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This page shows you the most recent publications within this specialty of the MedWorm directory.

Recovery of sit-to-stand function in patients with intensive-care-unit-acquired muscle weakness: Results from the General Weakness Syndrome Therapy cohort study.
CONCLUSION: Rapid recovery of sit-to-stand function for most patients with intensive-care-unit-acquired muscle weakness were seen. The variables older age and longer duration of ventilation decreased, and higher FSS-ICU increased the chance of regaining independent sit-to-stand function. PMID: 27670853 [PubMed - as supplied by publisher] (Source: Journal of Rehabilitation Medicine)
Source: Journal of Rehabilitation Medicine - September 29, 2016 Category: Rehabilitation Tags: J Rehabil Med Source Type: research

Fluid overload and outcomes in neonates receiving continuous renal replacement therapy
ConclusionsNeonates with a higher percentage FO and higher levels of serum creatinine at CRRT initiation showed poor outcomes. Early initiation of CRRT before the development of severe FO or azotemia might improve the outcomes of neonates requiring CRRT. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - September 29, 2016 Category: Urology & Nephrology Source Type: research

Muscle disorders: Preventing diaphragm dysfunction
Nature Reviews Drug Discovery 15, 678 (2016). doi:10.1038/nrd.2016.196 Author: Sarah Crunkhorn Mechanical ventilation of critically ill patients can result in ventilation-induced diaphragm dysfunction. Here, using a rat intensive care unit model of mechanical ventilation, Salah et al. show that such negative effects on diaphragm muscle are caused by impaired myosin function, which is related to (Source: Nature Reviews Drug Discovery)
Source: Nature Reviews Drug Discovery - September 29, 2016 Category: Drugs & Pharmacology Authors: Sarah Crunkhorn Tags: Research Highlight Source Type: research

First report of macroscopic biofilm formation caused by Candida albicans on silver hydrogel –coated urinary catheters
We report macroscopic biofilms on silver hydrogel–coated urinary catheters in 2 patients from 2 different intensive care units. The catheters were removed on observation of a white, jelly layer on the catheters, respectively, 9 and 21 days after insertion. Yeast cells and pseudohyphal structures were observed with microscopy. Both isolates were identified as Candida albicans. To our knowledge, these are the first cases demonstrating the formation of macroscopic biofilm layers on silver nitrate–coated catheters in the literature. (Source: American Journal of Infection Control)
Source: American Journal of Infection Control - September 29, 2016 Category: Infectious Diseases Source Type: research

A systematic review of observational pain assessment instruments for use with nonverbal intubated critically ill adult patients in the emergency department: an assessment of their suitability and psychometric properties
ConclusionThe use of an appropriate and valid observational pain assessment instrument is fundamental to detecting and optimising pain management in nonverbal critically ill intubated patients in the ED. Of the observational pain assessment instruments reviewed, the Critical Care Pain Observation Tool was identified as most appropriate for testing in a prospective trial in an ED setting.This article is protected by copyright. All rights reserved. (Source: Journal of Clinical Nursing)
Source: Journal of Clinical Nursing - September 29, 2016 Category: Nursing Authors: Wayne Varndell, Margaret Fry, Doug Elliott Tags: Review Source Type: research

MITK-OpenIGTLink for combining open-source toolkits in real-time computer-assisted interventions
ConclusionWith the integration of OpenIGTLink into MITK, this protocol is now supported by all established open-source toolkits in the field. This eases interoperability between MITK and toolkits such as PLUS or 3D Slicer and facilitates cross-toolkit research collaborations. MITK and its submodule MITK-OpenIGTLink are provided open source under a BSD-style licence (http://mitk.org). (Source: International Journal of Computer Assisted Radiology and Surgery)
Source: International Journal of Computer Assisted Radiology and Surgery - September 29, 2016 Category: Intensive Care Source Type: research

