Outcomes of Noninvasive Positive Pressure Ventilation in Acute Respiratory Distress Syndrome and Their Predictors: A National Cohort.
Conclusions: NIPPV success in ARDS exhibits significantly lower hospital mortality rates and shorter LOS compared with IMV, and NIPPV failure exhibits no significant difference in hospital mortality or LOS compared with patients who were initially intubated. Therefore, an initial trial of NIPPV may be considered in ARDS. Sepsis, pneumonia, and chronic liver disease were associated with higher odds of NIPPV failure; these factors should be used to stratify patients to the most suitable ventilation modality. PMID: 31641538 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - October 24, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax.
Conclusions: Displaced rib fractures and moderate-sized pneumothoraces are significant factors associated with chest tube placement in a victim of blunt trauma with occult pneumothorax. The optimal timing for the first follow-up chest X-ray remains unclear. PMID: 31565433 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - October 1, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Contribution of Levosimendan in Weaning from Mechanical Ventilation in Patients with Left Ventricular Dysfunction: A Pilot Study.
Conclusions: In difficult-to-wean from mechanical ventilation patients with LV dysfunction, levosimendan might contribute to successful weaning by improving both systolic and diastolic LV function. PMID: 31428473 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 21, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Impact of a Premorbid Psychiatric Disorder on the Incidence of Delirium during ICU Stay, Morbidity, and Long-Term Mortality.
Conclusions: In ICU patients with a length of stay>48 hours and a premorbid psychiatric disorder, the incidence of delirium was not significantly higher in comparison with patients without a premorbid psychiatric disorder. PMID: 31396415 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 11, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Renal Replacement Therapy in the Critical Care Setting.
Authors: Ahmed AR, Obilana A, Lappin D Abstract Renal replacement therapy (RRT) is frequently required to manage critically ill patients with acute kidney injury (AKI). There is limited evidence to support the current practice of RRT in intensive care units (ICUs). Recently published randomized control trials (RCTs) have further questioned our understanding of RRT in critical care. The optimal timing and dosing continues to be debatable; however, current evidence suggests delayed strategy with less intensive dosing when utilising RRT. Various modes of RRT are complementary to each other with no definite benefits to...
Source: Critical Care Research and Practice - August 11, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Determination of Electrolytes in Critical Illness Patients at Different pH Ranges: Whom Shall We Believe, the Blood Gas Analysis or the Laboratory Autoanalyzer?
Conclusion: Data from our single-center study indicate that urgent and vital decisions based on potassium measurements can be made by trusting the value obtained on the ABG machine irrespective of pH values. PMID: 31396417 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 11, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients.
Authors: Kyeremanteng K, Robidoux R, D'Egidio G, Fernando SM, Neilipovitz D Abstract Pay-for-performance (P4P) programs have been introduced into the Canadian medical system in the last decades. This paper examines the underlying characteristics of P4P and describes both their advantages and drawbacks. Most P4P programs provide the advantage of rewarding medical acts, thus providing an incentive to take on complex patients. There is a variety of nuanced P4P initiatives, which provide financial incentive according to differing criteria, based on quality measures, incentives, and/or benchmark structures. However, the...
Source: Critical Care Research and Practice - July 21, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Volumetric and End-Tidal Capnography for the Detection of Cardiac Output Changes in Mechanically Ventilated Patients Early after Open Heart Surgery.
Authors: Hoff IE, Høiseth LØ, Kirkebøen KA, Landsverk SA Abstract Background: Exhaled carbon dioxide (CO2) reflects cardiac output (CO) provided stable ventilation and metabolism. Detecting CO changes may help distinguish hypovolemia or cardiac dysfunction from other causes of haemodynamic instability. We investigated whether CO2 measured as end-tidal concentration (EtCO2) and eliminated volume per breath (VtCO2) reflect sudden changes in cardiac output (CO). Methods: We measured changes in CO, VtCO2, and EtCO2 during right ventricular pacing and passive leg raise in 33 ventilated patients ...
Source: Critical Care Research and Practice - July 11, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest.
Conclusions: Urine levels of β2M, osteopontin, and TFF3 at admission and day three were associated with increased risk for AKI, mortality, and PNO in comatose OHCA patients. This trail is registered with NCT01239420. PMID: 31205786 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - June 19, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Modified Sick Neonatal Score (MSNS): A Novel Neonatal Disease Severity Scoring System for Resource-Limited Settings.
