Analysis of thin-section CT in patients with coronavirus disease (COVID-19) after hospital discharge.
CONCLUSIONS: Pulmonary fibrosis may develop early in patients with COVID-19 after hospital discharge. Older patients with severe illness during treatment were more prone to develop fibrosis according to thin-section CT results. PMID: 32474479 [PubMed - as supplied by publisher] (Source: Journal of X-Ray Science and Technology)
Source: Journal of X-Ray Science and Technology - June 1, 2020 Category: Radiology Tags: J Xray Sci Technol Source Type: research

Evaluation of quality of care in trauma patients using international scoring systems
Publication date: Available online 31 May 2020Source: Medicina Intensiva (English Edition)Author(s): J. Sainz Cabrejas, C. García Fuentes, C. García Juarranz, A.M. González López, L. Maure Blesa, J.C. Montejo González, M. Chico Fernández (Source: Medicina Intensiva)
Source: Medicina Intensiva - June 1, 2020 Category: Intensive Care Source Type: research

Active humidification in mechanical ventilation is not associated to an increase in respiratory infectious complications in a quasi-experimental pre–post intervention study
Publication date: Available online 31 May 2020Source: Medicina Intensiva (English Edition)Author(s): L. Picazo, M.P. Gracia Arnillas, R. Muñoz-Bermúdez, X. Durán, F. Álvarez Lerma, J.R. Masclans (Source: Medicina Intensiva)
Source: Medicina Intensiva - June 1, 2020 Category: Intensive Care Source Type: research

Have there been changes in the application of mechanical ventilation in relation to scientific evidence? A multicenter observational study in Mexico
Publication date: Available online 31 May 2020Source: Medicina Intensiva (English Edition)Author(s): M.C. Marín, J. Elizalde, A. Villagómez, U. Cerón, M. Poblano, I. Palma-Lara, J.R. Sánchez, E. Monares, A. Arellano, A. Muriel, Ó. Peñuelas, F. Frutos-Vivar, A. Esteban, F. Aguilera Almazán, M. Benítez Cortázar, R. Carrillo Speare, R. Castaño, R. Corral, D.N. D’Ector Lira, G. Díaz Polanco (Source: Medicina Intensiva)
Source: Medicina Intensiva - June 1, 2020 Category: Intensive Care Source Type: research

The Effect of Imputation of Pao2/Fio2 From Spo2/Fio2 on the Performance of the Pediatric Index of Mortality 3*
Conclusions: Imputation of the Pao2/Fio2 ratio in cases where arterial sampling was not performed resulted in a large reduction in the rate of missing data if all values of Spo2 were included. The imputation technique improved the discrimination of Pediatric Index of Mortality 3; however, the magnitude of the increment in overall model performance was small. A possible benefit of the approach is reducing the potential for bias resulting from variation in practice for invasive monitoring of oxygenation. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2020 Category: Pediatrics Tags: Feature Articles Source Type: research

Risk Factors for Electronic Prescription Errors in Pediatric Intensive Care Patients
Objectives: To assess risk factors for electronic prescription errors in a PICU. Design: A database of electronic prescriptions issued by a computerized physician order entry with clinical decision support system was analyzed to identify risk factors for prescription errors. Measurements and Main Results: Of 6,250 prescriptions, 101 were associated with errors (1.6%). The error rate was twice as high in patients older than 12 years than in patients children 6–12 and 0–6 years old (2.4% vs 1.3% and 1.2%, respectively, p (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2020 Category: Pediatrics Tags: Quality and Safety Source Type: research

