (GI) bleeding. Therefore, stress ulcer prophylaxis (SUP) is recommended in high-risk patients, especially those mechanically ventilated > 48 h and those with a manifest coagulopathy. Proton pump inhibitors (PPI) and, less effectively, histamine 2 receptor antagonists (H2RA) prevent GI bleeding in critically ill patients in the ICU...
February 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26855899/mild-to-moderate-intra-abdominal-hypertension-does-it-matter
#15
REVIEW
Liivi Maddison, Joel Starkopf, Annika Reintam Blaser
This review summarizes the epidemiology, pathophysiological consequences and impact on outcome of mild to moderate (Grade I to II) intra-abdominal hypertension (IAH), points out possible pitfalls in available treatment recommendations and focuses on tasks for future research in the field. IAH occurs in about 40% of ICU patients. Whereas the prevalence of abdominal compartment syndrome seems to be decreasing, the prevalence of IAH does not. More than half of IAH patients present with IAH grade I and approximately a quarter with IAH grade II...
February 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27776092/perceived-nonbeneficial-treatment-of-patients-burnout-and-intention-to-leave-the-job-among-icu-nurses-and-junior-and-senior-physicians
#16
Daniel Schwarzkopf, Hendrik Rüddel, Daniel O Thomas-Rüddel, Jörg Felfe, Bernhard Poidinger, Claudia T Matthäus-Krämer, Christiane S Hartog, Frank Bloos
OBJECTIVES: Perceiving nonbeneficial treatment is stressful for ICU staff and may be associated with burnout. We aimed to investigate predictors and consequences of perceived nonbeneficial treatment and to compare nurses and junior and senior physicians. DESIGN: Cross-sectional, multicenter paper-pencil survey on personal and work-related characteristics, perceived nonbeneficial treatment, burnout, and intention to leave the job. SETTING: Convenience sample of 23 German ICUs...
October 21, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27339681/the-liver-in-critical-illness
#17
REVIEW
Tessa W Damm, David J Kramer
Caring for critically ill patients with acute and/or chronic liver dysfunction poses a unique challenge. Proper resuscitation and early consideration for transfer to liver transplant centers have resulted in improved outcomes. Liver support devices and cellular models have not yet shown mortality benefit, but they hold promise in the critical care of patients with liver disease. This article reviews pertinent anatomic and physiologic considerations of the liver in critical illness, followed by a selective review of associated organ dysfunction...
July 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/27771302/blurred-lines-dysbiosis-and-probiotics-in-the-intensive-care-unit
#18
Lee E Morrow, Paul Wischmeyer
Clinicians have traditionally dichotomized bacteria as friendly commensals or harmful pathogens. However, the line separating the two has become blurred with the recognition that the intestinal microbiome is a complex entity wherein species can shift sides - from friend to foe and back again - based on crucial factors in their local environment. Significant disruptions in the homeostasis of the microbiome, a phenomenon called 'dysbiosis,' is increasingly associated with a host of untoward effects. Intensive care unit patients are at high risk for dysbiosis given high rates of antibiotic use, acute changes in diet, and the stress of critical illness...
October 19, 2016: Chest
https://www.readbyqxmd.com/read/27671976/burnout-syndrome-in-critical-care-team-members-a-monocentric-cross-sectional-survey
#19
Stéphanie Malaquin, Yazine Mahjoub, Arianna Musi, Elie Zogheib, Alexis Salomon, Mathieu Guilbart, Hervé Dupont
INTRODUCTION: There has been a growing interest in evaluating the occurrence of burnout syndrome (BOS) among intensive care units (ICU) team over recent years. The aims of this study were to determine the prevalence of BOS among staff working in the Amiens University Hospital and to assess associated factors. PATIENTS AND METHODS: Prospective observational study based on self-administered questionnaires filled in by physicians and non-physicians working in 3 ICUs...
September 23, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27581757/pyrexia-aetiology-in-the-icu
#20
REVIEW
Daniel J Niven, Kevin B Laupland
Elevation in core body temperature is one of the most frequently detected abnormal signs in patients admitted to adult ICUs, and is associated with increased mortality in select populations of critically ill patients. The definition of an elevated body temperature varies considerably by population and thermometer, and is commonly defined by a temperature of 38.0 °C or greater. Terms such as hyperthermia, pyrexia, and fever are often used interchangeably. However, strictly speaking hyperthermia refers to the elevation in body temperature that occurs without an increase in the hypothalamic set point, such as in response to specific environmental (e...
2016: Critical Care: the Official Journal of the Critical Care Forum
label_collection
label_collection
8048
1
2
2016-10-25 19:28:28
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"