case examples evidence based care and outcomes in depressed adults and in critically ill children
Báo cáo khoa học: "Early percutaneous dilatational tracheostomy leads to improved outcomes in critically ill medical patients as compared to delayed tracheostomy" doc
... communicate, and easier nursing care [2] It is, however, not without risk and there continues to be considerable debate regarding the optimal timing of tracheostomy In an attempt to balance the risks and ... patients randomized to the late group did not require tracheostomy points out the inherent difficulty in making this prediction In this study, this determination was made by clinicians and lacked ... the findings of reduced mortality, ICU length of stay, and duration of mechanical ventilation are quite striking, which raises the question, why? By reducing work of breathing [3] and improving...
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Báo cáo khoa học: "Cystatin C and beta2-microglobulin: markers of glomerular filtration in critically ill children" potx
... creatinine • In our study, correlations with creatinine clearance and creatinine clearance estimated by Schwartz formula are better for cystatin C and beta2-microglobulin than for serum creatinine ... low-molecular-weight proteins in critically ill children The aim of this study was to evaluate the accuracies of serum Cr, serum cystatin C, and B2M as markers of GFR in critically ill children by comparing their ... creatinine in our study • In our experience, serum cystatin C and beta2microglobulin are confirmed as simple and useful markers, better than serum creatinine, to detect acute kidney disease in critically...
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Báo cáo y học: "Hyperglycaemia results from beta-cell dysfunction in critically ill children with respiratory and cardiovascular failure: a prospective observational study" pot
... Effect of intensive insulin therapy on insulin sensitivity in the critically ill J Clin Endocrinol Metab 2007, 92:3890-3897 28 Faustino EV, Apkon M: Persistent hyperglycemia in critically ill children ... with insulin in critically ill patients Lancet 2005, 365:53-9 Andreelli F, Jacquier D, Troy S: Molecular aspects of insulin therapy in critically ill patients Curr Opin Clin Nutr Metab Care 2006, ... absolute insulin deficiency Those children may derive clinical benefit from insulin replacement, analogous to using insulin to treat type DM Practitioners may need to rethink insulin administration and...
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Báo cáo y học: "Early mobilization improves functional outcomes in critically ill patients" pdf
... helpful in answering some of these questions Even in the absence of such evidence, it would seem prudent our best to minimize sedation and to initiate PT/OT as early as possible Competing interests ... competing interests Author details Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA 2The Clinical Research, Investigation, and Systems Modeling of Acute Illness ... reinitiate sedation, the timing of extubation, and ICU and hospital discharge that may have accounted for differences in outcomes Finally, despite reduction in days with delirium no information is provided...
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Báo cáo y học: "Urine neutrophil gelatinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: a prospective cohort study" pot
... the minimum amount required for processing and storage Urine processing was similar to that in previous studies [18,19], in order to limit variations in findings resulting from differences in sample ... another urinary AKI biomarker, interleukin-18, is elevated in critically ill adult patients who later die, which can complicate the interpretation of urinary interleukinn-18 in the most severely ill ... analysis sample handling required minimal time and effort (approximately 10 min) DeSamples were shipped to Cincinnati Children' s Hospital Medical Center for uNGAL and creatinine measurement;...
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Báo cáo y học: "Continuous noninvasive monitoring of barbiturate coma in critically ill children using the Bispectral™ index monitor" doc
... required that combine pharmacokinetics and pharmacodynamics with continuous EEG and BIS monitoring to determine the safety and efficacy of barbiturate-induced comas in children Competing interests The ... medical intensive care: applications and limitations Intensive Care Med 1990, 16:60-68 Grindstaff RJ, Tobias JD: Applications of bispectral index monitoring in the pediatric intensive care unit J Intensive ... barbiturate-induced coma in critically ill children who require intensive neuro-monitoring For this purpose, BIS recordings were compared with standard full-channel EEG recordings Materials and methods Patients...
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Báo cáo y học: "Circuit life span in critically ill children on continuous renal replacement treatment: a prospective observational evaluation study" potx
... blood flows, thus increasing capillary shear forces and reducing protein layering, with the consequent decrease in membrane clotting and the prolongation of filter life [6] In a prospective study, ... and participated in the study design, data collection and analysis, and drafting of the manuscript EC, JU, SM, and MJS participated in the data collection and analysis and drafting of the manuscript ... receiving continuous renal replacement therapy Kidney Int 2005, 67:653-658 Fernández C, López-Herce J, Flores JC, Galaviz D, Rupérez M, Brandstrup KB, Bustinza A: Prognosis in critically ill children...
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Báo cáo y học: "Complications of continuous renal replacement therapy in critically ill children: a prospective observational evaluation study" doc
... continuous renal replacement therapy in children Kidney Int 2009, 75:312-316 Demirjian S, Teo BW, Paganini EP: Alkalemia during continuous renal replacement therapy and mortality in critically ill ... hypochloremia, and hypophosphatemia increased significantly during CRRT, requiring an increase in the concentration of these electrolytes in the dialysis and replacement fluids and/ or intravenous ... Spain) in the first 35 patients and the Prisma (Hospal®, Barcelona, Spain) in the remaining 139 The caliber of the catheters used was between 4F and 11F and the filters were between 0.04 m2 and...
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Báo cáo y học: "Extravascular lung water index measurement in critically ill children does not correlate with a chest x-ray score of pulmonary edema" docx
... without septal lines 45 interstitial edema with septal lines 50 mixed interstitial and alveolar edema with some sparing of pulmonary region 55 mixed interstitial and alveolar edema involving entire ... minute and indexed to body surface area (l/min/m2) Global end diastolic volume is expressed in milliliters and indexed to body surface area (ml/m2) Extravascular lung water is also expressed in ... other studies considering the clinical value of routine chest x-rays in adults and children [42-46] With regard to EVLWI measurements we believe, at present, that EVLWI in children should be studied...