Testing for Common Respiratory Viruses in Children Admitted to Pediatric Intensive Care: Epidemiology and Outcomes
Objectives: Viral infections are common in children, but there is a lack of data on severe viral infections in critically ill children. We investigated testing for viral infections in children requiring PICU admission and describe the epidemiology and outcomes. Design: Multicenter retrospective study. Results of viral testing for nine respiratory viruses using polymerase chain reaction were collected. Participants: Children less than 16 years old nonelectively admitted to PICU over a 6-year period. Setting: Two tertiary PICUs in Queensland, Australia. Interventions: None. Main Outcome Measures: Primary out...
Source: Pediatric Critical Care Medicine - June 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Platelet Inhibition With IV Glycoprotein IIb/IIIa Inhibitor to Prevent Thrombosis in Pediatric Patients Undergoing Aortopulmonary Shunting*
Objectives: Shunt thrombosis, a potential complication of aortopulmonary shunting, is associated with high mortality. Commonly used oral antiplatelet drugs such as aspirin demonstrate variable absorption and inconsistent antiplatelet effect in critically ill patients early after surgery. IV glycoprotein IIb/IIIa inhibitors are antiplatelet agents with rapid and reproducible effect that may be beneficial as a bridge to oral therapy. Design: Retrospective review of pediatric patients undergoing treatment with IV tirofiban. Discarded blood samples were used to determine pharmacokinetic parameters. Setting: Pediatric c...
Source: Pediatric Critical Care Medicine - June 1, 2020 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research

Hospital-Associated Venous Thromboembolism in a Pediatric Cardiac ICU: A Multivariable Predictive Algorithm to Identify Children at High Risk
Objectives: Critically ill children with cardiac disease are at significant risk for hospital-associated venous thromboembolism, which is associated with increased morbidity, hospital length of stay, and cost. Currently, there are no widely accepted guidelines for prevention of hospital-associated venous thromboembolism in pediatrics. We aimed to develop a predictive algorithm for identifying critically ill children with cardiac disease who are at increased risk for hospital-associated venous thromboembolism as a first step to reducing hospital-associated venous thromboembolism in this population. Design: This is a pr...
Source: Pediatric Critical Care Medicine - June 1, 2020 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research

Implementation of an Evidence-Based Guideline of Enteral Nutrition for Infants With Congenital Heart Disease: A Controlled Before-and-After Study*
Objectives: To describe the implementation process of a nutrition risk screening and assessment guideline for infants with congenital heart disease and to assess the impact of nurses’ behavior and the effect on infants’ outcomes. Design: A controlled before-and-after implementation study. The three dimensions of the integrated-Promoting Action on Research Implementation in Health Services framework were used to assess barriers and promoting factors. Setting: Cardiac center at Children’s Hospital of Fudan University, Shanghai, China. Patients: Infants with congenital heart disease (n = 142) and ...
Source: Pediatric Critical Care Medicine - June 1, 2020 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research

The Limitations of Pain Scales —Reply
In Reply Several years ago, we implemented a protocol to manage pain and sedation based on regular clinical pain and sedation assessments in our neonatal intensive care units. At that time, given the significant amount of studies published in that field, we found it extremely difficult to choose 1 scale, among others. These difficulties motivated us to write this systematic review to provide clinicians and researchers with a useful blueprint to facilitate the search for the optimal scale. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - June 1, 2020 Category: Pediatrics Source Type: research

POCUS to Guide Fluid Therapy in COVID-19
PROVIDING ADEQUATE care to the large number of patients critically ill with coronavirus disease 2019 (COVID-19) with severe acute respiratory distress syndrome (ARDS) is a resource-intensive task. Reducing duration of mechanical ventilation may assist in decompressing intensive care units (ICUs). Standard of care in managing ARDS includes lung-protective ventilation and appropriate diuresis.1,2 Recent literature regarding using portable ultrasonography at the bedside (point-of-care ultrasound or POCUS) on critically ill patients suggested current use in modern ICUs. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 1, 2020 Category: Anesthesiology Authors: Richard Thalappillil, Christopher W. Tam Tags: Letter to the Editor Source Type: research

Ecthyma gangrenosum: an early hint for diagnosis
A 51-year old man in his fourth-line with daratumumab after two autologous cell transplantation for an IgG-kappa myeloma was admitted to the intensive care unit for septic shock with multi-organ failure. On examination, he had febrile respiratory failure with left inferior lobe pulmonary crackling. The skin was covered with diffuse painful nodular ringworm-shaped lesions surrounded by an erythematous halo without mucosal involvement Fig. 1, Panel A and B. Biology showed arterial hyperlactatemia at 9.5  mmol/l and pancytopenia. (Source: International Journal of Infectious Diseases)
Source: International Journal of Infectious Diseases - June 1, 2020 Category: Infectious Diseases Authors: Anastasia Saade, Adrien Mirouse, Lara Zafrani Tags: Medical Imagery Source Type: research