This study was planned to evaluate Modified Sick Neonatal Score (MSNS), a novel neonatal disease severity score designed for resource-constrained settings. It was a facility-based cross-sectional analytical study, conducted in the "Special Newborn Care Unit" (SNCU) of government district hospital, attached to Kasturba Medical College, Mangalore, India from November 2016 to October 2017. A convenience sample of 585 neonates was included. Disease severity was assessed immediately at admission using MSNS. MSNS had 8 parameters with 0, 1, and 2 scores for each. 41% of study population was preterm (n=240), and 84.1% h...
Source: Critical Care Research and Practice - June 19, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Identification of Maltase Glucoamylase as a Biomarker of Acute Kidney Injury in Patients with Cirrhosis.
Conclusions: Patients with cirrhosis and AKI have upregulation of renal brush border disaccharidase, MGAM, in urinary exosomes which may differentiate the type of kidney injury in cirrhosis; however, the clinical significance of this requires further validation. PMID: 31179128 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - June 12, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Relationship between Microcirculatory Perfusion and Arterial Elastance: A Pilot Study.
Authors: Bond O, De Santis P, Iesu E, Franchi F, Vincent JL, Creteur J, Taccone FS, Scolletta S Abstract Background: Arterial elastance (Ea) represents the total afterload imposed on the left ventricle, and it is largely influenced by systemic vascular resistance (SVR). Although one can expect that Ea is influenced by peripheral endothelial function, no data are available to support it in patients. The aim of this study was to investigate the relationship between Ea, SVR, and microvascular perfusion in critically ill patients undergoing the fluid challenge (FC). Methods: A prospective study in patients receivin...
Source: Critical Care Research and Practice - May 5, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Epidural Analgesia for Severe Chest Trauma: An Analysis of Current Practice on the Efficacy and Safety.
Conclusion: Epidural analgesia was successful in 59% of patients; however, 30% needed additional analgesic interventions. As about half of the patients had epidural-related complications, it remains debatable whether epidural analgesia is a sufficient treatment modality in patients with multiple rib fractures. PMID: 31016043 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - April 26, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Anemia, Blood Transfusion, and Filter Life Span in Critically Ill Patients Requiring Continuous Renal Replacement Therapy for Acute Kidney Injury: A Case-Control Study.
Authors: Al-Dorzi HM, Alhumaid NA, Alwelyee NH, Albakheet NM, Nazer RI, Aldakhil SK, AlSaif SA, Masud N Abstract Background: Filter clotting is frequent during continuous renal replacement therapy (CRRT), which increases anemia risk. We studied anemia and blood transfusion in critically ill patients requiring CRRT for acute kidney injury and assessed the relationship between CRRT filter life span and PRBC transfusion. Methods: A case-control study was conducted at a tertiary-care intensive care unit (ICU) where CRRT cases were matched with controls for age, gender, admission category, and severity of illness. D...
Source: Critical Care Research and Practice - March 7, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Corrigendum to "Factors Associated with the Incidence and Severity of New-Onset Atrial Fibrillation in Adult Critically Ill Patients".
Corrigendum to "Factors Associated with the Incidence and Severity of New-Onset Atrial Fibrillation in Adult Critically Ill Patients". Crit Care Res Pract. 2019;2019:5710734 Authors: Duarte PAD, Leichtweis GE, Andriolo L, Delevatti YA, Jorge AC, Fumagalli AC, Santos LC, Miura CK, Saito SK Abstract [This corrects the article DOI: 10.1155/2017/8046240.]. PMID: 30838134 [PubMed - in process] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - March 7, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Procalcitonin Value Is an Early Prognostic Factor Related to Mortality in Admission to Pediatric Intensive Care Unit.
Conclusion: We suggest that the initial PCT and CRP levels during admission can be used to predict the outcome of patients in PICU. PMID: 30675399 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - January 25, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

The Effect of Support Surfaces on the Incidence of Pressure Injuries in Critically Ill Patients: A Randomized Clinical Trial.
Authors: Bueno de Camargo WH, Pereira RC, Tanita MT, Heko L, Grion IC, Festti J, Mezzaroba AL, Carvalho Grion CM Abstract Purpose: To analyze whether a viscoelastic mattress support surface can reduce the incidence of stage 2 pressure injuries compared to a standard hospital mattress with pyramidal overlay in critically ill patients. Method: A randomized clinical trial with intention-to-treat analysis was carried out recruiting patients with Braden scale ≤14 on intensive care unit admission from April 2016 to April 2017. Patients were allocated into two groups: intervention group (viscoelastic mattress) and ...