The corrective effect of norepinephrine on hypotension induced by dexmedetomidine for  critical patients: a clinical study
CONCLUSION: Dexmedetomidine plays an important role in ICU patients due to its pharmacological ability of sedation and analgesia. In our study, dexmedetomidine was successfully applied to ensure goal-directed sedation therapy (GDST). Norepinephrine can correct hypotension and bradycardia induced by intravenous dexmedetomidine. According to the hemodynamic indexes and oxygen metabolism indexes, the application of dexmedetomidine or the combination of dexmedetomidine with norepinephrine are both safe and appropriate to maintain the sedation status and hemodynamic situation in ICU patients.
. PMID: 27668696 [PubMed - as...
Source: International Journal of Clinical Pharmacology and Therapeutics - September 28, 2016 Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research

Skin Rounds: A Quality Improvement Approach to Enhance Skin Care in the Neonatal Intensive Care Unit.
Abstract BACKGROUND: Skin injuries are common among neonatal intensive care unit (NICU) patients and may lead to significant complications. Standardized methods of preventing, detecting, and treating skin injuries are needed. PURPOSE: The aim of this project was to standardize the assessment, documentation, and tracking of skin injuries among hospitalized neonatal patients and to determine the incidence of pressure ulcers in this patient population. METHODS: (1) Creation of an interdisciplinary skin team to identify skin injuries through weekly skin rounds. (2) Assessment of all patients at least twice d...
Source: Advances in Neonatal Care - September 28, 2016 Category: Nursing Authors: Nist MD, Rodgers EA, Ruth BM, Bertoni CB, Bartman T, Keller LA, Dail JW, Gardikes-Gingery R, Shepherd EG Tags: Adv Neonatal Care Source Type: research

Diaper Dermatitis: What Do We Do Next?
Abstract Diaper dermatitis is a major issue among hospitalized infants, leading to increased medical costs, pain, risk for infection, and distress among patients and caregivers. An evidence-based algorithm for prevention and treatment of diaper dermatitis was developed and introduced in a level IV neonatal intensive care unit (NICU). Two cases are discussed as examples of severe diaper dermatitis. The first case demonstrates the final case of severe diaper dermatitis since the introduction of the algorithm. The second case demonstrates a less severe, but equally frustrating, case of diaper dermatitis that occurred...
Source: Advances in Neonatal Care - September 28, 2016 Category: Nursing Authors: Esser M Tags: Adv Neonatal Care Source Type: research

Extremely Preterm Infant Skin Care: A Transformation of Practice Aimed to Prevent Harm.
We describe the use of a harm prevention, or consequence-centered, approach to skin care, which facilitates safer practice for extremely premature infants. METHOD: Neonatal and pediatric Advanced Practice Registered Nurses (APRN) came together for monthly meetings to review the evidence around best skin care practices for extremely preterm infants, with an emphasis on reduction of skin harm. Findings were focused on the population of interest and clinical implementation strategies. FINDINGS: Skin care for extremely preterm infants remains overlooked by current literature. However, clinical practice pearls were ex...
Source: Advances in Neonatal Care - September 28, 2016 Category: Nursing Authors: Johnson DE Tags: Adv Neonatal Care Source Type: research

Bathing and Beyond: Current Bathing Controversies for Newborn Infants.
Abstract BACKGROUND: Bathing the newborn infant is controversial, ranging from how and when to give the newborn their first bath, whether to bathe newborns at all in the initial days of life, and how to approach bathing the hospitalized premature and full-term infant in the neonatal intensive care unit (NICU). PURPOSE: To review relevant literature about bathing newborn infants, as well as examine the controversies about bathing NICU patients including the use of daily chlorhexidine gluconate (CHG) baths. FINDINGS: Despite studies showing that temperature can be maintained when the first bath was at 1 ho...
Source: Advances in Neonatal Care - September 28, 2016 Category: Nursing Authors: Lund C Tags: Adv Neonatal Care Source Type: research

Nursing Management of Delirium in the Postanesthesia Care Unit and Intensive Care Unit.
CONCLUSIONS: Nurses need to be supported to take part in courses, conferences, and training seminars. A standard data tool or scale needs to be used to assess delirium routinely in all patients admitted. PMID: 27667346 [PubMed - in process] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - September 28, 2016 Category: Nursing Authors: Karabulut N, Yaman Aktaş Y Tags: J Perianesth Nurs Source Type: research