Precision Vision: Empowering Innovation and Well-Being
Elizabeth Card, MSN, APRN, FNP-BC, CPAN, CCRP, FASPAN, is honored to serve as ASPAN's 40th President. During the last 3 decades, she has worked in the PACU/holding room, cardiovascular and surgical intensive care units, as a nurse manager/leader, family nurse practitioner, and nurse researcher. She joined Vanderbilt University Medical Center, Nashville, TN, in 1994; she currently is a research nurse practitioner for the Department of Anesthesiology and a nursing research consultant for Vanderbilt University Medical Center. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - June 1, 2020 Category: Nursing Authors: Elizabeth Card Tags: The President's Page Source Type: research

2019 novel coronavirus: what is currently known, cardiovascular implications and management.
Authors: Cappannoli L, Scacciavillani R, Iannaccone G, Anastasia G, Di Giusto F, Crea F Abstract From first cases reported on December 31, 2019, in Wuhan, Hubei-China, SARS-CoV2 has spread worldwide and finally the World Health Organization declared the pandemic status. We summarize what makes SARS-CoV2 different from previous highly pathogenic coronaviruses and why it is so contagious, with focus on its clinical presentation and diagnosis, which is mandatory to start the appropriate management and reduce the transmission. As far as infection pathophysiology is still not completely clarified, this review focuses al...
Source: Minerva Cardioangiologica - May 31, 2020 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research

Evaluating the Outcomes of an Organizational Initiative to Expand End-of-Life Resources in Intensive Care Units With Palliative Support Tools and Floating Hospice.
CONCLUSION: This study provided the organization with vital information about their initiative to expand end-of-life resources. Utilization and timing of palliative consults and floating hospice referrals were lower and later than expected, highlighting the importance of developing purposeful strategies beyond education to address ICU cultural and structural barriers. PMID: 32467406 [PubMed - in process] (Source: Dimensions in Critical Care Nursing)
Source: Dimensions in Critical Care Nursing - May 31, 2020 Category: Nursing Tags: Dimens Crit Care Nurs Source Type: research

Sleep Deprivation Etiologies Among Patients in the Intensive Care Unit: Literature Review.
DISCUSSION: Sleep deprivation etiologies are multifactorial and have several effects on ICU patients. Sleep protocol and staff training should be introduced to reduce unnecessary interventions by ICU staff. Tele-ICU monitoring can also be introduced to reduce unnecessary interventions where clinicians can monitor patients remotely and therefore enhance sleep in the ICU. During their stay in the ICU, patients can be instructed to wear earplugs and also have aromatherapy massage to reduce stress and enhance sleep quality. More research on the physical pain and the psychological factors using objective methods should be condu...
Source: Dimensions in Critical Care Nursing - May 31, 2020 Category: Nursing Tags: Dimens Crit Care Nurs Source Type: research

Implementing Cardiac Surgical Unit-Advanced Life Support Through Simulation-Based Learning: A Quality Improvement Project.
Authors: Marler GS, Molloy MA, Engel JR, Walters G, Smitherman MB, Sabol VK Abstract BACKGROUND: The European Association for Cardio Thoracic Surgery and the Society of Thoracic Surgeons endorse Cardiac Surgical Unit-Advanced Life Support, a protocol designed specifically for cardiothoracic surgical patients who suffer postoperative cardiac arrests. To enhance patient outcomes and to reduce death rates, cardiothoracic intensive care unit nurses must be able to perform the protocol with confidence, proficiency, and without delays. To this end, simulation-based learning (SBL) is a pedagogical method ideal for optimiz...
Source: Dimensions in Critical Care Nursing - May 31, 2020 Category: Nursing Tags: Dimens Crit Care Nurs Source Type: research

