Subscribe: MedWorm: Intensive Care
http://www.medworm.com/rss/medicalfeeds/specialities/Intensive-Care.xml
Preview: MedWorm: Intensive Care

MedWorm: Intensive Care



MedWorm.com provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in Intensive Care



Last Build Date: Mon, 28 Mar 2016 03:44:38 +0100

 



Complications of Cardiac Catheterization in Structural Heart Disease.

Sun, 27 Mar 2016 13:03:02 +0100

CONCLUSION: Currently, the use of cardiac catheterization in SHD is increasing and becoming more complex; this could cause complications despite the preventive efforts. Careful patient selection for therapeutic catheterization and improved technique and management during the peri-procedural period are required to reduce complications. PMID: 27014356 [PubMed] (Source: Korean Circulation Journal)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Continuous "Air" tonometry of the sigmoid colon during abdominal aortic surgery.

Sun, 27 Mar 2016 13:01:01 +0100

CONCLUSIONS: Air tonometry (TONOCAP) is an effective and easily applicable method, allowing the surgeon to be better informed of the tissue oxygenation of the intestinal wall, for the prevention of colon ischemia complications and to take the appropriate measures. PMID: 27015235 [PubMed - as supplied by publisher] (Source: International Angiology)



Monochorionic versus dichorionic twins: Are obstetric outcomes always different?

Sun, 27 Mar 2016 03:07:01 +0100

Authors: Coutinho Nunes F, Domingues AP, Vide Tavares M, Belo A, Ferreira C, Fonseca E, Moura P Abstract This prospective cohort study compared obstetric, perinatal and postpartum outcomes of monochorionic diamniotic (n = 228) versus (vs.) dichorionic (n = 598) twin pregnancies. Statistical analysis was performed using software SPSS® v19.0.0.2. Chi square, Fischer's exact, Student's t and Mann-Withney tests were applied. Obstetrical complications rates were 85.5% vs. 75.1% (p < 0.01). Differences were found in preterm premature rupture of membranes (26.3% vs. 19.3%, p < 0.05) and intrauterine growth restriction (19.7% vs. 10.5%, p < 0.01). Twin-to-twin transfusion syndrome (TTTS) occurred in 7.9% of monochorionic pregnancies. Vaginal delivery occurred ...



Advance directives in intensive care: Health professional competences

Sat, 26 Mar 2016 23:00:00 +0100

Conclusions Although health professionals displayed poor knowledge of advance directives, they had a favorable attitude toward their usefulness. However, most did not know whether their patients had a living will, and some professionals even failed to respect such instructions despite knowledge of the existence of advance directives. Improvements in health professional education in this field are needed. (Source: Medicina Intensiva)



Flexible bronchoscopy during noninvasive positive pressure mechanical ventilation: two are better than one?

Sat, 26 Mar 2016 14:20:02 +0100

Authors: Scala R Abstract Flexible bronchoscopy (FBO) and non-invasive positive pressure ventilation (NIPPV) are largely applied in respiratory and general intensive care units. FBO plays a crucial role for the diagnosis of lung infiltrates of unknown origin and for the treatment of airways obstruction due to bronchial mucous plugging and haemoptysis in critical patients. NIPPV is the first-choice ventilatory strategy for acute respiratory failure (ARF) of different causes as it could be used as prevention or as alternative to the conventional mechanical ventilation (CMV) via endotracheal intubation (ETI). Some clinical scenarios represent contraindications for these techniques such as severe ARF in spontaneous breathing patients for FBO and accumulated tracheo-bronchial secretions...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.










Early and late aortic propagation velocity values in STEMI patients after successful primary PCI and their relationship with neutrophil to lymphocyte ratio.

Sat, 26 Mar 2016 11:11:03 +0100

CONCLUSIONS: We demonstrated for the first time that AVP values could improve after successful treatment in STEMI patients. The increment in AVP values was closely correlated with a decrement in neutrophil lymphocyte ratio. It can be postulated that AVP has strong correlations with the inflammatory markers. PMID: 27010150 [PubMed - in process] (Source: European Review for Medical and Pharmacological Sciences)



Perinatal Backgrounds and NICU Bed Occupancy of Multiple-Birth Infants in Japan.

Sat, 26 Mar 2016 10:06:02 +0100

Authors: Koshida S, Ono T, Tsuji S, Murakami T, Takahashi K Abstract Multiple pregnancies (twin, triplet, and higher-order pregnancy) are associated with an increased risk of resultant preterm and low birth weight infants. The increase of multiple pregnancies for several decades in Japan has been an important consideration in bed allocation planning for neonatal intensive care unit (NICU). The guideline of the Japan Society of Obstetrics and Gynecology (JSOG) in 2008 recommended that embryo transfer be limited to one. The epidemiological data of Japanese regional multiple pregnancies before the JSOG recommendation are valuable in assessing the perinatal effects after this recommendation. The aim of this study was to investigate regional backgrounds of multiple pregnancies and neona...



Pathophysiology and Classification of Respiratory Failure

Sat, 26 Mar 2016 07:44:23 +0100

This article covers the basic lung anatomy, pathophysiology, and classification of respiratory failure. (Source: Critical Care Nursing Quarterly)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Massive Hemoptysis

Sat, 26 Mar 2016 07:44:23 +0100

Hemoptysis, or coughing of blood, oftentimes triggers anxiety and fear for patients. The etiology of hemoptysis will determine the clinical course, which includes watchful waiting or intensive care admission. Any amount of hemoptysis that compromises the patient's respiratory status is considered massive hemoptysis and should be considered a medical emergency. In this article, we review introduction, definition, bronchial circulation anatomy, etiology, and management of massive hemoptysis. (Source: Critical Care Nursing Quarterly)



A wearable navigation display can improve attentiveness to the surgical field

Fri, 25 Mar 2016 23:00:00 +0100

Conclusions Attentiveness to the surgical field can be improved with the use of a light-weight, untracked, wearable display. A through-the-lens display performs better than a peripheral display, and both perform better than a computer monitor. Eye dominance should be considered when positioning the display. (Source: International Journal of Computer Assisted Radiology and Surgery)



Context region discovery for automatic motion compensation in fluoroscopy

Fri, 25 Mar 2016 23:00:00 +0100

Conclusion In this work, we open a new paradigm to provide dynamic real-time guidance for TAVI without user interventions, specially in case of severe occlusion where conventional tracking methods are challenged. (Source: International Journal of Computer Assisted Radiology and Surgery)