Risk factors for methicillin-resistant Staphylococcus aureus colonisation or infection in intensive care units and their reliability for predicting MRSA on ICU admission.
We describe risk factors for colonisation/infection related to MRSA (MRSA-C/I) in critically ill patients once in the ICU and on ICU admission, and search for an easy-to-use predictive model for MRSA colonisation/infection on ICU admission. This multicentre cohort study included 69,894 patients admitted consecutively (stay>24h) in April-June in the five-year period 2006-2010 from 147 Spanish ICUs participating in the National Surveillance Study of Nosocomial Infections in ICUs (ENVIN-HELICS). Data from all patients included were used to identify risk factors for MRSA-C/I during ICU stays, from admission to discharge, us...
Source: Infezioni in Medicina - September 28, 2016 Category: Infectious Diseases Tags: Infez Med Source Type: research

Drug dosage in continuous venoveno hemofiltration in critically ill children.
Authors: Assadi F, Shahrbaf FG Abstract The dosage of drugs in patients requiring continuous renal replacement therapy need to be adjusted based on a number of variables that that affect pharmacokinetics (PK) including patient weight, CRRT modality (convention, vs. diffusion), blood and/or effluent flow, hemofilter characteristics, physiochemical drug properties, volume of distribution, protein binding and half-life as well as residual renal function. There is a paucity of data on PK studies in children with acute kidney injury requiring CRRT. When possible, therapeutic drug monitoring should be utilized for those ...
Source: Frontiers in Bioscience - Scholar - September 28, 2016 Category: Biomedical Science Tags: Front Biosci (Schol Ed) Source Type: research

The use of multiplex PCR for the diagnosis of viral severe acute respiratory infection in children: a high rate of co-detection during the winter season
This study confirms the high rate of detection of viral nucleic acids by multiplex PCR among hospitalized children admitted with SARI, as well as the high rate of co-de tection of multiple viruses. AdV, HBoV, HRV, HEV, and HCoV-OC43 were also detected in asymptomatic children, resulting in challenges in clinical interpretation. Studies are required to provide quantitative conclusions that will facilitate clinical interpretation and application of the results in the clinical setting. (Source: European Journal of Clinical Microbiology and Infectious Diseases)
Source: European Journal of Clinical Microbiology and Infectious Diseases - September 28, 2016 Category: Microbiology Source Type: research

Bleeding complications of anticoagulant therapy in sepsis-induced disseminated intravascular coagulation
(Source: Critical Care)
Source: Critical Care - September 28, 2016 Category: Intensive Care Authors: Toshiaki Iba Source Type: research

Adrenaline use is associated with excess organ injury and mortality in cardiogenic shock: facts and fiction
(Source: Critical Care)
Source: Critical Care - September 28, 2016 Category: Intensive Care Authors: Shou-Yin Jiang, Ye-Hua Shen and Xiao-Gang Zhao Source Type: research

Can diaphragmatic ultrasonography performed during the T-tube trial predict weaning failure? The role of diaphragmatic rapid shallow breathing index
The rapid shallow breathing index (RSBI), which is the ratio between respiratory rate (RR) and tidal volume (VT), is one of the most widely used indices to predict weaning outcome. Whereas the diaphragm plays ... (Source: Critical Care)
Source: Critical Care - September 28, 2016 Category: Intensive Care Authors: Savino Spadaro, Salvatore Grasso, Tommaso Mauri, Francesca Dalla Corte, Valentina Alvisi, Riccardo Ragazzi, Valentina Cricca, Giulia Biondi, Rossella Di Mussi, Elisabetta Marangoni and Carlo Alberto Volta Source Type: research