Intensive Care Unit Delirium, Clinical Observations, and Patients' Statements: A Case Study.
CONCLUSION: A continuity of skilled observations and listening to patients' statements are vital for detection of ongoing ICU delirium or experiences of delirium. PMID: 32467399 [PubMed - in process] (Source: Dimensions in Critical Care Nursing)
Source: Dimensions in Critical Care Nursing - May 31, 2020 Category: Nursing Tags: Dimens Crit Care Nurs Source Type: research

Opioid Management in Pregnancy and Postpartum
Pregnant and postpartum women with opiate use disorder present a challenge in perinatal care. It is important for health care teams to provide sensitive and compassionate evidence-based care for these women, who often are stigmatized during the prenatal, delivery, and postpartum periods. Women with opiate use disorder are at risk for inadequate prenatal and postpartum care and for complications. Infants are at risk for neonatal abstinence syndrome and are expected to require neonatal intensive care. Pain management during labor and for cesarean delivery requires consultation and collaboration with providers who have expert...
Source: Obstetrics and Gynecology Clinics - May 31, 2020 Category: OBGYN Authors: Haywood L. Brown Source Type: research

Navigated tissue characterization during skin cancer surgery
AbstractPurposeBasal cell carcinoma (BCC) is the most commonly diagnosed skin cancer and is treated by surgical resection. Incomplete tumor removal requires surgical revision, leading to significant healthcare costs and impaired cosmesis. We investigated the clinical feasibility of a surgical navigation system for BCC surgery, based on molecular tissue characterization using rapid evaporative ionization mass spectrometry (REIMS).MethodsREIMS enables direct tissue characterization by analysis of cell-specific molecules present within surgical smoke, produced during electrocautery tissue resection. A tissue characterization ...
Source: International Journal of Computer Assisted Radiology and Surgery - May 31, 2020 Category: Intensive Care Source Type: research

Extracorporeal membrane oxygenation in patients with acute respiratory distress syndrome caused by COVID-19
Coronaviruses are single-stranded RNA viruses that cause respiratory and intestinal infections in humans. At the beginning of the XXI century, two new coronaviruses with high pathogenicity were described; the severe acute respiratory syndrome coronavirus (SARS-CoV) and the middle east respiratory syndrome coronavirus (MERS-CoV). The coronaviruses (HCoV-NL63, HCoV-229E, HCoV-OC43 and HKU1), were known to cause mild infections in immunocompromised persons. In the Wuhan city, the capital of China's Hubei province in december 2019 a new coronavirus (2019-nCoV) was identified 1,2. (Source: Heart and Lung)
Source: Heart and Lung - May 31, 2020 Category: Intensive Care Authors: Valdir Assis dos Reis Filho, Felipe Ara újo Pimenta Source Type: research

First Successful Treatment of Coronavirus Disease 2019 Induced Refractory Cardiogenic Plus Vasoplegic Shock by Combination of Percutaneous Ventricular Assist Device and Extracorporeal Membrane Oxygenation: A Case Report
The novel coronavirus severe acute respiratory syndrome coronavirus 2 is infecting hundreds of thousands of humans around the globe. The coronavirus disease 2019 (COVID-19) is known to generate mild as well as critical courses. Complications on the intensive care units include acute respiratory distress syndrome, acute cardiac, and kidney injury as well as shock. Here, we present the first case report of a successful treatment of a COVID-19 patient presenting with adult respiratory distress syndrome plus refractory combined cardiogenic and vasoplegic shock, which could be successfully stabilized after implantation of a per...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Management of COVID-19 Patients Source Type: research

How Computational Modeling can Help to Predict Gas Transfer in Artificial Lungs Early in the Design Process
In this study, we applied our previously introduced micro-scale CFD model to the full fiber bundle of a small oxygenator for gas transfer prediction. Three randomized geometries as well as a staggered and in-line configuration were modeled and simulated with Ansys CFX. Three small laboratory oxygenator prototypes were built by stacking fiber segments unidirectionally with spacers between consecutive segments. The devices were tested in vitro for gas transfer with porcine blood in accordance with ISO 7199. The error of the predicted averaged CFD oxygen saturations of the random 1, 2, and 3 configurations relative to the ave...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Pulmonary Source Type: research

