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

Implementation of Patient-Centered Bedside Rounds in the Pediatric Intensive Care Unit
We describe the application of PDSA (Plan, Do, Study, Act) cycles in a quality improvement project to improve the process of rounds and increase family participation and provider satisfaction. We conducted pre-/postintervention surveys and used 5 process measures for a total of 1296 daily patient rounds over 7 months. We were successful in conducting family-centered rounds for 90% of patients, with 40% family participation and a 64.6% satisfactory rating by pediatric intensive care unit providers. (Source: Journal of Nursing Care Quality)
Source: Journal of Nursing Care Quality - March 3, 2015 Category: Nursing Tags: Articles Source Type: research

Surgical Suite to Pediatric Intensive Care Unit Handover Protocol: Implementation Process and Long-term Sustainability
This study stresses the importance of long-term assessment to control for possible observation biases; it also illustrates a successful implementation strategy that used video recording to engage staff in identifying solutions to the observed defects. (Source: Journal of Nursing Care Quality)
Source: Journal of Nursing Care Quality - March 3, 2015 Category: Nursing Tags: Articles Source Type: research

Low C-reactive protein values at admission predict mortality in patients with severe community-acquired pneumonia caused by Streptococcus pneumoniae that require intensive care management
Conclusions The mortality of patients with S. pneumoniae CAP requiring ICU management was much lower than predicted by severity scores. The presence of septic shock and a CRP value at admission <169.5 mg/L predicted a fatal outcome. (Source: Infection)
Source: Infection - March 3, 2015 Category: Infectious Diseases Source Type: research

Early amplitude-integrated EEG monitoring 6 h after birth predicts long-term neurodevelopment of asphyxiated late preterm infants
Conclusion: Early aEEG patterns are important determinants of long-term prognosis of neurodevelopmental outcome in asphyxiated late preterm infants. What is Known: • Perinatal asphyxia has been reported to lead to adverse long-term neurological outcome of late preterm infants. Early amplitude-integrated EEG (aEEG) is a valuable method in predicting the long-term prognosis within the first 6 h of birth in the neonatal intensive care units. ...
Source: European Journal of Pediatrics - March 3, 2015 Category: Pediatrics Source Type: research

Early thrombus formation on a pulmonary artery catheter
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - March 3, 2015 Category: Intensive Care Source Type: research

Reverse triggering in a patient with ARDS
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - March 3, 2015 Category: Intensive Care Source Type: research

Severe preeclampsia: what’s new in intensive care?
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - March 3, 2015 Category: Intensive Care Source Type: research

Chronotypes, night shifts and intensive care
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - March 3, 2015 Category: Intensive Care Source Type: research

Outcome of acute mesenteric ischemia in the intensive care unit: a retrospective, multicenter study of 780 cases
Conclusion Acute mesenteric ischemia in ICU patients was associated with a 58 % ICU death rate. Age and SOFA severity score at diagnosis were risk factors for mortality. Plasma lactate concentration over 2.7 mmol/l was also an independent risk factor, but values in the normal range did not exclude the diagnosis of AMI. (Source: Intensive Care Medicine)
Source: Intensive Care Medicine - March 3, 2015 Category: Intensive Care Source Type: research

Impact of follow-up consultations for ICU survivors on post-ICU syndrome: a systematic review and meta-analysis
Conclusions The evidence indicates that follow-up consultations might reduce symptoms of PTSD at 3–6 months after ICU discharge in ICU survivors, but without affecting QOL and other outcomes investigated. This review highlights that planning of future RCTs should aim to standardize interventions and outcome measures to allow for comparisons across studies. (Source: Intensive Care Medicine)
Source: Intensive Care Medicine - March 3, 2015 Category: Intensive Care Source Type: research