Source: Critical Care Research and Practice - January 22, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Ex Vivo Evaluation of Secretion-Clearing Device in Reducing Airway Resistance within Endotracheal Tubes.
Authors: Waters C, Wiener RC, Motlagh HM Abstract Background: Secretions accumulate in endotracheal tubes' (ETT) lumens upon their placement in patients. The secretions impact airway resistance and pressure. Secretions potentiate prolonged mechanical ventilation and ventilator-associated pneumonia. Our primary objective in this study was to evaluate an ETT-clearing device (ETT-CD) in its ability to remove secretions from ex vivo ETT lumens. Methods: Forty ETTs, obtained from intensive care patients at extubation, were individually placed into a ventilator field performance testing simulator at 37°C. The pre...
Source: Critical Care Research and Practice - January 18, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

The Role of Antifungals in Pediatric Critical Care Invasive Fungal Infections.
This study reviews important antifungals in the pediatric critical care setting including the pharmacologic properties, antifungal spectrum, adverse effects, and clinical uses of agents belonging to the four major classes of antifungals-the polyenes, azoles, echinocandins, and pyrimidine analogue flucytosine. The polyenes and azoles are the most often used classes of antifungals. The echinocandins are a relatively newer class of antifungal agents that offer excellent Candida activity and are currently recommended as the first-line therapy for invasive candidiasis. PMID: 30595916 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - January 2, 2019 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Current Evidence for the Use of Smoflipid ® Emulsion in Critical Care Patients for Parenteral Nutrition.
Current Evidence for the Use of Smoflipid® Emulsion in Critical Care Patients for Parenteral Nutrition. Crit Care Res Pract. 2018;2018:6301293 Authors: Leguina-Ruzzi AA, Ortiz R Abstract There are strong data showing that malnutrition is highly prevalent in intensive care unit patients (20-50% in the worldwide), presenting a negative accumulated body energy balance. This results in an increased mortality, infections, and hospital length stay with high costs associated with the total treatment. Parenteral nutrition is the first option when the patient's physical condition is not suitable for oral nu...
Source: Critical Care Research and Practice - December 28, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Emerging Evidence concerning the Role of Sirtuins in Sepsis.
Authors: Li L, Chen Z, Fu W, Cai S, Zeng Z Abstract Sepsis, a dysregulated host response to infection, is a major public health concern. Though experimental and clinical studies relating to sepsis are increasing, the mechanism of sepsis is not completely understood. To date, numerous studies have shown that sirtuins (silent mating type information regulation 2 homolog), which belong to the class III histone deacetylases, may have a varied, or even opposite, effect in the pathogenesis of sepsis. Notably, downstream mechanisms of sirtuins are not fully understood. The sirtuin family consists of sirtuins 1-7; among th...
Source: Critical Care Research and Practice - December 13, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Gait Speed Is Not Associated with Vasogenic Shock or Cardiogenic Shock following Cardiac Surgery, but Is Associated with Increased Hospital Length of Stay.
Conclusion: There was no significant association between gait speed and the incidence of cardiogenic or vasogenic shock after cardiac surgery. Gait speed was associated with increased hospital length of stay and need for a permanent pacemaker after cardiac surgery. PMID: 30425858 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - November 16, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Institutional Incidence of Severe tPA-Induced Angioedema in Ischemic Cerebral Vascular Accidents.
Conclusion: This study found a higher incidence of severe angioedema than that reported. Development of severe angioedema increased length of stay but was not shown to worsen outcomes in regards to death. Consistent with previous studies, ACE inhibitor use was associated with a higher risk of developing angioedema. PMID: 30363665 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - October 27, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Creatinine- and Cystatin C-Based Incidence of Chronic Kidney Disease and Acute Kidney Disease in AKI Survivors.
Authors: Rimes-Stigare C, Ravn B, Awad A, Torlén K, Martling CR, Bottai M, Mårtensson J, Bell M Abstract Background: Renal dysfunction after acute kidney injury (AKI) is common, potentially modifiable, but poorly understood. Acute kidney disease (AKD) describes renal dysfunction 7 to 90 days after AKI and is determined by percentage change in creatinine from baseline. Chronic kidney disease (CKD) is defined as the estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m2 persisting for more than 90 days. We compared CKD incidence using both creatinine- and cystatin C-based G...