Customization and external validation of the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU) in Brazilian critically ill patients
Publication date: Available online 29 May 2020Source: Journal of Critical CareAuthor(s): Fernando G. Zampieri, Anders Granholm, Morten Hylander Møller, Alexandre Vaz Scotti, Alessandra Alves, Maurício Magalhães Cabral, Marcelo Ferreira Sousa, Henrique Miller Balieiro, Carlos Cesar Hortala, Edison Moraes Rodrigues Filho, Eric Perecmanis, Márcia Adélia de Magalhães Menezes, Carlos Eduardo Nassif Moreira, Giulliana Martines Moralez, Antônio Tonete Bafi, Clayton Barbieri de Carvalho, Jorge Ibrain Figueira Salluh, Fernando Augusto Bozza, Anders Perner, Marcio Soares (Source: Journal of Critical Care)
Source: Journal of Critical Care - May 30, 2020 Category: Gastroenterology Source Type: research

The benefits of agreeing on what matters most: Team cooperative norms mediate the effect of co-leaders’ shared goals on safety climate in neonatal intensive care units
Conclusion: Increasing the extent to which co-leaders share goals is an effective lever to strengthen interprofessional cooperation and foster a safety climate among nursing and physician team members of hospital units. (Source: Health Care Management Review)
Source: Health Care Management Review - May 30, 2020 Category: American Health Tags: Features Source Type: research

Principled decisions and virtuous care: an ethical assessment of the Siaarti guidelines for allocating intensive care resources.
This article sets forth ethical principles for responding to extraordinary circumstances in which the demand for medical care threatens to overwhelms available resources, as in the COVID-19 pandemic. In light of these principles, the author then assesses the ethics of the SIAARTI guidelines for rationing ICU beds and ventilators under such circumstances. PMID: 32463212 [PubMed - as supplied by publisher] (Source: Minerva Anestesiologica)
Source: Minerva Anestesiologica - May 30, 2020 Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research

Video call in intensive care and moral distress.
Authors: Borrelli V, Navarra M PMID: 32463211 [PubMed - as supplied by publisher] (Source: Minerva Anestesiologica)
Source: Minerva Anestesiologica - May 30, 2020 Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research

Thrombocytopenia and platelet course on hospital mortality in neurological intensive care unit: a retrospective observational study from large database
Thrombocytopenia (TP) has been shown to be an independent predictor of mortality in the intensive care unit (ICU) patients. Studies are lacking in the neurological ICU (NICU) population. The aim was to evaluat... (Source: BMC Neurology)
Source: BMC Neurology - May 30, 2020 Category: Neurology Authors: Dawei Zhou, Zhimin Li, Lei Wu, Guangzhi Shi and Jianxin Zhou Tags: Research article Source Type: research

Role of anesthesia nurses in the treatment and management of patients with COVID-19
As the backbone for the treatment of patients with coronavirus disease 2019 (COVID-19), nurses have been actively playing key roles in cabin hospitals, isolation wards, and intensive care units (ICUs) for critical cases. Anesthesia nurses have their own professional specialties, such as airway management, the use and maintenance of life support equipment, including ventilators, and the use of high-flow oxygen equipment. With rich experience in emergency responses and nursing, anesthesia nurses, along with emergency nurses and critical care nurses, play important roles during the treatment of COVID-19 patients. (Source: Jou...
Source: Journal of PeriAnesthesia Nursing - May 30, 2020 Category: Nursing Authors: Qinghong Chen, Xing Lan, Zhenghua Zhao, Shaofei Hu, Fang Tan, Ping Gui, Shanglong Yao Tags: Research Source Type: research