Alignment of the lower extremity mechanical axis by computer-aided design and application in total knee arthroplasty

Fri, 25 Mar 2016 23:00:00 +0100

Conclusions The navigation template produced through mechanical axis of lower extremity may provide a relative accurate and simple method for TKA. (Source: International Journal of Computer Assisted Radiology and Surgery)



Deformable registration of trans-rectal ultrasound (TRUS) and magnetic resonance imaging (MRI) for focal prostate brachytherapy

Fri, 25 Mar 2016 23:00:00 +0100

Conclusions The proposed method provides a promising framework for TRUS–MRI registration in focal prostate brachytherapy. (Source: International Journal of Computer Assisted Radiology and Surgery)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Patient-individualized boundary conditions for CFD simulations using time-resolved 3D angiography

Fri, 25 Mar 2016 23:00:00 +0100

Conclusion The presented methods have the potential to accurately estimate patient-specific boundary conditions from a single dedicated rotational scan. (Source: International Journal of Computer Assisted Radiology and Surgery)



Intraoperative application of hand-held structured light scanning: a feasibility study

Fri, 25 Mar 2016 23:00:00 +0100

Conclusions The results of this preliminary study indicate that structured light scanning could be applied accurately and safely in a surgical environment. This could result in a variety of applications for these scanners in image-guided interventions as intraoperative imaging and registration tools. (Source: International Journal of Computer Assisted Radiology and Surgery)






Insertion of a chest drain for pneumothorax

Fri, 25 Mar 2016 23:00:00 +0100

This article examines the indications for chest drain insertion for pneumothorax and the choice of drain. The equipment required is outlined and the positioning and preparation for the procedure described, including the choice of pre-medication. Techniques for insertion of both Seldinger-style and wide-bore chest drain are also described, including safe administration of local anaesthesia for intercostal block. The procedures outlined include how to place securing sutures and the preferred alternative to the old ‘purse-string’ technique for later closure of a tract following wide-bore chest drain. Troubleshooting for potential complications is also briefly covered. (Source: Anaesthesia and intensive care medicine)



Risk factors for candidemia in non-neutropenic critical patients in Colombia

Fri, 25 Mar 2016 23:00:00 +0100

Conclusions In Colombia, a long hospital stay, abdominal surgery, the use of meropenem and hemodialysis were identified as risk factors for candidemia. (Source: Medicina Intensiva)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Urinary albumin/creatinine ratio as an early predictor of outcome in critically-ill septic patients

Fri, 25 Mar 2016 23:00:00 +0100

Publication date: Available online 26 March 2016 Source:The Egyptian Journal of Critical Care Medicine Author(s): Osama Tayeh, Khaled M. Taema, Mohamed I. Eldesouky, Adel A. Omara Several cumbersome scoring systems were developed for prognosis and outcome prediction in sepsis. We intended in this study to evaluate the urinary albumin/creatinine ratio (ACR) as a prognostic predictor in sepsis. We included 40 adult septic patients in a prospective observational study. We excluded patients with preexisting chronic kidney disease or diabetes mellitus. After clinical evaluation, urine spot samples were collected on admission and 24h later for ACR1 and ACR2. Admission APACHE IV score and the highest recorded SOFA score of their daily estimation were considered. We also evaluated the need f...



Mortality as an endpoint in studies in critically ill patients: a reappraisal of definitions.

Fri, 25 Mar 2016 17:21:02 +0100

Authors: Groeneveld JA Abstract The recent literature was critically reviewed reporting heterogeneous mortality endpoints in studies involving critically ill patients. Both location- and duration-dependent definitions are used, more or less arbitrarily and sometimes with contradictory results. Location-dependent mortality refers to intensive care or in-hospital mortality whereas duration-dependent mortality concerns 7-180 day mortality after admission or intervention. There is no consensus on how mortality should be evaluated in the critically ill. It is argued that trialists should aim at uniformity in outcome evaluation of critical care, in order to allow comparison of studies, and that 28-day mortality should remain the primary endpoint for intervention studies. PMID: 270037...



Smaller circuits for smaller patients: improving renal support therapy with Aquadex™

Fri, 25 Mar 2016 16:22:21 +0100

Conclusions CRRT machines with low ECV can enable clinicians to provide adequate, timely, safe, and efficient renal support to small, critically ill infants. (Source: Pediatric Nephrology)



Epidemiology of hospital-acquired pneumonia: Results of a Central European multicenter, prospective, observational study compared with data from the European region.

Fri, 25 Mar 2016 15:35:02 +0100

CONCLUSIONS: The present study was the first to collect multicenter data on the epidemiology of HAP in the Central European Region, with respect to the incidence of etiologic agents causing HAP. It was concerned with relationships between 30-day patient mortality and the type of HAP, etiologic agent and adequacy of initial empirical antibiotic therapy. PMID: 27003315 [PubMed - as supplied by publisher] (Source: Biomedical Papers of the Medical Faculty of the Univ Palacky Olomouc Czech Repub)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Identifying Prognostic Criteria for Survival after Resuscitation Assisted by Extracorporeal Membrane Oxygenation.

Fri, 25 Mar 2016 13:45:06 +0100

In conclusion, in our center, ECPR has a poorer outcome than expected. Therefore, it might be important to identify, a priori, patients who might benefit from this treatment. PMID: 27006826 [PubMed] (Source: Critical Care Research and Practice)



AMINOGLYCOSIDE RESISTANCE GENES IN Pseudomonas aeruginosa ISOLATES FROM CUMANA, VENEZUELA.

Fri, 25 Mar 2016 12:16:02 +0100

Authors: Teixeira B, Rodulfo H, Carreño N, Guzmán M, Salazar E, Donato M Abstract The enzymatic modification of aminoglycosides by aminoglycoside-acetyltransferases (AAC), aminoglycoside-adenyltransferases (AAD), and aminoglycoside-phosphotransferases (APH), is the most common resistance mechanism in P. aeruginosa and these enzymes can be coded on mobile genetic elements that contribute to their dispersion. One hundred and thirty seven P. aeruginosa isolates from the University Hospital, Cumana, Venezuela (HUAPA) were evaluated. Antimicrobial susceptibility was determined by the disk diffusion method and theaac, aadB and aph genes were detected by PCR. Most of the P. aeruginosa isolates (33/137) were identified from the Intensive Care Unit (ICU), mainly from discharges (96/137). ...