Does intermediate care improve patient outcomes or reduce costs?
ICUs are an essential but expensive part of all modern hospitals. With increasingly limited healthcare funding, methods to reduce expenditure without negatively influencing patient outcomes are, therefore, of interest. One possible solution has been the development of ‘intermediate care units’, which provide more intensive monitoring and patient management with higher nurse:patient ratios than the general ward but less than is offered in the ICU. However, although such units have been introduced in many hospitals, there is relatively little published, especially prospective, evidence to support the benefits of this app...
Source: BioMed Central - March 2, 2015 Category: Journals (General) Authors: Jean-Louis VincentGordon D Rubenfeld Source Type: research

Prognostic factors associated with mortality of drug-resistant Acinetobacter baumannii ventilator-associated pneumonia
Background: Ventilator-associated pneumonia (VAP) caused by drug-resistant Acinetobacter baumannii is associated with high mortality in critically ill patients. We identified the prognostic factors of 30-day mortality in patients with VAP caused by drug-resistant A. baumannii and compared survival outcomes among multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR) A. baumannii VAP. Methods: A retrospective cohort study was conducted in the Medical Intensive Care Unit at Chiang Mai University Hospital, Thailand. All adult patients diagnosed with A. baumannii VAP between 2005 and 2011 were ...
Source: Epidemiologic Perspectives and Innovations - March 2, 2015 Category: Epidemiology Authors: Juthamas InchaiChaicharn PothiratChaiwat BumroongkitAtikun LimsukonWeerayut KhositsakulchaiChalerm Liwsrisakun Source Type: research

Droperidol v. haloperidol for sedation of aggressive behaviour in acute mental health: randomised controlled trial [PAPERS]
Conclusions Both haloperidol and droperidol were effective for sedation of patients with acute behavioural disturbance. (Source: The British Journal of Psychiatry)
Source: The British Journal of Psychiatry - March 2, 2015 Category: Psychiatry Authors: Calver, L., Drinkwater, V., Gupta, R., Page, C. B., Isbister, G. K. Tags: PAPERS Source Type: research

Major thrombotic complications with lower limb PICCs in surgical neonates
PICC lines are now used routinely to provide central access for neonatal intensive care unit (NICU) patients. Neonates are known to be at risk for venous thromboembolism (VTE) related to central catheters. No literature exists about VTE PICC-related morbidity in the NICU abdominal surgery subgroup. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - March 2, 2015 Category: Surgery Authors: Phyllis Kisa, Joseph Ting, Allison Callejas, Horacio Osiovich, Sonia A. Butterworth Source Type: research

Am J Respir Crit Care Med; +40 new citations
40 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results: Am J Respir Crit Care Med These pubmed results were generated on 2015/03/01PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites. (Source: Am J Respir Crit Car...)
Source: Am J Respir Crit Car... - March 1, 2015 Category: Intensive Care Tags: Report Source Type: research

Prevalence of unnecessary laboratory tests and related avoidable costs in intensive care unit
Conclusion: Significant number of unnecessary testing was found, with occurrence pattern on Monday and not dependent on age or length of stay. The data indicate the need to implement guidelines or protocols for ordering laboratory tests in the ICU, which have proven effective in helping the prescribing professional in their clinical practice, and contribute to optimize for health care spending. Introdução: Com o aumento dos recursos diagnósticos, os exames laboratoriais têm se tornado ferramenta indispensável nas elucidações diagnósticas. Observa-se, portanto, um crescimento nas solicitações desses exames. Objeti...
Source: Jornal Brasileiro de Patologia e Medicina Laboratorial - March 1, 2015 Category: Pathology Source Type: research

Interference and characteristics of periorbital edema in pupil examination after craniotomy
Conclusion Periorbital edema was found in most postoperative craniotomy patients and pupil examination was not performed in 30% of them. The presence of severe periorbital edema and purplish coloration were the factors that hampered pupil examination. (Source: Acta Paulista de Enfermagem)
Source: Acta Paulista de Enfermagem - March 1, 2015 Category: Nursing Source Type: research