IJERPH, Vol. 13, Pages 962: A Brief Cognitive-Behavioral Psycho-Education (B-CBE) Program for Managing Stress and Anxiety of Main Family Caregivers of Patients in the Intensive Care Unit
Having a loved one in the intensive care unit (ICU) is a stressful event, which may cause a high level of anxiety to the family members. This could threaten their wellbeing and ability to support the patients in, or after discharge from, the ICU. To investigate the outcomes of a brief cognitive-behavioral psycho-education program (B-CBE) to manage stress and anxiety of the main family caregivers (MFCs), a pragmatic quasi-experimental study involving 45 participants (treatment group: 24; control group: 21) was conducted in an ICU. The Depression and Anxiety Stress Scale and the Critical Care Family Need Inventory were used ...
Source: International Journal of Environmental Research and Public Health - September 28, 2016 Category: Environmental Health Authors: Vico Chiang Wai Chien Ho Wong Rainbow Lee Juana Ha Sharron Leung Daniel Wong Tags: Article Source Type: research

Paediatric chronic pain
Publication date: Available online 27 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Paul M. Rolfe Chronic pain in childhood is common and if untreated may lead to significant pain-related disability, emotional disturbance and poor school attendance. These children and adolescents are often successfully managed outside of specialist paediatric pain management clinics in a wide range of clinical settings. However, some children require the expertise of a multidisciplinary pain management team in a dedicated paediatric centre. Following multidisciplinary assessment an individualized pain mana...
Source: Anaesthesia and intensive care medicine - September 28, 2016 Category: Anesthesiology Source Type: research

Predictors of intensive care unit utilization in patients with posterior reversible encephalopathy syndrome
AbstractPosterior reversible encephalopathy syndrome (PRES) is an acute neurological syndrome that requires prompt, aggressive management to improve outcomes. Our aim was to identify factors that would necessitate care in the intensive care unit (ICU) in patients with PRES and the outcomes on discharge following ICU stay. We retrospectively reviewed the medical records and radiological data of adult PRES patients admitted to our tertiary care medical center. We dichotomized them into two groups based on their need for ICU care and compared their clinical, laboratory, imaging characteristics and discharge outcomes. Outcomes...
Source: Acta Neurologica Belgica - September 28, 2016 Category: Neurology Source Type: research

PROTECT – Trial: A multicentre prospective pragmatic RCT and health economic analysis of the effect of tailored repositioning to prevent pressure ulcers – study protocol
This study is approved by the Ethics Committee (February 2016). DiscussionData collection is currently ongoing. The results are expected to be obtained in March 2017.This article is protected by copyright. All rights reserved. (Source: Journal of Advanced Nursing)
Source: Journal of Advanced Nursing - September 28, 2016 Category: Nursing Authors: D De Meyer, N Van Damme, K Van Den Bussche, A Van Hecke, S Verhaeghe, D Beeckman Tags: Protocol Source Type: research

Infrequent cardiac manifestations of sarcoidosis
Cardiac sarcoidosis (CS) is found in 2 –7% of patients with systemic sarcoidosis (SS). Its diagnosis and treatment is challenging, notwithstanding the poor prognosis and treatment. Hereby, we present a case of systemic sarcoidosis with rare cardiac manifestations of severe mitral incompetence and large coronary aneurysm in a previously healthy woman. She underwent successful mitral valve replacement and coronary artery bypass surgery and was maintained on low dose glucocorticoid therapy. (Source: Heart and Lung)
Source: Heart and Lung - September 28, 2016 Category: Intensive Care Authors: Said Ashraf, Alexandros Briasoulis, Luis Afonso Source Type: research

Integration of safe sleep and sudden infant death syndrome (SIDS) education among parents of preterm infants in the Neonatal Intensive Care Unit (NICU)
Conclusion The educational session and safe sleep handout increased parental knowledge of safe sleep recommendations and SIDS prevention and resulted in significant compliance to safe sleep practices at home. (Source: Journal of Neonatal Nursing)
Source: Journal of Neonatal Nursing - September 28, 2016 Category: Perinatology & Neonatology Source Type: research

Therapeutic plasma exchange in primary hemophagocytic lymphohistiocytosis: reports of two cases and a review of the literature
We report two children who were diagnosed as having primary hemophagocytic syndrome and who successfully underwent therapeutic plasma exchange (TPE). The first patient was a 6-month-old girl diagnosed with HLH who was admitted to the pediatric intensive care unit. The patient's clinical condition worsened on the 9th day of the HLH-2004 treatment protocol. Her ferritin level was found 50.000 ng/mL, and TPE was performed for 9 sessions, after which her clinical condition and laboratory findings improved. (Source: Transfusion and Apheresis Science)
Source: Transfusion and Apheresis Science - September 28, 2016 Category: Hematology Authors: Seher Erdogan, Mehmet Bosnak, Elif Aktekin, Ali Bay Tags: Case Report Source Type: research