Evaluation of mRNA Biomarkers to Identify Risk of Hospital Acquired Infections in Children Admitted to Paediatric Intensive Care Unit

Thu, 24 Mar 2016 23:00:00 +0100

In this study our objective was to evaluate mRNA candidate biomarkers for HAI prediction in a pediatric intensive care unit. Design Serial blood samples were collected from patients admitted to pediatric intensive care unit between March and June 2012. Candidate gene expression (IL1B, TNF, IL10, CD3D, BCL2, BID) was quantified using RT-qPCR. Comparisons of relative gene expression between those that did not develop HAI versus those that did were performed using Mann Whitney U-test. Patients Exclusion criteria were: age (Source: PLoS One)



Cumulative Antimicrobial Susceptibility Data from Intensive Care Units at One Institution: Should Data Be Combined? [Epidemiology]

Thu, 24 Mar 2016 23:00:00 +0100

In this study, susceptibility data for two different ICUs at a tertiary care hospital in Toronto, Canada, were used to create a traditional CSTD report, which combined data from different ICUs, and a rolling-average CSTD report, which pooled 2 years of data for each ICU separately. For simplicity, data for only the most common Gram-negative organisms (Escherichia coli, Pseudomonas aeruginosa) and the most relevant antibiotics (ciprofloxacin, piperacillin-tazobactam) were examined. With the rolling-average method, significant differences in susceptibility were seen between the ICUs in 50% of the organism-antimicrobial combinations. Furthermore, the 3% median year-over-year difference in susceptibilities seen for the 16 organism-antibiotic combinations by using the traditional method was low...



Pediatric Specialty Transport Teams Are Not Associated With Decreased 48-Hour Pediatric Intensive Care Unit Mortality: A Propensity Analysis of the VPS, LLC Database

Thu, 24 Mar 2016 23:00:00 +0100

Conclusion No significant difference in adjusted 48-hour PICU mortality for children transported by transport team type was discovered. (Source: Air Medical Journal)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Inhibition of Protease-ENaC Signaling Improves Mucociliary Function in Cystic Fibrosis Airways.

Thu, 24 Mar 2016 23:00:00 +0100

CONCLUSIONS: QUB-TL1 corrects aberrant CAP activities providing a mechanism to delay or prevent the development of CF lung disease in a manner independent of CFTR mutation. PMID: 27014936 [PubMed - as supplied by publisher] (Source: Am J Respir Crit Car...)



Lobular Capillary Hemangioma ("Pyogenic Granuloma") of the Trachea.

Thu, 24 Mar 2016 23:00:00 +0100

Lobular Capillary Hemangioma ("Pyogenic Granuloma") of the Trachea. Am J Respir Crit Care Med. 2016 Mar 25; Authors: Kalanjeri S, Kumar A, Mukhopadhyay S, Mehta AC PMID: 27014842 [PubMed - as supplied by publisher] (Source: Am J Respir Crit Car...)



Epidemiology and Outcomes of Congenital Diaphragmatic Hernia in Croatia: A Population‐Based Study

Thu, 24 Mar 2016 23:00:00 +0100

ConclusionsThe incidence of CDH in Croatia is within the range of previous reports. Survival was substantially higher in neonates treated in a centre with higher case volume, which suggests that centralisation of medical care for CDH may be warranted in Croatia. (Source: Paediatric and Perinatal Epidemiology)



Advanced Technology in Pediatric Intensive Care Units

Thu, 24 Mar 2016 18:43:29 +0100

This article highlights some studies and advances in informatics that have influenced intensive care unit outcomes. (Source: Pediatric Clinics of North America)



Ankyloglossia and the Breastfeeding Infant: Assessment and Intervention.

Thu, 24 Mar 2016 18:14:02 +0100

Authors: Manipon C Abstract BACKGROUND: Our current culture defines breastfeeding and the use of human breast milk as the preferred criterion standard for infant nutrition. Medical and health professionals have a responsibility to support breastfeeding in the mother-infant dyad. This includes the recognition of anatomical barriers to breastfeeding such as a tongue-tie, ankyloglossia. PURPOSE: The purpose of this article is to enrich and expand the clinical knowledge of health professionals about the physical assessment of ankyloglossia and its impact on breastfeeding. Techniques for assessing anterior and posterior ankyloglossia and interventions across the spectrum are discussed. We also explore maternal emotional experiences of breastfeeding an infant with ankyloglossia. ...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




This Disease Can Still Get You Quarantined For Months -- And It's On The Rise

Thu, 24 Mar 2016 17:08:03 +0100

In August 2014, Kate O’Brien, a 34-year-old media producer from Brooklyn, found out she was expecting her second child. She was ecstatic. But this pregnancy didn't proceed like the first. For the next few months, O'Brien had a cold she couldn't shake. She woke up in the middle of the night drenched in sweat. She wanted to blame it on her pregnancy, yet she kept losing weight. She could barely eat. She coughed up balls of bloody mucus. Her throat burned. None of her doctors could figure out what was wrong. A physician sent her to Mount Sinai West Hospital in Manhattan in January 2015, when, at five months pregnant, she still couldn't gain any weight. "No one likes a skinny pregnant lady," she said. O'Brien expected to stay at the hospital overnight. She didn’t get a chance to sa...



Obesity and critical illness: insights from animal models

Thu, 24 Mar 2016 15:34:08 +0100

ABSTRACT: Critical illness is a major cause of morbidity and mortality around the world. While obesity is often detrimental in the context of trauma, it is paradoxically associated with improved outcomes in some septic patients. The reasons for these disparate outcomes are not well understood. A number of animal models have been used to study the obese response to various forms of critical illness. Just as there have been many animal models that have attempted to mimic clinical conditions, there are many clinical scenarios that can occur in the highly heterogeneous critically ill patient population that occupies hospitals and intensive care units. This poses a formidable challenge for clinicians and researchers attempting to understand the mechanisms of disease and develop appropriate ther...