Integrating Solution ‐Focused Brief Therapy for Systemic Posttraumatic Stress Prevention in Paediatrics
This article discusses and provides rationale for the use of solution‐focused brief therapy (SFBT) through a biopsychosocial lens when treating paediatric intensive care unit (PICU) patients and th eir families. A fictionalised illustration is provided to guide family therapists in applying SFBT to the PICU population. (Source: Australian and New Zealand Journal of Family Therapy (ANZJFT))
Source: Australian and New Zealand Journal of Family Therapy (ANZJFT) - May 30, 2020 Category: Psychiatry & Psychology Authors: Benjamin T. Finlayson, Gregory N. Hall, Sara Smock Jordan Tags: Original Article Source Type: research

Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series.
Authors: Mitra AR, Fergusson NA, Lloyd-Smith E, Wormsbecker A, Foster D, Karpov A, Crowe S, Haljan G, Chittock DR, Kanji HD, Sekhon MS, Griesdale DEG Abstract BACKGROUND: Pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with high intensive care unit (ICU) mortality. We aimed to describe the clinical characteristics and outcomes of critically ill patients with coronavirus disease 2019 (COVID-19) in a Canadian setting. METHODS: We conducted a retrospective case series of critically ill patients with laboratory-confirmed SARS-CoV-2 infection consecutively admitted to 1 of 6 ICUs ...
Source: Canadian Medical Association Journal - May 29, 2020 Category: General Medicine Tags: CMAJ Source Type: research

[Bilateral endogenous endophthalmitis in the intensive care unit].
Authors: Routier M, de Saint Martin G, Cornee C PMID: 32461188 [PubMed - as supplied by publisher] (Source: Journal Francais d Ophtalmologie)
Source: Journal Francais d Ophtalmologie - May 29, 2020 Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research

Comparison of American Association for the Surgery of Trauma grading scale with modified Hinchey classification in acute colonic diverticulitis: A pilot study
CONCLUSION The AAST grading of acute diverticulitis is equivalent to the modified Hinchey classification in predicting procedural intervention and complications. The AAST system may be preferable to Hinchey because it can be applied preoperatively. Although this pilot study demonstrated that the AAST score predicts surgical need, a larger study is required to evaluate the AAST score for other outcomes. LEVEL OF EVIDENCE Prognostic and epidemiological study, level III. (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 29, 2020 Category: Orthopaedics Tags: AAST 2019 PODIUM Source Type: research

How does continuous venovenous hemofiltration theoretically expose (ex-vivo models) inpatients to diethylhexyladipate, a plasticizer of PVC medical devices?
In this study, 2 CVVH models were used to evaluate the potential migration of DEHA from PVC tubings, allowing the determination of (Rachoin and Weisberg, 2019) the highest rates of DEHA able to migrate into a simulant flowing in a marketed adult CVVH circuit by disregarding any metabolisation and (Krieter et al., 2013) the clinical-reflecting exposure of patients to this plasticizer and its metabolites by assessing their migration into blood. In the first model, we showed that patients undergoing a CVVH procedure may be exposed to high rates of DEHA. Moreover, DEHA is continuously hydrolyzed into its primary metabolit...
Source: Chemosphere - May 29, 2020 Category: Chemistry Authors: Bernard L, Bailleau M, Eljezi T, Chennell P, Souweine B, Lautrette A, Sautou V Tags: Chemosphere Source Type: research

STAPLAg: a convenient early warning score for use in infected patients in the intensive care unit
Sepsis is a life-threatening disease in the intensive care unit (ICU). The current diagnostic criteria for sequential organ failure assessment (SOFA) scores do not reflect the current understanding of sepsis. We developed a novel and convenient score to aid early prognosis. Retrospective multivariable regression analysis of 185 infected emergency ICU (EICU) patients was conducted to identify independent variables associated with death, to develop the new “STAPLAg” score; STAPLAg was then validated in an internal cohort (n = 106) and an external cohort (n = 78) and its predictive efficacy was compared w...
Source: Medicine - May 29, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Costs and length of sepsis-related hospitalizations in Taiwan
This study provides an updated and better understanding of the costs and LOS of sepsis-related hospitalizations in Taiwan. It was found that ward fees and medicine fees were the major components of hospital costs. (Source: Medicine)
Source: Medicine - May 29, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Factors Associated With Maternal and Neonatal Interventions at the Threshold of Viability.
CONCLUSION: Maternal and neonatal interventions occur frequently at the threshold of viability, especially at 23 weeks of gestation where the occurrence of interventions exceeds 50%. This study identifies sociodemographic and medical factors associated with using interventions with periviable deliveries. These data elucidate observed practice patterns in the management of periviable births and may assist providers in the counseling of women at risk of periviable birth. PMID: 32459432 [PubMed - in process] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - May 29, 2020 Category: OBGYN Authors: Hajdu SA, Rossi RM, DeFranco EA Tags: Obstet Gynecol Source Type: research