The impact of peripheral nerve blocks on perioperative outcome in hip and knee arthroplasty—a population-based study
Abstract: The role of anesthesia techniques on perioperative outcomes on a population level has recently gained widespread interest. Although mainly neuraxial vs general anesthesia has been addressed, population-level data on the impact of peripheral nerve blocks (PNBs) are still lacking. Therefore, we investigated the association between PNB use and outcomes using retrospective data on 1,062,152 recipients of hip and knee arthroplasties (total hip arthroplasty [THA]/total knee arthroplasty [TKA]) from the national Premier Perspective database (2006-2013). Multilevel multivariable logistic regression models measured associ...
Source: Pain - September 27, 2016 Category: Anesthesiology Tags: Research Paper Source Type: research

Vasopressors and inotropes in cardiogenic shock: is there room for “adrenaline resuscitation”?
(Source: Critical Care)
Source: Critical Care - September 27, 2016 Category: Intensive Care Authors: Nuccia Morici, Miriam Stucchi, Alice Sacco, Maurizio A. Bottiroli and Fabrizio Oliva Source Type: research

Stress hyperglycaemia in critically ill patients and the subsequent risk of diabetes: a systematic review and meta-analysis
Hyperglycaemia occurs frequently in critically ill patients without diabetes. We conducted a systematic review and meta-analysis to evaluate whether this ‘stress hyperglycaemia’ identifies survivors of critica... (Source: Critical Care)
Source: Critical Care - September 27, 2016 Category: Intensive Care Authors: Yasmine Ali Abdelhamid, Palash Kar, Mark E. Finnis, Liza K. Phillips, Mark P. Plummer, Jonathan E. Shaw, Michael Horowitz and Adam M. Deane Source Type: research

Acute kidney injury 2016: diagnosis and diagnostic workup
Acute kidney injury (AKI) is common and is associated with serious short- and long-term complications. Early diagnosis and identification of the underlying aetiology are essential to guide management. In this ... (Source: Critical Care)
Source: Critical Care - September 27, 2016 Category: Intensive Care Authors: Marlies Ostermann and Michael Joannidis Source Type: research

Implantable technology for pain management
Publication date: Available online 26 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Sanad Hadidi, G. Baranidharan Neuropathic pain is a well-recognized chronic pain condition. This can have a significant impact in patients' quality of life. Neuromodulation is defined by the International Neuromodulation Society as ‘the therapeutic alteration of activity in the central or peripheral nervous system either electrically or pharmacologically’. Electrical stimulation can be performed at the motor cortex, deep brain, spinal cord, dorsal root ganglion, peripheral nerve and peripheral nerve fie...
Source: Anaesthesia and intensive care medicine - September 27, 2016 Category: Anesthesiology Source Type: research

Piperacillin/tazobactam ‐induced immune‐mediated thrombocytopenia in the intensive care unit
We describe the first case of piperacillin/tazobactam‐induced immune‐mediated thrombocytopenia that was mitigated by the administration of corticosteroid therapy. This case highlights the importance of identifying potential drug‐related causes of isolated thrombocytopenia. Drug‐induced immune‐modulated thrombocytopenia (DITP) is thought to occur when drug‐dependent antibodies bind to the platelet membrane glycoproteins, leading to signalling for platelet consumption. This graph shows the change in this patient's platelet count after administration and discontinuation of piperacillin/tazobactam. (Source: Journa...
Source: Journal of Clinical Pharmacy and Therapeutics - September 27, 2016 Category: Drugs & Pharmacology Authors: K. Boyce, H. Brar, S. N. Stabler Tags: Case Report Source Type: research