Source: Critical Care Research and Practice - October 27, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Prevalence and Temporal Distribution of Extrasystoles in Septic ICU Patients: The Feasibility of Predicting Fluid Responsiveness Using Extrasystoles.
Conclusions: Extrasystoles are available for fluid responsiveness prediction in septic patients in about half of the time. With this extrasystolic availability, we believe the method to be considered for clinical use, provided that future studies validate the method's fluid responsiveness prediction ability. PMID: 30364006 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - October 27, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Outcome in Patients with Isolated Moderate to Severe Traumatic Brain Injury.
Conclusion: In-hospital mortality in isolated brain injured patients was 33%. The vast majority died after a decision to withdraw life-sustaining treatment. None of the patients were discharged with an unresponsive wakefulness syndrome. PMID: 30345113 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - October 23, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Characteristics, Outcomes, and Cost Patterns of High-Cost Patients in the Intensive Care Unit.
Authors: Reardon PM, Fernando SM, Van Katwyk S, Thavorn K, Kobewka D, Tanuseputro P, Rosenberg E, Wan C, Vanderspank-Wright B, Kubelik D, Devlin RA, Klinger C, Kyeremanteng K Abstract Background: ICU care is costly, and there is a large variation in cost among patients. Methods: This is an observational study conducted at two ICUs in an academic centre. We compared the demographics, clinical data, and outcomes of the highest decile of patients by total costs, to the rest of the population. Results: A total of 7,849 patients were included. The high-cost group had a longer median ICU length of stay (26 versus 4 days, P
Source: Critical Care Research and Practice - September 26, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Emergency Laparotomy in the Critically Ill: Futility at the Bedside.
Authors: Martin ND, Patel SP, Chreiman K, Pascual JL, Braslow B, Reilly PM, Kaplan LJ Abstract Background: Critically ill patients are often evaluated for an intra-abdominal catastrophe. In the absence of a preoperative diagnosis, abdominal exploration may be offered despite desperate circumstances. We hypothesize that (1) abdominal exploration for such patients is associated with a high mortality and (2) commonly obtained physiologic measures at laparotomy anticipate mortality. Methods: All acute care surgery (ACS) patients undergoing emergency laparotomy at a quaternary referral center during a 3-year period ...
Source: Critical Care Research and Practice - September 20, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Predictors of Major Depressive Disorder following Intensive Care of Chronically Critically Ill Patients.
Conclusions: Every fifth CCI patient suffers from MDD up to six months after being discharged from ICU. Particularly, perceived helplessness during the ICU stay seems to mainly affect the long-term evolvement of MDD. CCI patients with symptoms of acute stress disorder/PTSD should also be screened for MDD. PMID: 30155292 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 31, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Updates in Neurocritical Care.
Authors: Lazaridis C, Altaweel L, Karakitsos D PMID: 30155293 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 31, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-Analysis.
Conclusions: Buprenorphine provided a longer duration of analgesia than morphine. This in combination with its unique sublingual preparation could prove particularly advantageous in the paediatric population. The studies included are likely underpowered to detect differences in the incidence of adverse effects; therefore, the same precautions should be taken as with any other opioid. PMID: 30159170 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 31, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

A Proposal for an Intermediate Care Unit-Quality Measurement Framework.
Conclusions. Current focus in IMCU quality research is towards measuring quality at the IMCU itself. Since the influence of the structure of IMCUs on its utilization and its effects on hospital outcome are only rarely investigated, attention should shift towards these important issues in further research. The proposed IMCU quality measurement framework can thereby serve as a helpful tool. PMID: 30151281 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 30, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Improved Outcomes following the Establishment of a Neurocritical Care Unit in Saudi Arabia.
Authors: Soliman I, Aletreby WT, Faqihi F, Mahmood NN, Ramadan OE, Mady AF, Kahlon B, Alharthy A, Brindley P, Karakitsos D Abstract Background: Dedicated neurocritical care units have dramatically improved the management and outcome following brain injury worldwide. Aim: This is the first study in the Middle East to evaluate the clinical impact of a neurocritical care unit (NCCU) launched within the diverse clinical setting of a polyvalent intensive care unit (ICU). Design and Methods: A retrospective before and after cohort study comparing the outcomes of neurologically injured patients. Group one met crit...