End-tidal sevoflurane concentration for ProSeal™ versus Classic™ laryngeal mask airway insertion in unpremedicated anaesthetised adult females

Thu, 24 Mar 2016 14:08:04 +0100

The optimal end-tidal sevoflurane concentration for successful ProSeal™ (Teleflex, Morrisville, NC, USA) laryngeal mask airway (PLMA) versus Classic™ (Teleflex, Morrisville, NC, USA) laryngeal mask airway (CLMA) insertion in unpremedicated anaesthetised adults is unknown. We determined end-tidal sevoflurane concentrations for successful insertion in fifty percent of anaesthetised adults. This randomised, prospective, double-blind study was conducted in the operating theatre of a government tertiary care hospital. Forty-four unpremedicated American Society of Anesthesiologists physical status I and II women with cervical carcinoma (aged 30 to 60 years), scheduled for intracavity caesium implantation under general anaesthesia with a laryngeal mask airway (LMA) were included in the study....



Bristol teen exposes her mother's battle with breast cancer to help break 'taboo'

Thu, 24 Mar 2016 14:05:05 +0100

Chloe Oliver, 18, from Bolton, documented her mother Samantha's breast cancer battle after the 49-year-old intensive care nurse endured six rounds of chemotherapy and a mastectomy. (Source: the Mail online | Health)



Postoperative blood pressure deficit and acute kidney injury progression in vasopressor-dependent cardiovascular surgery patients

Thu, 24 Mar 2016 00:00:00 +0100

In vasopressor-dependent patients who had undergone cardiovascular surgery, we examined whether those with progression of acute kidney injury (AKI) had a greater difference (deficit) between premorbid and with... (Source: Critical Care)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




CTX-M-15 in combination with aac(6′)-Ib-cr is the most prevalent mechanism of resistance both in Escherichia coli and Klebsiella pneumoniae, including K. pneumoniae ST258, in an ICU in Uruguay

Wed, 23 Mar 2016 23:00:00 +0100

In conclusion, non-KPC-producing K. pneumoniae ST258 harbouring different ESBL and PMQR genes was the main clone disseminated in the ICU. Extensive surveillance measures must be implemented to prevent the emergence of acquired plasmid-encoded bla KPC by ST258 K. pneumoniae. (Source: Journal of Global Antimicrobial Resistance)



Surgery in the Cardiovascular Surgical Intensive Care Unit

Wed, 23 Mar 2016 23:00:00 +0100

Conclusions Operations in the ICU represent a safe, life-saving alternative in specific subgroups of patients. The risk of wound infection is not increased, unstable patients are not transferred and there is time savings. (Source: Cirugia Espanola)



Results of Conservative Treatment in Patients With Occult Pneumothorax

Wed, 23 Mar 2016 23:00:00 +0100

Conclusion Observation is a safe treatment in occult pneumothorax, even in pressure positive ventilated patients. (Source: Cirugia Espanola)



Building partnerships to reduce heart disease in women

Wed, 23 Mar 2016 23:00:00 +0100

Despite efforts to increase awareness among American women of their risk for heart disease, only about half (56%) of all women are aware1 that heart disease is the #1 killer of women.1,2 Gaps in awareness are even lower among women of color, with only about a third (36%) of Black women and (34%) of Hispanic women citing heart disease as the leading cause of death in a recent national survey.1 The need to increase awareness is not limited to women; but extends to health care providers, the public and policymakers. (Source: Heart and Lung)



Women's perceptions of biases and barriers in their myocardial infarction triage experience

Wed, 23 Mar 2016 23:00:00 +0100

To examine women's perceptions of their emergency department (ED) cardiac triage experience for myocardial infarction (MI). (Source: Heart and Lung)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




IJERPH, Vol. 13, Pages 357: Using the Reverse Shock Index at the Injury Scene and in the Emergency Department to Identify High-Risk Patients: A Cross-Sectional Retrospective Study

Wed, 23 Mar 2016 23:00:00 +0100

Conclusions: Using an RSI < 1 as a threshold to evaluate the hemodynamic condition of the patients at the injury scene and upon arrival to the ED provides valid information regarding deteriorating outcomes for certain subgroups of patients in the ED setting. Particular attention and additional resources should be provided to patients with an EMS RSI ≥ 1 that deteriorates to an RSI < 1 upon arrival to the ED since a higher odds of mortality was found in these patients. (Source: International Journal of Environmental Research and Public Health)



Case history. “Coral snake” Micrurus mipartitus bite in 1968. A herpetologist's ordeal

Wed, 23 Mar 2016 23:00:00 +0100

Publication date: Available online 24 March 2016 Source:Colombian Journal of Anesthesiology Author(s): Bernardo Ocampo Trujillo Historical clinical case that presented back in 1968 at a time when respiratory support and intensive care techniques were just emerging, with many shortcomings in hospital care areas and monitoring devices. The case is of a 58 year-old patient, outstanding citizen, recent winner in a television contest on snakes, who was bitten accidentally by a coral snake Micrurus mipartitus. The poison of this snake is a macromolecule that induces complete depolarizing muscle blockade which, if not reverted, leads to death from respiratory failure. A group of social leaders in the region managed to obtain the specific anti-venom that was not produced in the country, as well...



Insertion sequence ISRP10 inactivation of the oprD gene in imipenem-resistant Pseudomonas aeruginosa clinical isolates

Wed, 23 Mar 2016 23:00:00 +0100

Pseudomonas aeruginosa is an important opportunistic pathogen in clinical practice. The European Prevalence of Infection in Intensive Care (EPIC) study reported that P. aeruginosa is the second most common pathogenic bacteria after Staphylococcus aureus in intensive care unit infections. According to nosocomial infection surveillance studies, P. aeruginosa is the most common nosocomial Gram-negative pathogen, accounting for 13.2% of all nosocomial infections. (Source: International Journal of Antimicrobial Agents)



End-of-life decisions in surgical intensive care medicine – the relevance of blood transfusions

Wed, 23 Mar 2016 23:00:00 +0100

End-of-life decisions (EOLD) are common on the intensive care unit (ICU). EOLDs underlie a dynamic process and limitation of ICU-therapies is often done sequentially. Questionnaire-based and observational studies on medical ICUs and in palliative care reveal blood transfusions as the first therapy physicians withhold as an EOLD. (Source: Transfusion and Apheresis Science)



Hospital air: A potential route for transmission of infections caused by β-lactam–resistant bacteria

Wed, 23 Mar 2016 23:00:00 +0100

Conclusions The results revealed that hospital air is a potential route of transmission of BLRB, such as Acinetobacter and Staphylococcus, 2 important causative agents of nosocomial infections. Therefore, improvement of control measures against the spreading of airborne bacteria in hospital environments is warranted. (Source: American Journal of Infection Control)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Antibiotic-Impregnated Catheters and Risk for Infections in KidsAntibiotic-Impregnated Catheters and Risk for Infections in Kids

