August 27, 2010
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| PIRO Concepts in Respiratory Sepsis - Clinical Pulmonary Medicine |
| Moreno RP – In this manuscript, the authors propose the use of a modified version of the PIRO system (based on predisposition, infection, response, and organ dysfunction/failure) to stratify patients admitted to the intensive care unit (ICU) with severe infection and sepsis. The proposed model, presented excellent calibration and discrimination in the global population and in specific groups of patients and seems to be able to replace the use of several disease–specific models. It allows the user to stratify patients based on severity and to forecast vital status at hospital discharge based on a small set of variables, collected at ICU admission or in the first 48 hours in the ICU.... |
| Risk Factors for Catheter-associated Bloodstream Infections in a Pediatric Cardiac Intensive Care Unit - The Pediatric Infectious Disease Journal |
| Prasad PA et al. – In this study population, tunneled catheters were associated with a higher risk of CA–BSI, possibly because of the catheter material. Additionally, authors did not find that the burden of catheters and medical devices was associated with an increased risk of infection. Because most CA–BSIs in this study population occurred >=7 days after catheter insertion, strict attention to aseptic technique when using or dressing a catheter might reduce CA–BSI rates in the pediatric CICU.... |
| Pain Assessment Tool in the Critically Ill Post-Open Heart Surgery Patient Population - Pain Management Nursing |
| Marmo L et al. – This descriptive repeated–measures study compared three pain assessment tools in nonverbal critically ill patients in a cardiac postanesthesia care unit. Tools included the Critical–Care Pain Observation Tool (CPOT), adult Nonverbal Pain Scale (NVPS), and the Faces, Legs, Activity, Cry, and Consolability scale (FLACC). Two painful events, suctioning and repositioning, were studied...Both the CPOT and the NVPS demonstrated high reliability. The NVPS and the CPOT were highly correlated for both raters (11 out of 12 times). Correlations between the two raters was generally moderate to high, but higher with the CPOT. There was more disagreement between raters in overall pain scores for the NVPS. When raters disagreed, it was most often in rating the face component on both scales. Disagreement was highest during the event. Both scales adequately capture pain in the nonverbal sedated critically ill patient based on assessment of patients' face, body movements, muscle tension, and respirations, with the NVPS also considering vital signs. Pictures depicting facial expressions for scoring purposes are helpful. Adequate education and understanding of use of the scales is critical for accurate assessment and subsequent interventions.... |
| The Design of Future Pediatric Mechanical Ventilation Trials for Acute Lung Injury - American Journal of Respiratory and Critical Care Medicine |
| Khemani RG et al. – The purpose of this review will be to highlight these challenges, discuss pertinent work which has begun to address them, and propose potential solutions or future investigations which may help facilitate comprehensive trials on pediatric mechanical ventilation and define clinical practice standards.... |
August 24, 2010
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| Family witnessed resuscitation-experience and attitudes of German intensive care nurses - Nursing in Critical Care |
| Koberich S et al. – German intensive care nurses have guarded attitudes towards FWR because of their experiences and concerns for the well–being of relatives and staff. Introducing this topic within nursing curricula, as part of resuscitation training and by wider professional debate will help challenge and resolve practitioner concerns and objections.... |
| Extracorporeal membrane oxygenation in a Scottish intensive care unit - Nursing in Critical Care |
| Berryman S – These patient was on ECMO for 9 days. She went on to make a remarkable recovery and was discharged from the ICU 1 week after ECMO was discontinued. She was discharged to the cardiothoracic high–dependency unit, where she was successfully rehabilitated. The authors were able to successfully treat a young lady, while providing the care for all other patients. This was a complex treatment, one that uses many resources including time and finance. Now that authors have all the equipment, the necessary training and the knowledge, authors can continue to deliver this service to the public in our locality.... |
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