Acute Kidney Injury Treated with Dialysis outside the Intensive Care Unit: A Retrospective Observational Single-Center Study
by Hannelore Sprenger-M ähr, Emanuel Zitt, Karl Lhotta IntroductionThe number of patients suffering from acute kidney injury requiring dialysis (AKI-D) is increasing. Whereas causes and outcome of AKI-D in the intensive care unit (ICU) are described extensively, few data exist about AKI-D patients treated outside the ICU. Aim of this study was to identify the causes of AKI-D, determine in-depth the comorbid conditions and outcome of this particular patient group and identify possibilities for its prevention. MethodsWe retrospectively studied all AKI-D patients treated outside the ICU in a single nephrology referral center...
Source: PLoS One - September 27, 2016 Category: Biomedical Science Authors: Hannelore Sprenger-M ähr Source Type: research

Early Physiotherapy by Passive Range of Motion Does Not Affect Partial Brain Tissue Oxygenation in Neurocritical Care Patients
Conclusions Based on ptiO2 measurements, our data provide new information about the feasibility and safety of physiotherapy in patients with severe brain diseases. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part A: Central European Neurosurgery)
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - September 27, 2016 Category: Neurosurgery Authors: Roth, Christian Stitz, Hubertus Kleffmann, Jens Kaestner, Stefanie Deinsberger, Wolfgang Ferbert, Andreas Gehling, Markus Tags: Original Article Source Type: research

Quality of Life in Relation to Length of Intensive Care Unit Stay After Cardiac Surgery
THERE IS A SIGNIFICANT knowledge gap regarding the impact of prolonged intensive care unit (ICU) stay on quality of life (QOL) after cardiac surgery. QOL has been defined as “a person’s sense of well-being that stems from satisfaction or dissatisfaction with the areas of life that are important to him/her.”1 (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 27, 2016 Category: Anesthesiology Authors: Mohammad Diab, Rajdeep Bilkhu, Gopal Soppa, Nadine McGale, Shashivadan P. Hirani, Stanton P. Newman, Marjan Jahangiri Tags: Review Article Source Type: research

Time to decannulation and associated risk factors in the post-acute rehabilitation of critically ill patients with intensive care unit-acquired weakness: a cohort study.
CONCLUSIONS: We described the detailed time course of decannulation in the rehabilitation of chronic critically ill patients and no adverse events were observed. Taken many single factors into account the quantity of medical tubes and the duration of weaning from respirator were associated risk factors for decannulation in this population. CLINICAL REHABILITATION IMPACT: Knowing an exact time course of decannulation supports medical decisions in clinical rehabilitation and might help to give a prognosis for decannulation. The amount of medical tubes and the duration of weaning from respirator may highly influence deca...
Source: European Journal of Physical and Rehabilitation Medicine - September 27, 2016 Category: Rehabilitation Authors: Thomas S, Sauter W, Starrost U, Pohl M, Mehrholz J Tags: Eur J Phys Rehabil Med Source Type: research

Climate change in cardiothoracic intensive care
(Source: Anaesthesia)
Source: Anaesthesia - September 26, 2016 Category: Anesthesiology Authors: N. Fletcher Tags: Editorial Source Type: research

Effects of N-acetylcysteine (NAC) supplementation in resuscitation fluids on renal microcirculatory oxygenation, inflammation, and function in a rat model of endotoxemia
In this study, we ev... (Source: Intensive Care Medicine Experimental)
Source: Intensive Care Medicine Experimental - September 26, 2016 Category: Surgery Authors: Bulent Ergin, Philippe Guerci, Lara Zafrani, Frank Nocken, Asli Kandil, Ebru Gurel-Gurevin, Cihan Demirci-Tansel and Can Ince Source Type: research

Real-life use of vasopressors and inotropes in cardiogenic shock —observation is necessarily ‘theory-laden’
(Source: Critical Care)
Source: Critical Care - September 26, 2016 Category: Intensive Care Authors: Samiran Ray, Mirjana Cvetkovic, Daniel H. Lutman, Nazima Pathan, Padmanabhan Ramnarayan, David P. Inwald and Mark J. Peters Source Type: research