Nursing visit and doubts expressed by families in the intensive care unit
Conclusion : The doubts expressed by family members were about the health status, medical conditions and the care provided. The average number of questions was lower in the third nursing visit. (Source: Acta Paulista de Enfermagem)
Source: Acta Paulista de Enfermagem - March 1, 2015 Category: Nursing Source Type: research

Early Initiation of Continuous Renal Replacement Therapy Improves Clinical Outcomes in Patients With Acute Respiratory Distress Syndrome
Conclusions: Our findings showed that early initiation of CRRT is associated with favorable clinical outcomes in ARDS patients, which might be due to the reduced serum and BALF TGF-β1 levels through CRRT. However, large multi-center studies are needed to make further recommendations as to the optimal use of CRRT in ARDS patient populations. (Source: The American Journal of the Medical Sciences)
Source: The American Journal of the Medical Sciences - March 1, 2015 Category: Journals (General) Tags: Clinical Investigation Source Type: research

Experience and Results with VV-ECMO for Severe Acute Respiratory Failure: Weaning Versus Nonweaning
Acute respiratory distress syndrome (ARDS) remains an unsolved problem in the intensive care unit (ICU), which can be treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We summarized retrospectively collected data from an institutional experience with VV-ECMO in patients with severe acute respiratory failure and identified the clinical parameters associated with successful ECMO weaning. Among the 45 cases who received ECMO for pneumonia (n = 19), exacerbation of interstitial lung disease (n = 11), ARDS secondary to sepsis (n = 8), aspiration pneumonitis (n = 2), postoperative ARDS (n = 3), and others (n...
Source: ASAIO Journal - March 1, 2015 Category: Medical Equipment Tags: Clinical Critical Care Source Type: research

Identifying and Assessing the Substance-Exposed Infant
This article provides an overview of identification and assessment considerations for providers who care for babies at risk for or who are experiencing alterations in state, behavior, and responses after prenatal or iatrogenic exposure to agents associated with the spectrum of withdrawal. (Source: MCN: The American Journal of Maternal Child Nursing)
Source: MCN: The American Journal of Maternal Child Nursing - March 1, 2015 Category: Nursing Tags: Feature: CE Connection Source Type: research

Continuous noninvasive arterial pressure measurement using the volume clamp method: an evaluation of the CNAP device in intensive care unit patients
Abstract The CNAP system allows continuous noninvasive arterial pressure measurement based on the volume clamp method using a finger cuff. We aimed to evaluate the agreement between arterial pressure measurements noninvasively obtained using the CNAP device and arterial catheter-derived arterial pressure measurements in intensive care unit patients. In 55 intensive care unit patients, we simultaneously recorded arterial pressure values obtained by an arterial catheter placed in the abdominal aorta through the femoral artery (criterion standard) and arterial pressure values determined noninvasively using CNAP. We p...
Source: Journal of Clinical Monitoring and Computing - March 1, 2015 Category: Information Technology Source Type: research

Very long apnea events in preterm infants
We describe here very long (>60 s) central apnea events (VLAs) with bradycardia and desaturation, discovered using a computerized detection system applied to our database of over 100 infant years of electronic signals. Eighty-six VLAs occurred in 29 out of 335 VLBW infants. Eighteen of the 29 infants had a clinical event or condition possibly related to the VLA. Most VLAs occurred while infants were on nasal continuous positive airway pressure, supplemental oxygen, and caffeine. Apnea alarms on the bedside monitor activated in 66% of events, on average 28 s after cessation of breathing. Bradycardia alarms activated late...
Source: Journal of Applied Physiology - March 1, 2015 Category: Physiology Authors: Mohr, M. A., Vergales, B. D., Lee, H., Clark, M. T., Lake, D. E., Mennen, A. C., Kattwinkel, J., Sinkin, R. A., Moorman, J. R., Fairchild, K. D., Delos, J. B. Tags: ARTICLES Source Type: research