Wed, 23 Mar 2016 22:41:49 +0100

Antibiotic-impregnated central venous catheters may reduce the risk of pediatric bloodstream infections better than heparin-impregnated or standard central venous catheters, according to research from the United Kingdom. Reuters Health Information (Source: Medscape Critical Care Headlines)



The Lungmotor

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



Assessing anaesthesia trainees at work: opportunities and challenges

Wed, 23 Mar 2016 18:44:09 +0100

NA (Source: Anaesthesia and Intensive Care)



Reliability of Numerical scales used for Direct Observation of Procedural Skills

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



Reliability of the Direct Observation of Procedural Skills assessment tool for ultrasound-guided regional anaesthesia

Wed, 23 Mar 2016 18:44:09 +0100

The objective of this study was to evaluate the reliability of DOPS when used to score trainees performing ultrasound-guided regional anaesthesia. Reliability of an assessment tool is defined as the reproducibility of scores given by different assessors viewing the same trainee. Forty-nine anaesthetists were recruited to score two scripted videos of trainees performing a popliteal sciatic nerve block and an axillary brachial plexus block. Reliability, as measured by intraclass correlation coefficients, was -0.01 to 0.43 for the individual items in DOPS, and 0.15 for the ‘Overall Performance for this Procedure’ item. Assessors demonstrated consistency of scoring within DOPS, with significant correlation of sum of individual item scores with the 'Overall Performance for this Procedure' i...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Learning from defects using a comprehensive management system for incident reports in critical care

Wed, 23 Mar 2016 18:44:09 +0100

Incident reporting systems are often used without a structured review process, limiting their utility to learn from defects and compromising their impact on improving the healthcare system. To describe the experience of implementing a Comprehensive Management System (CMS) for incident reports in the ICU, a physician-led multidisciplinary Incident Report Committee was created to review, analyse and manage the department incident reports. New protocols, policies and procedures, and other patient safety interventions were developed as a result. Information was disseminated to staff through multiple avenues. We compared the pre- and post-intervention periods for the impact on the number of incident reports, level of harm, time needed to close reports and reporting individuals. A total of 1719 ...



End-tidal sevoflurane concentration for ProSeal® versus Classic™ laryngeal mask airway insertion in unpremedicated anaesthetised adult females

Wed, 23 Mar 2016 18:44:09 +0100

The optimal end-tidal sevoflurane concentration for successful ProSeal™ (Teleflex, Morrisville, NC, USA) laryngeal mask airway (PLMA) versus Classic™ (Teleflex, Morrisville, NC, USA) laryngeal mask airway (CLMA) insertion in unpremedicated anaesthetised adults is unknown. We determined end-tidal sevoflurane concentrations for successful insertion in fifty percent of anaesthetised adults. This randomised, prospective, double-blind study was conducted in the operating theatre of a government tertiary care hospital. Forty-four unpremedicated American Society of Anesthesiologists physical status I and II women with cervical carcinoma (aged 30 to 60 years), scheduled for intracavity caesium implantation under general anaesthesia with a laryngeal mask airway (LMA) were included in the study....



Risk factors for bleeding complications after percutaneous dilatational tracheostomy: a ten-year institutional analysis

Wed, 23 Mar 2016 18:44:09 +0100

Bleeding complications after percutaneous dilatational tracheostomy (PDT) are infrequent but may have a tremendous impact on a patient's further clinical course. Therefore, it seems necessary to perform risk stratification for patients scheduled for PDT. We retrospectively reviewed the records of 1001 patients (46% male, mean age 68.1 years) undergoing PDT (using the Ciaglia Blue Rhino® technique with direct bronchoscopic guidance) in our cardiothoracic ICU between January 2003 and February 2013. Patients were stratified into two groups: patients suffering acute moderate, severe, or major bleeding (Group A) and patients who had no or only mild bleeding (Group B). In the majority of patients, no or only mild bleeding during PDT occurred (none: 425 [42.5%], mild: 488 [48.8%]). In 84 pati...



The anaesthetic assessment, management and risk factors of bariatric surgical patients requiring post-operative intensive care support: a state-wide, five-year cohort study.

Wed, 23 Mar 2016 18:44:09 +0100

Bariatric surgery is a rapidly growing and dynamic discipline necessitating a specialised anaesthetic approach coordinating high-risk patients with appropriate post-operative intensive care (ICU) support. The relationship between the anaesthetic and ICU utilisation after bariatric surgery is poorly understood. All adult bariatric surgery patients admitted to any ICU over a five-year period between 2007 and 2011 in Western Australia were identified from hospital admission records and cross-referenced against the Western Australian Department of Health Data Linkage Unit database. During the study period 12,062 patients under went bariatric surgery with 581 (4.8%) patients admitted to ICU immediately following surgery. The mean pre-operative ASA score was 3.3 [standard deviation 1.1] with 76....



Intensive Care Management of Children Intubated for Croup: a retrospective analysis

Wed, 23 Mar 2016 18:44:09 +0100

Croup remains the commonest reason for acute upper airway obstruction in children, yet there are scarce contemporary data of airway management in those requiring intubation. We performed a retrospective analysis of the intensive care management of children intubated for croup in two quaternary Paediatric Intensive Care Units: Royal Children’s Hospital Melbourne, Australia and Alberta Children’s Hospital Calgary, Canada. Patients intubated for less than three days were compared with those intubated for greater than three days. Patients less than 10 kg body weight were compared to those greater than 10 kg. Demographic, clinical and microbiological data were recorded. Seventy-seven cases of croup requiring intubation were identified. The median duration of intubation was 60 hours. Parainf...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Acute kidney injury following liver transplantation: a systematic review of published predictive models

Wed, 23 Mar 2016 18:44:09 +0100

Acute kidney injury is a frequent postoperative complication amongst liver transplant recipients and is associated with increased morbidity and mortality. This systematic review analysed the existing predictive models, in order to solidify current understanding. Articles were selected for inclusion if they described the primary development of a clinical prediction model (either an algorithm or risk score) to predict AKI post liver transplantation. The database search yielded a total of seven studies describing the primary development of a prediction model or risk score for the development of AKI following liver transplantation. The models span thirteen years of clinical research and highlight a gradual change in the definitions of AKI, emphasising the need to employ standardised definition...