Source: Critical Care Research and Practice - August 21, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Effects of Neuromuscular Electrical Stimulation of the Quadriceps and Diaphragm in Critically Ill Patients: A Pilot Study.
Conclusions: Electrical stimulation of quadriceps had best outcomes for peripheral muscle strength compared with controls or electrical stimulation of diaphragm among mechanically ventilated critically ill subjects and promoted functional independence and decreased length of hospitalization. PMID: 30123586 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 21, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Reversal Strategies for Intracranial Hemorrhage Related to Direct Oral Anticoagulant Medications.
This article is an attempt to provide an overview of the management of hemorrhage, especially ICH, related to DOAC use. PMID: 30073093 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 4, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Update in the Early Management and Reperfusion Strategies of Patients with Acute Ischemic Stroke.
Authors: Mendez AA, Samaniego EA, Sheth SA, Dandapat S, Hasan DM, Limaye KS, Hindman BJ, Derdeyn CP, Ortega-Gutierrez S Abstract Acute ischemic stroke (AIS) remains a leading cause of death and long-term disability. The paradigms on prehospital care, reperfusion therapies, and postreperfusion management of patients with AIS continue to evolve. After the publication of pivotal clinical trials, endovascular thrombectomy has become part of the standard of care in selected cases of AIS since 2015. New stroke guidelines have been recently published, and the time window for mechanical thrombectomy has now been extended u...
Source: Critical Care Research and Practice - July 28, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Combination of APACHE Scoring Systems with Adductor Pollicis Muscle Thickness for the Prediction of Mortality in Patients Who Spend More Than One Day in the Intensive Care Unit.
Conclusion: Although improvements in the area under ROC curves were not statistically significant when the APM thickness added to the APACHE systems, but the numerical value added to AUCs are considerable. PMID: 29973987 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - July 7, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Exploring Factors Affecting the Emergency Specialists' Decision-Making in Case of Emergencies in Patients.
Conclusions. The conditions governing the decision-making process about patients in the emergency department differ from the conditions in other health-care departments at hospitals. Emergency specialists may have several approaches to decide about the patients' emergency conditions. Therefore, notably, the emergency specialists' working conditions and the others' expectations from these specialists should be considered. PMID: 29888001 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - June 12, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

New Optic Nerve Sonography Quality Criteria in the Diagnostic Evaluation of Traumatic Brain Injury.
Authors: Soliman I, Johnson GGRJ, Gillman LM, Zeiler FA, Faqihi F, Aletreby WT, Balhamar A, Mahmood NN, Ahmad Mumtaz S, Alharthy A, Lazaridis C, Karakitsos D Abstract Background: New sonographic quality criteria to optimize optic nerve sheath diameter (ONSD) measurements were suggested. The latter were correlated to elevated intracranial pressure (ICP) in traumatic brain injury (TBI). Aim: We investigated whether ONSD measurements were correlated to simultaneous ICP measurements in severe TBI. Methods: Forty patients with severe TBI (Marshall Scale ≥II and GCS ≤8) participated in the study. All patien...
Source: Critical Care Research and Practice - June 5, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Clinical Utility of a Structured Program to Reduce the Risk of Health-Related Quality of Life Impairment after Discharge from Intensive Care Unit: A Real-World Experience.
Conclusion: In this real-world analysis that lacks a control group, patients who used a program aimed at minimizing the risk of HRQoL deterioration and PICS reported a good perception of their state of health with a relatively low prevalence of PICS. PMID: 29854449 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - June 5, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Child Psychiatry Engagement in the Management of Delirium in Critically Ill Children.
Conclusions: Child psychiatry can play an integral role in collaborative management of PICU delirium. Continuity of care with child psychiatry after transfer or discharge is particularly important given the prevalence of antipsychotic use. Furthermore, the results of this retrospective study would suggest that staff education surrounding the delirium screening tool increased awareness of delirium, resulting in an increase in child psychiatry consultations. PMID: 29854450 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - June 5, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Design and Deployment of a Pediatric Cardiac Arrest Surveillance System.
Conclusion: By leveraging hospital information technology and medical device data, identification of pediatric cardiac arrest with an associated increased capture in the proportion of objective performance data is possible. PMID: 29854451 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - June 5, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Updates in Refractory Status Epilepticus.