The Assessment of Risk in Cardiothoracic Intensive Care (ARCtIC): prediction of hospital mortality after admission to cardiothoracic critical care
Summary The models used to predict outcome after adult general critical care may not be applicable to cardiothoracic critical care. Therefore, we analysed data from the Case Mix Programme to identify variables associated with hospital mortality after admission to cardiothoracic critical care units and to develop a risk‐prediction model. We derived predictive models for hospital mortality from variables measured in 17,002 patients within 24 h of admission to five cardiothoracic critical care units. The final model included 10 variables: creatinine; white blood count; mean arterial blood pressure; functional dependency; pl...
Source: Anaesthesia - September 26, 2016 Category: Anesthesiology Authors: J. Shahin, P. Ferrando ‐Vivas, G. S. Power, S. Biswas, S. T. Webb, K. M. Rowan, D. A. Harrison Tags: Original Article Source Type: research

Towards a new orientation: a qualitative longitudinal study of an intensive care recovery programme
ConclusionsThis study provides a contemporary understanding of the process of intensive care recovery. Recovery evolves through narratives of mortal danger, risk of relapse and moving forward towards a new orientation in life. Relevance to clinical practiceThese findings enable health care professionals to understand what patients experience during stages of recovery. This is important to improve health care professionals in the assessment of long‐term outcome, and management of patients after intensive care. (Source: Journal of Clinical Nursing)
Source: Journal of Clinical Nursing - September 26, 2016 Category: Nursing Authors: Janet F Jensen, Dorthe Overgaard, Morten H Bestle, Doris F Christensen, Ingrid Egerod Tags: Original Article Source Type: research

A Comparison of Morphine Delivery in Neonatal Opioid Withdrawal
The objective of this comparative study using a retrospective chart audit is to compare length of stay (LOS) and total accumulative morphine dose across these two morphine delivery protocols. Our audit revealed that there were a significantly higher proportion of newborns in the symptom-only model that received morphine and, perhaps accordingly, also had a significantly higher LOS compared to those in the weight-based model. Comparing only those infants who did receive morphine, the comparative total accumulative dose of morphine and LOS were not significantly different between the weight-based and symptom-only morphine de...
Source: Substance Abuse: Research and Treatment - September 26, 2016 Category: Addiction Authors: Brian Chisamore Safaa Labana Sandra Blitz Alice Ordean Source Type: research

Hyperglycemia: A Predictor of Death in Severe Head Injury Patients
Objectives: Management of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperglycemia in patients with traumatic head injury admitted to the intensive care unit (ICU). Methods: This prospective study included adults with traumatic primary brain injury with a Glasgow coma score of ≤8 necessitating mechanical ventilation treated in the period 2012–2015. After screening 311 patients, 220 were included i...
Source: Clinical Medicine Insights: Endocrinology and Diabetes - September 26, 2016 Category: Endocrinology Authors: Simin Babaie Kafaki Kamaledin Alaedini Ashkan Qorbani Leila Asadian Kaveh Haddadi Source Type: research

A family nursing educational intervention supports nurses and families in an adult intensive care unit
The family experience of critical illness is filled with distress that may have a lasting impact on family coping and family health. A nurse can become a source of comfort that helps the family endure. Yet, nurses often report a lack of confidence in communicating with families and families report troubling relationships with nurses. In spite of strong evidence supporting nursing practice focused on the family, family nursing interventions often not implemented in the critical care setting. This pilot study examined the influence of an educational intervention on nurses ’ attitudes towards and confidence in providing fam...
Source: Australian Critical Care - September 26, 2016 Category: Nursing Authors: Sandra K. Eggenberger, Marita Sanders Source Type: research

Challenges in Sepsis Care
There are 2 important recent changes in sepsis care. The first key change is the 2016 Sepsis-3 definitions from the recent consensus workgroup with new sepsis and septic shock definitions. Useful tools for assessing patients that have a greater risk of mortality include Sequential Organ Failure Assessment (SOFA) in intensive care units and quick SOFA outside intensive care units. The second change involves management of fluid resuscitation and measures of volume responsiveness. Measures such as blood pressure and central venous pressure are not reliable. Fluid challenges and responsiveness should be based on stroke volume ...
Source: Critical Care Nursing Clinics of North America - September 26, 2016 Category: Nursing Authors: Maureen A. Seckel, Thomas Ahrens Source Type: research