Characteristics and dying trajectories of adult hospital patients from acute care wards who die following review by the rapid response team

Wed, 23 Mar 2016 18:44:09 +0100

A third of patients reviewed by rapid response teams (RRT) require end-of-life care. However, little is known about the characteristics and management of these patients following RRT review. This paper presents results of a retrospective, descriptive audit that explored the dying trajectory of adult ward inpatients who died outside of intensive care following RRT review. The study setting was a 430-bed tertiary New Zealand hospital during 2013. RRT, inpatient databases and hospital notes were used to identify 100 consecutive adult inpatients who died subsequent to RRT review. Outcome measures included time from RRT review to death, place of death, pre-existing co-morbidities and frequency of medical review. Results demonstrated that patients were old (median 77 years, IQR 63–85years), em...



Intravenous lipid emulsion for levobupivacaine intoxication in acidotic and hypoxaemic pigs

Wed, 23 Mar 2016 18:44:09 +0100

Intravenous lipid emulsion is, in some countries, the recommended treatment for local anaesthetic toxicity. Systemic local anaesthetic toxicity results in hypoxaemia and acidosis, and whether this influences the effects of lipid therapy on drug concentrations and cardiovascular recovery is currently unknown. Twenty anaesthetised pigs were given a 3-mg/kg bolus of levobupivacaine followed by a five minute phase of hypoventilation and 1 mmol/kg of lactic acid in one minute. After lactic acid infusion, pigs were treated, in randomised order, with either 20% lipid emulsion or Ringer’s acetate for 30 min: a 1.5-ml/kg bolus followed by a 0.25-ml/kg/minute infusion. Haemodynamic parameters were recorded and blood samples were collected for pharmacokinetic analysis. There was no difference betwe...



The effect of adjuvant remifentanil with propofol or thiopentone on seizure quality during electroconvulsive therapy

Wed, 23 Mar 2016 18:44:09 +0100

In order to optimise outcome to Electro Convulsive therapy (ECT), there has been a trend to utilise remifentanil as an adjunct to standard intravenous induction agents. This has allowed a reduction in the dose of anaesthetic agent, and usually an improved response to stimulation. However there have been no previous studies to ascertain whether this improvement is simply as a result of the reduced dose of anaesthetic agent or whether remifentanil itself might possess epileptogenic properties. This retrospective case-controlled study examined ECT outcomes, determined by EEG quality analysis, in patients who received ECT with or without remifentanil, where there was no dose reduction in the anaesthetic agent. There were no improvements seen in the measurements of any EEG parameter, including ...



Chewing gum in the preoperative fasting period: an analysis of de-identified incidents reported to webAIRS

Wed, 23 Mar 2016 18:44:09 +0100

The role of preoperative fasting is well established in current anaesthetic practice with different guidelines for clear fluids and food. However, chewing gum may not be categorised as either food or drink by some patients, and may not always be specified in instructions given to patients about preoperative fasting. The aim of this paper was to review anaesthesia incidents involving gum chewing reported to webAIRS to obtain information on the risks, if any, of gum chewing during the preoperative fasting period. There were nine incidents involving chewing gum reported between late 2009 and early 2015. There were no adverse outcomes from the nine incidents other than postponement of surgery in three cases and cancellation in one. In particular, there were no reports of aspiration or airway o...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Spontaneous ventilation using Propofol TCI for microlaryngoscopy in adults: a retrospective audit

Wed, 23 Mar 2016 18:44:09 +0100

We conducted a retrospective audit of 285 adult elective microlaryngoscopy cases in our institution over a three-and-a-half year period. Conventional anaesthesia with intubation and mechanical ventilation was the most common technique, used in 71% of cases. Tubeless spontaneous ventilation during total intravenous anaesthesia with a target-controlled infusion of propofol (SVTCI) was the most common alternative. Spontaneous ventilation with target-controlled infusion was used for 79 (27.7%) anaesthetic inductions and was continued through the maintenance phase for 60 patients (21.1%). Jet and intermittent ventilation were both used infrequently (1% each). The most common SVTCI technique since 2013 involved adjusting the target-controlled infusion rate during induction using a formula we dev...






Damage to a flexible laryngeal mask by metallic dental braces preventing removal of the mask

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



Ingested dental prosthesis causing significant gastrointestinal bleeding

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



Anaphylaxis to chlorhexidine in a chlorhexidine-coated central venous catheter during general anaesthesia

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Septic shock due to Myroides odoratus in a medical intensive care unit patient with severe necrotizing pancreatitis

Wed, 23 Mar 2016 18:44:09 +0100

We present the first case of severe necrotizing pancreatitis and septic shock due to Myroides odoratus. Moreover, our case demonstrates the pathogenicity of Myroides, and the importance given its resistance to multiple antibiotics. (Source: Anaesthesia and Intensive Care)



Erratum

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



ANZICS/ACCCN Annual Scientific Meeting, October 2015, Auckland, New Zealand

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



Peripheral T-lymphocyte and natural killer cell population imbalance is associated with septic encephalopathy in patients with severe sepsis.

Wed, 23 Mar 2016 14:45:02 +0100

Authors: Lu CX, Qiu T, Tong HS, Liu ZF, Su L, Cheng B Abstract Septic encephalopathy (SE) is a diffuse cerebral dysfunction resulting from a systemic inflammatory response, and is associated with an increased risk of mortality. The pathogenesis of SE is complex and multifactorial, but unregulated immune imbalance may be an important factor. The current retrospective study examined the clinical data of 86 patients with severe sepsis who were admitted to the Intensive Care Unit at Zhongshan Hospital, Xiamen University (Xiamen, China) from January, 2014 to January, 2015. The patients were assigned to SE and non-SE patient groups according to the presence or absence of SE. The proportion of T-lymphocyte subsets and natural killer (NK) cells in the immune cell population, representing t...



Modality of RRT and Recovery of Kidney Function after AKI in Patients Surviving to Hospital Discharge.