Outcomes of video-assisted minimally invasive approach through right mini-thoracotomy for resection of benign cardiac masses; compared with median sternotomy
Conclusions We concluded that the clinical outcome of the minimally invasive technique for myxoma resection was acceptable and the technique is feasible. (Source: General Thoracic and Cardiovascular Surgery)
Source: General Thoracic and Cardiovascular Surgery - March 1, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Mucolytics for intubated asthmatic children: a national survey of United kingdom paediatric intensive care consultants.
Conclusion. Significant variation exists regarding the necessity for mucolytics, choice of agent, optimal route, and dose in intubated asthmatic children. PMID: 25722885 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - February 28, 2015 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Management of Extensive Facial Burns in the Intensive Care Unit: Introducing a Novel Device with a Four-Fold Use
Perioral facial burns have a high propensity to formation of microstomia and numerous prosthetic devices have been described that can be used postoperatively to address this problem. We introduce a novel device, the Whiston Buccal Prosthesis, which is used intraoperatively and in the early postoperative period and it acts as a surgical aid to prevent or curtail microstomia, as well as to address other problems associated with facial burns. Our device has an overall 4-fold purpose; 1) it acts as a commissural and circumoral retractor, 2) as a means of counter-pressure during excision of burn eschar, 3) counter-pressure for ...
Source: Journal of Burn Care and Research - February 28, 2015 Category: Rehabilitation Tags: Original Articles Source Type: research

Honey Oil Burns: A Growing Problem
There is an emerging mechanism of burn injury as a result of the ignition of butane, during the manufacture of a tetrahydrocannabinol concentrate known as butane honey oil. The authors report of a series of patients who presented with this mechanism of injury and a description of the process that causes these burns. Patient data were gathered from the medical records of eight patients treated at the University of California Davis Medical Center and Shriners Hospital of Northern California. Information on the manufacturing process of butane honey oil was gathered from Internet searches and published literature on the topic....
Source: Journal of Burn Care and Research - February 28, 2015 Category: Rehabilitation Tags: Original Articles Source Type: research

Operative Utilization Following Severe Combat-Related Burns
The goal of burn surgical therapy is to minimize mortality and to return survivors to their preinjury state. Prompt removal of the burn eschar, early durable coverage, and late corrections of functional deformities are the basic surgical principles. The operative burden, while presumed to be substantial and significant, is neither well described nor quantified. The burn registry at the U.S. Institute of Surgical Research Burn Center was queried from March 2003 to August 2011 for all active duty burn admissions; active duty subjects were chosen to eliminate subject follow-up as a significant variable. Subject demographics i...
Source: Journal of Burn Care and Research - February 28, 2015 Category: Rehabilitation Tags: Original Articles Source Type: research

Suspected Adrenal Insufficiency in Critically Ill Burned Patients: Etomidate-Induced or Critical Illness–Related Corticosteroid Insufficiency?—A Review of the Literature
Adrenal insufficiency (AI), whether etomidate-induced or secondary to critical illness–related corticosteroid insufficiency (CIRCI), is a common and under appreciated problem in the intensive care unit intensive care unit (ICU). However, AI is often difficult to identify and diagnose in the critically ill. The pathophysiology and ideal management of etomidate-induced AI and CIRCI, especially in burn patients, is unknown. Many studies, however, have examined the prevalence of and risk factors for developing AI in critically ill populations as well as the effect of AI on morbidity and mortality. Observing a seemingly incre...
Source: Journal of Burn Care and Research - February 28, 2015 Category: Rehabilitation Tags: Original Articles Source Type: research

The Effect of Diphenhydramine on Sleep in Pediatric Burn Patients: A Secondary Analysis
Adequate sleep is essential for maintaining homeostasis, especially when recovering from an illness; however, studies have shown that sleep disruption and sleep deprivation are common in intensive care unit patients, including children who have sustained burn injury. The purpose of this study was to evaluate the effect of diphenhydramine (DPH) on sleep in pediatric intensive care unit burn patients using Myra Levine’s Conservation Model as the organizing framework. For this study, secondary analysis of polysomnography data and retrospective chart review were used. Twelve DPH patients were pair matched in terms of morphin...
Source: Journal of Burn Care and Research - February 28, 2015 Category: Rehabilitation Tags: Original Articles Source Type: research