Authors: Marawar R, Basha M, Mahulikar A, Desai A, Suchdev K, Shah A Abstract Refractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can be seen in up to 40% of cases of status epilepticus with an acute symptomatic etiology as the most likely cause. New-onset refractory status epilepticus (NORSE) is a recently coined term for refractory status epilepticus where no apparent cause is found after initial testing. A large proportion of NORSE cases are eventually found to have an autoimmune etiology needing immunomodula...
Source: Critical Care Research and Practice - June 5, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Can Diaphragm Dysfunction Be Reliably Evaluated with Pocket-Sized Ultrasound Devices in Intensive Care Unit?
Conclusion: These results suggest that PSD can be useful in ICU patients for evaluating DD. But further studies are required to determine the exact place of these devices in evaluation of DD in ICU patients. PMID: 29808117 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - May 31, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Cerebral Pathophysiology in Extracorporeal Membrane Oxygenation: Pitfalls in Daily Clinical Management.
Authors: Kazmi SO, Sivakumar S, Karakitsos D, Alharthy A, Lazaridis C Abstract Extracorporeal membrane oxygenation (ECMO) is a life-saving technique that is widely being used in centers throughout the world. However, there is a paucity of literature surrounding the mechanisms affecting cerebral physiology while on ECMO. Studies have shown alterations in cerebral blood flow characteristics and subsequently autoregulation. Furthermore, the mechanical aspects of the ECMO circuit itself may affect cerebral circulation. The nature of these physiological/pathophysiological changes can lead to profound neurological compli...
Source: Critical Care Research and Practice - May 12, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Intensive Care Unit Rotations and Predictors of Career Choice in Pulmonary/Critical Care Medicine: A Survey of Internal Medicine Residency Directors.
Authors: Minter DJ, Levy SD, Rao SR, Currier PF Abstract Background: The United States (US) is experiencing a growing shortage of critical care medicine (CCM) trained physicians. Little is known about the exposures to CCM experienced by internal medicine (IM) residents or factors that may influence their decision to pursue a career in pulmonary/critical care medicine (PCCM). Methods: We conducted a survey of US IM residency program directors (PDs) and then used multivariable logistic regression to identify factors that were predictive of residency programs with a higher percentage of graduates pursuing careers ...
Source: Critical Care Research and Practice - April 26, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Efficacy of Dexmedetomidine versus Ketofol for Sedation of Postoperative Mechanically Ventilated Patients with Obstructive Sleep Apnea.
Authors: Elmoutaz Mahmoud H, Rashwan DAE Abstract Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex: received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2-0.7 mcg/kg/hr; Group KFL: received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofo...
Source: Critical Care Research and Practice - April 8, 2018 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Survey of Extent of Translation of Oral Healthcare Guidelines for ICU Patients into Clinical Practice by Nursing Staff.
Authors: Agarwal V, Singhal R, Khanna R, Rastogi P, Agarwal A, Tripathi S Abstract Nosocomial infections in critically ill/ventilated patients result from bacterial load in oropharyngeal regions. Oral decontamination serves as the easiest effective means of controlling infections. Knowledge, attitude, and practices followed by healthcare personnel in intensive care settings need to be assessed to implement concrete measures in health-care. Survey questionnaire was constructed and implemented following its validation on seventy nursing and paramedical staff working in government and private intensive care units thro...
Source: Critical Care Research and Practice - December 2, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Challenges with Surveillance of Healthcare-Associated Infections in Intensive Care Units in South Africa.
Conclusions: A manual system that adds to the administrative workload of nurses is not an effective method of measuring the burden of HAIs. Change management is required to promote an organizational culture that supports accurate data collection for HAIs. PMID: 29158918 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - November 23, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Improvement in Quality Metrics Outcomes and Patient and Family Satisfaction in a Neurosciences Intensive Care Unit after Creation of a Dedicated Neurocritical Care Team.
This study evaluated the impact of newly appointed neurointensivists and creation of a neurocritical care team on quality outcome measures including patient satisfaction in a NSICU. Methods: This is a retrospective study of data over 36 months from a 14-bed NSICU evaluating quality outcome measures and anonymous patient satisfaction questionnaires before and after neurointensivists appointment. Results: After appointment of neurointensivists, patient acuity of the NSICU increased by 33.4% while LOS decreased by 3.5%. There was a decrease in neurosciences mortality (35.8%), catheter-associated urinary tract infectio...
Source: Critical Care Research and Practice - November 10, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research