Wed, 23 Mar 2016 13:25:13 +0100

This retrospective cohort study examined 4738 patients with KDIGO stage 3 AKI admitted to intensive care units from 2000 to 2008 who received RRT for AKI and survived to hospital discharge or 90 days.   There was no significant difference in hazards for nonrecovery or reasons for nonrecovery (mortality or ESRD) with intermittent hemodialysis versus continuous RRT.   : Trends in In-Hospital Cardiopulmonary Resuscitation and Survival in Adults Receiving Maintenance Dialysis Trends in In-Hospital Cardiopulmonary Resuscitation and Survival in Adults Receiving Maintenance Dialysis Outcomes of In-Hospital Cardiopulmonary Resuscitation in Maintenance Dialysis Patients (Source: Nephrology Now)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Index

Wed, 23 Mar 2016 08:22:05 +0100

Note: Page numbers of article titles are in boldface type. (Source: Critical Care Clinics)



Forthcoming Issues

Wed, 23 Mar 2016 08:22:05 +0100

Hepatology and Critical Care (Source: Critical Care Clinics)



Contents

Wed, 23 Mar 2016 08:22:05 +0100

Rahul S. Nanchal and Ram M. Subramanian (Source: Critical Care Clinics)



Contributors

Wed, 23 Mar 2016 08:22:05 +0100

RICHARD W. CARLSON, MD, PhD (Source: Critical Care Clinics)



Copyright

Wed, 23 Mar 2016 08:22:05 +0100

ELSEVIER (Source: Critical Care Clinics)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Gastrointestinal Issues in Critical Care

Wed, 23 Mar 2016 08:22:05 +0100

CRITICAL CARE CLINICS (Source: Critical Care Clinics)



Role of the Open Abdomen in Critically Ill Patients

Wed, 23 Mar 2016 08:22:05 +0100

An open abdomen is common used in critically ill patients to temporize permanent abdominal closure. The most common reason for leaving the abdomen open by reopening a laparotomy, not closing, or creating a fresh laparotomy is the abdominal compartment syndrome. The open abdomen technique is also used in damage control operations and intra-abdominal sepsis. Negative pressure wound therapy may be associated with better outcomes than other temporary abdominal closure techniques. The open abdomen is associated with many early and late complications, including infections, gastrointestinal fistulas, and ventral hernias. Clinicians should be vigilant regarding the development of these complications. (Source: Critical Care Clinics)



Defining Appropriate Use of Proton-Pump Inhibitors Among Medical Inpatients

Wed, 23 Mar 2016 07:34:28 +0100

CONCLUSIONS For the majority of medical inpatients outside the ICU, use of PPIs likely leads to a net increase in hospital mortality. Even in patients at particularly high risk of UGIB, only those at the very lowest risk of HCAP and CDI should be considered for prophylactic PPI use. Continuation of outpatient PPIs may also increase expected hospital mortality. Apart from patients with active UGIB, use of PPIs in hospitalized patients should be discouraged. (Source: Journal of General Internal Medicine)



Sensibility of professionals to information needs: experience of the family at the intensive care unit

Wed, 23 Mar 2016 07:13:38 +0100

This study aimed to interpret, in the experience the family has at the intensive care unit, the sensitivity of professionals regarding their need for information. We held open interviews with 21 adults, family members of adults hospitalized in intensive care. The analysis and interpretation of the narratives, with the support of the software Nvivo8(r), was undertaken in accordance with the phenomenological approach suggested by Van Manen. Two situations were found: the presence and absence of information. The family states that the sensitivity of the professional was essential in the response to their needs. The care taken in the content that it is transmitted and how it is transmitted were significant in the experience lived. Knowledge of the family's true and potential needs is decisive ...



Communication and patient safety in the change-of-shift nursing report in neonatal intensive care units

Wed, 23 Mar 2016 07:13:38 +0100

Estudo quantitativo, descritivo-exploratório, com objetivo de identificar fatores relacionados à segurança do paciente quanto à comunicação no processo de passagem de plantão das equipes de enfermagem. Realizado entre abril e maio de 2012, com 70 profissionais de enfermagem de três unidades de cuidados intensivos neonatais, através de instrumento validado sobre passagem de plantão. Para análise dos dados, utilizaram-se os testes Qui-Quadrado e t-Student. Os resultados demonstraram que os fatores que podem comprometer a segurança do paciente durante a passagem de plantão devido à interrupção e, assim, causando possível perda de importantes informações para a assistência segura, foram atrasos, saídas antecipadas, realização de cuidados e conversas paralelas. Os enferme...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Isolation of Enterobacter aerogenes carrying blaTEM‐1 and blaKPC‐3 genes recovered from a hospital Intensive Care Unit

Wed, 23 Mar 2016 06:07:29 +0100

In conclusion, it's necessary a continuous monitoring of multidrug‐resistant strains for the detection of any KPC‐producing bacteria that could expand the circulation of carbapenem‐resistant pathogens. (Source: APMIS)



The role of neutrophils in immune dysfunction during severe inflammation

Wed, 23 Mar 2016 00:00:00 +0100

Critically ill post-surgical, post-trauma and/or septic patients are characterised by severe inflammation. This immune response consists of both a pro- and an anti-inflammatory component. The pro-inflammatory ... (Source: Critical Care)



The incidence of chromosome abnormalities in neonates with structural heart disease

Tue, 22 Mar 2016 23:00:00 +0100

Conclusions Chromosome abnormalities, including syndromes, are prevalent in newborns with congenital heart disease. Further research is needed to evaluate the utility of cytogenetic screening in all children with congenital heart disease. (Source: Heart)



Morbidity, mortality, associated injuries, and management of traumatic rib fractures

Tue, 22 Mar 2016 23:00:00 +0100

Conclusion The severity of traumatic rib fractures was identified in this study. Therefore, a trauma team needs better preparation to provide effective treatment strategies when encountering thoracic trauma patients, especially patients who are older and have rib fractures. (Source: Journal of the Chinese Medical Association)



Preterm cranial ultrasound scanning is both feasible and effective in a middle‐income country

Tue, 22 Mar 2016 23:00:00 +0100

ConclusionOur study demonstrated that cranial ultrasound can be used effectively in a middle‐income country to identify high‐risk infants and monitor quality of care.This article is protected by copyright. All rights reserved. (Source: Acta Paediatrica)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Urinary biomarker incorporation into the renal angina index early in intensive care unit admission optimizes acute kidney injury prediction in critically ill children: a prospective cohort study

Tue, 22 Mar 2016 23:00:00 +0100

Conclusions We have now prospectively validated the RAI as a functional risk stratification methodology in a heterogeneous group of critically ill patients, providing context to direct measurement of novel urinary biomarkers and improving the prediction of severe persistent AKI. (Source: Nephrology Dialysis Transplantation)



Role of kidney injury in sepsis

Tue, 22 Mar 2016 23:00:00 +0100

Abstract Kidney injury, including acute kidney injury (AKI) and chronic kidney disease (CKD), has become very common in critically ill patients treated in ICUs. Many epidemiological studies have revealed significant associations of AKI and CKD with poor outcomes of high mortality and medical costs. Although many basic studies have clarified the possible mechanisms of sepsis and septic AKI, translation of the obtained findings to clinical settings has not been successful to date. No specific drug against human sepsis or AKI is currently available. Remarkable progress of dialysis techniques such as continuous renal replacement therapy (CRRT) has enabled control of “uremia” in hemodynamically unstable patients; however, dialysis-requiring septic AKI patients are still showing un...