Need for sedation and analgesia in patients with a history of substance misuse admitted to an intensive care unit
ConclusionsThe prevalence of substance misuse in this population was high. We found no greater need for sedation in patients with a history of substance misuse although these patients often require three or more drugs to achieve optimal sedation. Relevance to clinical practicePhysicians and nurses should be aware of substance misuse in order to provide adequate care by optimizing drug administration and dosages in the ICU. (Source: Nursing in Critical Care)
Source: Nursing in Critical Care - February 28, 2015 Category: Nursing Authors: Teresa Ruiz‐García, Santiago Nogué‐Xarau, Elisabeth Zavala‐Zegarra, Anna Cirera‐Guasch, José Ríos‐Guillermo Tags: Research Source Type: research

Are potential organ donors missed on general wards? A 6-month audit of hospital deaths.
CONCLUSION: We identified very few potential organ donors among patients who died outside the emergency department and intensive care unit. For these patients to have progressed to organ donation, medical interventions not in keeping with standard Australian practice would have been required. The DonateLife Audit appears to be a robust tool for identifying realistic potential organ donors. PMID: 25716604 [PubMed - in process] (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - February 28, 2015 Category: Journals (General) Tags: Med J Aust Source Type: research

Hospital acquired anemia: the contribution of diagnostic blood loss
This article is protected by copyright. All rights reserved. (Source: Journal of Thrombosis and Haemostasis)
Source: Journal of Thrombosis and Haemostasis - February 28, 2015 Category: Hematology Authors: Johanna (Anske) G. Bom, Suzanne C. Cannegieter Tags: Commentary Source Type: research

Paroxysmal Sympathetic Hyperactivity in Critically Ill Children with Encephalitis and Meningoencephalitis
Conclusions PSH was found in a high percentage of our patients with significant variation in risk factors and outcome noted between patients with bacterial and nonbacterial causes of their meningoencephalitis/encephalitis. (Source: Neurocritical Care)
Source: Neurocritical Care - February 28, 2015 Category: Neurology Source Type: research

Assessment of Satisfaction with Care and Decision-making among English and Spanish-speaking Family Members of Neuroscience ICU Patients
Patients’ and family members’ experiences of hospital care are important indicators of quality. Blacks, Asians, Hispanics, and individuals from low socioeconomic backgrounds are more at risk than Whites for decreased satisfaction with care. In addition, of any of the minority groups Hispanics were most likely to report a lack of patient-centered care. In the intensive care setting, (ICU) previous research has indicated that the needs and satisfaction of family members of neurological ICU patients are different from those of family members of other types of ICU patients. (Source: Applied Nursing Research : ANR)
Source: Applied Nursing Research : ANR - February 28, 2015 Category: Nursing Authors: Thomas A. Hagerty, Ángela Velázquez, J. Michael Schmidt, Cristina Falo Tags: Original Article Source Type: research

Family members’ experiences of being cared for by nurses and physicians in Norwegian intensive care units: A phenomenological hermeneutical study
This study aimed to illuminate the meaning of being taken care of by nurses and physicians for relatives in Norwegian intensive care units. (Source: Intensive and Critical Care Nursing)
Source: Intensive and Critical Care Nursing - February 28, 2015 Category: Nursing Authors: Gro Frivold, Bjørg Dale, Åshild Slettebø Tags: Original article Source Type: research

Intravenous immunoglobulin improves sepsis-induced coagulopathy: A retrospective, single-center observational study
This study aimed to determine whether intravenous immunoglobulin (IVIg) could improve the hyperinflammatory state as well as coagulation/fibrinolysis abnormalities in patients with sepsis. (Source: Journal of Critical Care)
Source: Journal of Critical Care - February 28, 2015 Category: Intensive Care Authors: Hiroyasu Ishikura, Yoshihiko Nakamura, Yasumasa Kawano, Junichi Tanaka, Mariko Mizunuma, Daiki Ohta, Takashi Nishida, Akira Murai Source Type: research