Clinical parameters that predict the need for medium or intensive care admission in intentional drug overdose patients – A retrospective cohort study
The objective of this study was to develop a decision tool, using parameters readily available in the emergency room (ER) for patients with an IDO, to identify patients requiring admission to a monitoring unit. (Source: Journal of Critical Care)
Source: Journal of Critical Care - September 26, 2016 Category: Intensive Care Authors: Huub L.A van den Oever, Mirja van Dam, Esther van ’t Riet, Frank G.A. Jansman Source Type: research

Selecting symptom instruments for cardiovascular populations
The purpose of this review is to provide a guide for researchers and clinicians in selecting an instrument to measure four commonly occurring symptoms (dyspnea, chest pain, palpitations, and fatigue) in cardiac populations (acute coronary syndrome, heart failure, arrhythmia/atrial fibrillation, and angina, or patients undergoing cardiac interventions). An integrative review of the literature was conducted. A total of 102 studies summarizing information on 36 different instruments are reported in this integrative review. (Source: Heart and Lung)
Source: Heart and Lung - September 26, 2016 Category: Intensive Care Authors: Lani Zimmerman, Bunny Pozehl, Karen Vuckovic, Susan Barnason, Paula Schulz, Yaewon Seo, Catherine J. Ryan, Julie J. Zerwic, Holli A. DeVon Source Type: research

Procedural safety of a fully implantable intravenous prostanoid pump for pulmonary hypertension
ConclusionsOur observational study provides preliminary evidence supporting the procedural safety of a fully implantable pump inserted under local or general anesthesia for patients with severe pulmonary hypertension. The observation of major complications in a subset of patients requires extensive pre- and post-operative assessments. Future trials are required to provide further evidence for the long-term safety and efficacy of the pump using this approach. (Source: Clinical Research in Cardiology)
Source: Clinical Research in Cardiology - September 26, 2016 Category: Cardiology Source Type: research

Are atherosclerotic risk factors associated with a poor prognosis in patients with hyperuricemic acute heart failure? The evaluation of the causal dependence of acute heart failure and hyperuricemia
AbstractAtherosclerosis induces the elevation of uric acid (UA), and an elevated UA level is well known to lead to a poor prognosis in patients with acute heart failure (AHF). However, the prognostic value of atherosclerotic risk factors in hyperuricemic AHF patients remains to be elucidated. The data from 928 patients who were admitted to the intensive care unit (ICU) at Nippon Medical School Chiba Hokusoh Hospital between January 2001 and December 2014, and whose serum UA levels were measured were screened. A total of 394 AHF patients with hyperuricemia were enrolled in this study. The patients were assigned to a low-ris...
Source: Heart and Vessels - September 26, 2016 Category: Cardiology Source Type: research

Atrial fibrillation following off-pump versus on-pump coronary artery bypass grafting: Incidence and risk factors.
CONCLUSIONS: In patients undergoing CABG, postoperative AF is a common arrhythmia independent of the type of surgical procedure. PMID: 27665857 [PubMed - as supplied by publisher] (Source: Cardiology Journal)
Source: Cardiology Journal - September 26, 2016 Category: Cardiology Authors: Lewicki Ł, Siebert J, Rogowski J Tags: Cardiol J Source Type: research

Maternal morbidity and perinatal outcomes among women in rural versus urban areas.
We examined the association between rural residence and severe maternal morbidity, in addition to perinatal mortality and morbidity. METHODS: We conducted a retrospective population-based cohort study of all women who gave birth in British Columbia, Canada, between Jan. 1, 2005, and Dec. 31, 2010. We compared maternal mortality and severe morbidity (e.g., eclampsia) and adverse perinatal outcomes (e.g., perinatal death) between women residing in areas with moderate to no metropolitan influence (rural) and those living in metropolitan areas or areas with a strong metropolitan influence (urban). We used logistic regress...
Source: cmaj - September 26, 2016 Category: Journals (General) Authors: Lisonkova S, Haslam MD, Dahlgren L, Chen I, Synnes AR, Lim KI Tags: CMAJ Source Type: research