Sepsis and disseminated intravascular coagulation

Tue, 22 Mar 2016 23:00:00 +0100

Abstract Sepsis is frequently complicated by coagulopathy and, in about 35 % of severe cases, by disseminated intravascular coagulation (DIC). In Japan, aggressive treatment of septic DIC is encouraged using antithrombin and recombinant thrombomodulin. The macrophages, monocytes, and neutrophils are a source of TF and participate in the direct activation of the coagulation cascade in the early phases of sepsis. And activated factor X (FXa), which is involved in hemostasis, thrombogenesis, inflammation, and cellular immune responses, induces TF expression in human peripheral monocytes and, conversely, that inhibition of FXa activity reduces TF expression. Both inflammation and coagulation play an important role in DIC due to sepsis. In addition to inflammatory cytokines (TNF-α, ...



A clinical perspective of sepsis-associated delirium

Tue, 22 Mar 2016 23:00:00 +0100

Abstract The term sepsis-associated encephalopathy (SAE) has been applied to animal models, postmortem studies in patients, and severe cases of sepsis. SAE is considered to include all types of brain dysfunction, including delirium, coma, seizure, and focal neurological signs. Clinical data for sepsis-associated delirium (SAD) have been accumulating since the establishment of definitions of coma or delirium and the introduction of validated screening tools. Some preliminary studies have examined the etiology of SAD. Neuroinflammation, abnormal cerebral perfusion, and neurotransmitter imbalances are the main mechanisms underlying the development of SAD. However, there are still no specific diagnostic blood, electrophysiological, or imaging tests or treatments specific for SAD. The...



Alert cell strategy in SIRS-induced vasculitis: sepsis and endothelial cells

Tue, 22 Mar 2016 23:00:00 +0100

Abstract Sepsis refers to systemic inflammatory response syndrome and organ failure resulting from infection. Inflammatory receptors (e.g., Toll-like receptors and nucleotide oligomerization domain) recognize bacterial components as inflammatory ligands. These are expressed not only in leukocytes but also in major organs and vascular endothelial cells. “Alert cell” is defined as the cell that expresses the inflammatory receptor and intracellular signaling system to produce inflammatory mediators such as inflammatory cytokines, chemokines, nitric oxide, and prostanoids in organs and the vasculature. NF-κB and AP-1, which are the transcriptional factors of these inflammatory molecules, are important regulators of multiple organ failure in sepsis and systemic inflammation. The ...



Sepsis-induced myocardial dysfunction: pathophysiology and management

Tue, 22 Mar 2016 23:00:00 +0100

Abstract Sepsis is aggravated by an inappropriate immune response to invading microorganisms, which occasionally leads to multiple organ failure. Several lines of evidence suggest that the ventricular myocardium is depressed during sepsis with features of diastolic dysfunction. Potential candidates responsible for septic cardiomyopathy include pathogen-associated molecular patterns (PAMPs), cytokines, and nitric oxide. Extracellular histones and high-mobility group box 1 that function as endogenous damage-associated molecular patterns (DAMPs) also contribute to the myocardial dysfunction associated with sepsis. If untreated, persistent shock causes cellular injury and the liberation of further DAMPs. Like PAMPs, DAMPs have the potential to activate inflammation, creating a viciou...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Antimicrobial dressings for the prevention of catheter-related infections in newborn infants with central venous catheters.

Tue, 22 Mar 2016 23:00:00 +0100

CONCLUSIONS: Based on moderate-quality evidence, chlorhexidine dressing/alcohol skin cleansing reduced catheter colonisation, but made no significant difference in major outcomes like sepsis and CRBSI compared to polyurethane dressing/povidone-iodine cleansing. Chlorhexidine dressing/alcohol cleansing posed a substantial risk of contact dermatitis in preterm infants, although it was unclear whether this was contributed mainly by the dressing material or the cleansing agent. While silver-alginate patch appeared safe, evidence is still insufficient for a recommendation in practice. Future research that evaluates antimicrobial dressing should ensure blinding of caregivers and outcome assessors and ensure that all participants receive the same co-interventions, such as the skin cleansing agent...



The impact of intensive care in a private hospital on patients aged 80 and over: health related quality of life, functional status and burden versus benefit

Tue, 22 Mar 2016 23:00:00 +0100

ConclusionWe demonstrated that HRQoL and previous lifestyle is preserved in the majority following ICU admission, associated with a high level of patient valuation of the episode of care. (Source: Internal Medicine Journal)



Vision-based deformation recovery for intraoperative force estimation of tool–tissue interaction for neurosurgery

Tue, 22 Mar 2016 23:00:00 +0100

Conclusions A novel approach for tissue deformation recovery has been proposed based on reliable quasi-dense stereo correspondences. The proposed framework does not rely on additional equipment, allowing seamless integration with the existing surgical workflow. The performance evaluation analysis shows the potential clinical value of the technique. (Source: International Journal of Computer Assisted Radiology and Surgery)



Stereological quantification of microvessels using semiautomated evaluation of X-ray microtomography of hepatic vascular corrosion casts

Tue, 22 Mar 2016 23:00:00 +0100

Conclusion The software QuantAn and its source code are openly available to researchers working in the field of stochastic geometry of microvessels in micro-CT scans or other three-dimensional imaging methods. The implemented methods comply with reproducible stereological techniques, and they were highly consistent with manual counting. Preliminary morphometrics of the classical hepatic lobules in pig were provided. (Source: International Journal of Computer Assisted Radiology and Surgery)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




[Prone positioning of patients during venovenous extracorporeal membrane oxygenation is safe and feasible].

Tue, 22 Mar 2016 23:00:00 +0100

CONCLUSION: Prone positioning significantly reduces the mortality of patients with severe ARDS. In this series of 26 patients with severe ARDS during ECMO therapy no serious adverse events were found during the use of prone positioning. PMID: 27007777 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)