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Báo cáo y học: "Correction: Extravascular lung water index measurement in critically ill children does not correlate with a chest x-ray score of pulmonary edem" doc
... repair 13 26 survived 10 M 36 15.0 Meningococcal disease survived 11 M 9.0 Meningococcal disease survived 12 F 14 10.0 Meningococcal disease 28 survived 13 M 9.0 Inborn error of metabolism 12 88 survived ... Drowning 19 17 85 Patient Age Weight number Gender (months) (kg) F 24 Probability of death PIM % Outcome 60 survived F 83 18.0 Reconstruction of pulmonary artery 18 16 survived F 23 14.0 Abdominal ... 16 survived F 23 14.0 Abdominal surgery 78 17 survived F 8.5 RSV 16 15 11 survived F 31 16.0 Meningococcal disease 22 19 survived F 4.8 Arterial switch operation 13 10 39 survived F 7.1 Tetrology...
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Báo cáo y học: "Assessing the quantity of pulmonary edema in critically ill children" docx
... detecting a correlation Values were reported from 24 patients and the reasons for treatment in the intensive care unit were quite variable The primary diagnosis necessitating treatment in the intensive ... useful in children, indexing is likely to be relevant in this cohort where the range of reported weights is up to 152 kg EVLW was inversely correlated with height in this study; this finding supports ... research is required in both adults and children to determine whether EVLW measured by the transpulmonary thermodilution method can be more accurately determined using this scoring system The authors...
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Báo cáo y học: "Continuous glucose monitors prove highly accurate in critically ill children" pot
... male with traumatic brain injury requiring mechanical ventilation and norepinephrine to maintain his cerebral perfusion pressure The arrows indicate when insulin was started and stopped per our ... variety of critically ill children • Our findings suggest that with further examination, existing CGM technology may be a useful adjunct in the detection and management of glucose disorders in critically ... www.survivingsepsis.org/Bundles/Individual_Changes/Pages/ maintain_glycemic.aspx] 11 Hirshberg E, Lacroix J, Sward K, Willson D, Morris AH: Blood glucose control in critically ill adults and children: ...
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Evidence-Based Medicine and the Changing Nature of Health Care: Meeting Summary docx
... the evidence that is available, and to too few incentives and decision supports for evidence- based care Pressing need for evidence development More and better evidence including comparative and ... IT will become an increasingly important vehicle for linking evidence to improved outcomes by providing information that is supported with convenience and capacities for discrimination and integration ... Defining and introducing value in health care, Michael E Porter, 161 References, 172 Appendixes A Meeting Agenda B Biographical Sketches of Principals C IOM Roundtable on Evidence- Based Medicine...
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báo cáo hóa học: " Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes" pptx
... between nursing staff in nursing homes and homebased care with respect to pain intensity in the lumbar spine In the cervical spine, pain intensity was lower for staff in nursing homes In both groups, ... findings in the lumbar spine, 10 were significantly more often abnormal in staff active in nursing homes than in home care (Table 3) The findings were mostly functional restrictions (including ... nursing staff, by care setting Nursing homes n = 1126 % Home care n = 264 % p-value1 Back pain on the examination day2 - in the lumbar spine - in the cervical spine 18 11 16 n.s
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Báo cáo y học: " Barriers and facilitators to evidence based care of type 2 diabetes patients: experiences of general practitioners participating to a quality improvement program" ppt
... with their blind spots and weaknesses, and increased their awareness of shortcomings in their case management habits Case coaching was identified as an important innovation in improving 'knowledge ... lifestyle, and even in the case of motivated individuals the changes were often minimal and temporary These findings confirm previous findings that sustainable lifestyle changes are hard to implement in ... in the interview and were replaced by the GP next in line In a post-hoc analysis, we found that few new themes were emerging after about 17 interviews, making it unnecessary to continue the interviewing...
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Tài liệu Evidence-based Series 15-1 IN REVIEW : Screening for Skin Cancer doc
... including total-body skin examination and counselling to perform skin self-examination? What characteristics should clinicians assess in order to determine risk for melanoma, basal cell carcinoma, ... health care provider trained in screening for skin cancers The general population not at increased risk of skin cancer There is at this time no evidence for or against skin cancer screening of ... skin cancer (i.e., those not included in the increased risk groups described above) Based on the limited evidence available at present, routine counselling on skin selfexamination by primary care...
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Tài liệu Evidence-Based Counselling and Psychological Therapies doc
... essential in seeking better care The practice of EBHC has three main components: generating evidence; seeking and combining (or ‘synthesising’) all evidence, new and old; and disseminating and using ... therapies, evidence- based health care is another umbrella term which includes evidence- based medicine, evidence- based nursing and evidence- based mental health, as well as evidence- based practice, evidence- based ... of randomised clinical trials or systematic reviews); The drive towards evidence- based health care 19 Box 2.1 Journals and databases Evidence- Based Medicine Evidence- Based Nursing Evidence- Based...
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báo cáo khoa học: " A realistic evaluation: the case of protocol-based care" docx
... scope, and impact of protocol -based care in the English NHS, and to determine the nursing, midwifery, and health visiting contribution to its development, implementation, and use, including decision ... understanding about the purpose and nature of protocol -based care by potential users will determine the extent to which standard care approaches are routinely used in practice The properties of standardised ... Subsequently, testing and refining these propositions in phase two may have resulted in findings with fewer nuances We hope to have counteracted this by drawing on and integrating various data...
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