Utilization pattern of kangaroo mother care after introduction in eight selected neonatal intensive care units in China
In this study, we ai... (Source: BMC Pediatrics)
Source: BMC Pediatrics - May 29, 2020 Category: Pediatrics Authors: Xin Liu, Zhankui Li, Xiaohui Chen, Bei Cao, Shaojie Yue, Changyi Yang, Qiongyu Liu, Chuanzhong Yang, Gengli Zhao and Qi Feng Tags: Research article Source Type: research

COVID-19 pneumonia: phenotype assessment requires bedside tools
(Source: Critical Care)
Source: Critical Care - May 29, 2020 Category: Intensive Care Authors: Zhanqi Zhao, Wan-Hsuan Kung, Hou-Tai Chang, Yeong-Long Hsu and In éz Frerichs Tags: Letter Source Type: research

Recruitment pattern of the diaphragm and extradiaphragmatic inspiratory muscles in response to different levels of pressure support
Inappropriate ventilator assist plays an important role in the development of diaphragm dysfunction. Ventilator under-assist may lead to muscle injury, while over-assist may result in muscle atrophy. This prov... (Source: Annals of Intensive Care)
Source: Annals of Intensive Care - May 29, 2020 Category: Intensive Care Authors: L. H. Roesthuis, J. G. van der Hoeven, H. W. H. van Hees, W.-J. M. Schellekens, J. Doorduin and L. M. A. Heunks Tags: Research Source Type: research

Intensive Care Unit Delirium, Clinical Observations, and Patients' Statements: A Case Study
Conclusion A continuity of skilled observations and listening to patients' statements are vital for detection of ongoing ICU delirium or experiences of delirium. (Source: Dimensions of Critical Care Nursing)
Source: Dimensions of Critical Care Nursing - May 29, 2020 Category: Nursing Tags: Clinical DIMENSION Source Type: research

Implementing Cardiac Surgical Unit—Advanced Life Support Through Simulation-Based Learning: A Quality Improvement Project
Background The European Association for Cardio Thoracic Surgery and the Society of Thoracic Surgeons endorse Cardiac Surgical Unit–Advanced Life Support, a protocol designed specifically for cardiothoracic surgical patients who suffer postoperative cardiac arrests. To enhance patient outcomes and to reduce death rates, cardiothoracic intensive care unit nurses must be able to perform the protocol with confidence, proficiency, and without delays. To this end, simulation-based learning (SBL) is a pedagogical method ideal for optimized learning. Objectives This quality improvement project was designed to implement ...
Source: Dimensions of Critical Care Nursing - May 29, 2020 Category: Nursing Tags: Educational DIMENSION Source Type: research

Sleep Deprivation Etiologies Among Patients in the Intensive Care Unit: Literature Review
Discussion Sleep deprivation etiologies are multifactorial and have several effects on ICU patients. Sleep protocol and staff training should be introduced to reduce unnecessary interventions by ICU staff. Tele-ICU monitoring can also be introduced to reduce unnecessary interventions where clinicians can monitor patients remotely and therefore enhance sleep in the ICU. During their stay in the ICU, patients can be instructed to wear earplugs and also have aromatherapy massage to reduce stress and enhance sleep quality. More research on the physical pain and the psychological factors using objective methods should be cond...
Source: Dimensions of Critical Care Nursing - May 29, 2020 Category: Nursing Tags: Research DIMENSION Source Type: research