Is Infection (CDI) an Increasingly Common Severe Disease in Adult Intensive Care Units? A 10-Year Experience
Despite the high concentration of patients with known risk factors for Clostridium difficile infection (CDI) in intensive care units (ICUs), data on ICU patients are scarce. The aim of this study was describe the incidence, clinical characteristics, and evolution of CDI in critically ill patients. (Source: Journal of Critical Care)
Source: Journal of Critical Care - February 28, 2015 Category: Intensive Care Authors: E. Bouza, M. Rodríguez-Créixems, A. Alcalá, M. Marín, V. De Egea, F. Braojos, P. Muñoz, E. Reigadas Source Type: research

Acute pancreatitis: an intensive care perspective
Publication date: Available online 27 February 2015 Source:Anaesthesia &amp; Intensive Care Medicine Author(s): Nessa Dooley , Simon Hew , Alistair Nichol Acute pancreatitis (AP) is a sudden inflammation of the pancreas, which is often mild and resolves spontaneously. However if severe, it can cause significant morbidity and mortality and requires management in the Intensive Care Unit. The diagnosis of AP is made, using a combination of clinical symptoms, elevations in pancreatic enzymes and/or characteristic findings on computer tomography. In 2012, the Atlanta Symposium revised the classification of pancreatitis in...
Source: Anaesthesia and intensive care medicine - February 28, 2015 Category: Anesthesiology Source Type: research

Factors Influencing Warfarin Response in Hospitalized Patients
Conclusion Gender, new initiation of warfarin therapy on hospital admission, shorter hospital stay periods and concurrent infection can have a significant effect on discharge INRs. Initiation of warfarin without giving loading doses increases the risk of having INRs below 1.5 during hospital stay and increases the likelihood of a patient to be discharged with INR below target range. Following warfarin dosing nomograms and careful monitoring of the effect of various factors on warfarin response should be greatly considered. (Source: Saudi Pharmaceutical Journal)
Source: Saudi Pharmaceutical Journal - February 28, 2015 Category: Drugs & Pharmacology Source Type: research

Family Experience Survey in the Surgical Intensive Care Unit
In the Intensive Care Unit (ICU), patients are critically-ill, often requiring mechanical ventilation and sedation which puts the decision-making burden on family members. This can be further complicated when the patient’s wishes and goals of care are unclear. The communication between healthcare providers and patients and their family members is vital in ensuring there is a clear view of treatment, diagnosis and prognosis especially in tenuous and quickly changing circumstances. Research to identify interventions to improve the patient and family experiences of the ICU include communication training for healthcare provi...
Source: Applied Nursing Research : ANR - February 28, 2015 Category: Nursing Authors: Bridget Twohig, Anthony Manasia, Adel Bassily-Marcus, John Oropello, Matthew Gayton, Christine Gaffney, Roopa Kohli-Seth Tags: Original Article Source Type: research

Delivering Best Care and Maintaining Emotional Wellbeing in the Intensive Care Unit: the Perspective of Experienced Nurses
Critical care nursing has never been tougher, patient acuity is high, technology has exploded and increasingly, regulations and documentation requirements dominate practice (Moloney-Harmon, 2010). Repeated exposure to patients with life threatening illness or trauma, and sudden critical events can be difficult for nurses working in Intensive Care Units (ICU). There is a plethora of research confirming that ICU nurses globally experience prolonged stress culminating in burnout and disengagement from the workforce. (Source: Applied Nursing Research : ANR)
Source: Applied Nursing Research : ANR - February 28, 2015 Category: Nursing Authors: Joanne Siffleet, Anne M. Williams, Pat Rapley, Susan Slatyer Tags: Original Article Source Type: research