Evaluating the Outcomes of an Organizational Initiative to Expand End-of-Life Resources in Intensive Care Units With Palliative Support Tools and Floating Hospice
Conclusion This study provided the organization with vital information about their initiative to expand end-of-life resources. Utilization and timing of palliative consults and floating hospice referrals were lower and later than expected, highlighting the importance of developing purposeful strategies beyond education to address ICU cultural and structural barriers. (Source: Dimensions of Critical Care Nursing)
Source: Dimensions of Critical Care Nursing - May 29, 2020 Category: Nursing Tags: Leadership DIMENSION Source Type: research

The Limited Impact of Current Therapeutic Interventions on Cerebrovascular Reactivity in Traumatic Brain Injury: A Narrative Overview
AbstractCurrent intensive care unit (ICU) treatment strategies for traumatic brain injury (TBI) care focus on intracranial pressure (ICP)- and cerebral perfusion pressure (CPP)-directed therapeutics, dictated by guidelines. Impaired cerebrovascular reactivity in moderate/severe TBI is emerging as a major associate with poor outcome and appears to dominate the landscape of physiologic derangement over the course of a patient ’s ICU stay. Within this article, we review the literature on the known drivers of impaired cerebrovascular reactivity in adult TBI, highlight the current knowledge surrounding the impact of guide...
Source: Neurocritical Care - May 29, 2020 Category: Neurology Source Type: research

What ’s new about pulmonary hyperinflation in mechanically ventilated critical patients
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - May 29, 2020 Category: Intensive Care Source Type: research

Sustaining Frontline ICU Healthcare Workers during the COVID-19 Pandemic and Beyond
Healthcare workers (HCWs) on the frontlines of the COVID-19 pandemic in the intensive care unit (ICU) are under immense pressure as they provide essential care with challenges few have previously encountered. Fear, anxiety, and uncertainty have been reported by even the most experienced ICU HCWs as they care for escalating numbers of critically ill patients, each of whom pose a risk to the HCWs ’ own health. Inconsistent messaging from government health agencies on appropriate precautions, often framed around availability of personal protective equipment (PPE) instead of best practices, has shaken the foundation of w...
Source: Heart and Lung - May 29, 2020 Category: Intensive Care Authors: Kathleen M. Akg ün, David Collett, Shelli L. Feder, Tracy Shamas, Dena Schulman-Green Source Type: research

Cardiothoracic Surgery at the Time of the Coronavirus Disease –2019 Pandemic: Lessons From the East (and From a Previous Epidemic) for Western Battlefields
THE CORONAVIRUS DISEASE 2019 (COVID-19) outbreak that spread from Wuhan, China, in December 2019 became a global pandemic within about 2 months, causing more than 330,000 deaths worldwide so far (at the time of writing).1 This has forced hospitals in the most affected countries and regions around the world to rearrange their activity, creating new spaces and pathways while reducing nonurgent admissions and health services.2 Although only a minority of patients infected with the new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) develop symptoms severe enough to require intensive care unit (ICU) admission,3 th...
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 29, 2020 Category: Anesthesiology Authors: Antonio Pisano, Giovanni Landoni, Luigi Verniero, Alberto Zangrillo Tags: Editorial Source Type: research

Evaluation serum levels of YKL-40, Periostin, and some inflammatory cytokines together with IL-37, a new anti-inflammatory cytokine, in patients with stable and exacerbated asthma
Asthma is a chronic inflammatory disease, characterized by bronchial hyperreactivity, airway obstruction and remodelling.1,2 Numerous cells and inflammatory mediators are known to play a role in the pathogenesis of asthma.3 Frequent variability in the clinical status of asthmatic patients, and the presence of numerous pathways which relate to asthma pathogenesis, have led researchers to investigate the role of various associated markers.4 (Source: Heart and Lung)
Source: Heart and Lung - May 29, 2020 Category: Intensive Care Authors: Hanifi Yildiz, Hamit Hakan Alp, Aysel S ünnetçioğlu, Selami Ekin, Buket Mermit Çilingir Source Type: research