integrative therapies to promote sleep in the intensive care unit
Báo cáo khoa học: "Remifentanil versus fentanyl for analgesia based sedation to provide patient comfort in the intensive care unit: a randomized, double-blind controlled trial [ISRCTN43755713]" ppsx
... were being made to enter the patient into the study The treatment period was defined as the following four phases: maintenance phase (from the start of the study drug until the start of the extubation ... centres in Belgium, eight in Germany, one in The Netherlands, four in Spain, four in the UK) In total, 152 patients were randomized, in a double-blind manner, to receive either a remifentanil based ... without pain was treated either by reducing or by discontinuing the propofol (if being administered) or opioid infusion Pain was treated with an opioid bolus dose and an increase in the opioid infusion...
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Báo cáo khoa học: "Bench-to-bedside review: Treating acid–base abnormalities in the intensive care unit – the role of renal replacement therapy" potx
... According to the Stewart–Figge approach, metabolic acidosis can then result from a reduction in the SID or from an increase in Atot, and respiratory acidosis can result from a gain in PCO2 The ... patients dialysed in the intensive care unit Am J Nephrol 1991, 11:44-47 Brivet F, Kleinknecht D, Loirat P: Acute renal failure in intensive care units – causes, outcome, and prognostic factors: a prospective, ... control individuals in an intensive care unit (P < 0.005; Fig 4) Accordingly, CVVHDF can be considered physiologically superior to IHD in the correction of metabolic acidosis The overwhelming superiority...
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Báo cáo khoa học: " How to compare adequacy of algorithms to control blood glucose in the intensive care unit" pptx
... serum insulin-like growth factor binding protein concentration both have AUCs of the ROC of about 0.8 (the latter being an indicator of hepatic insulin resistance or lack of insulin effect on the ... titrated intensive insulin therapy to maintain a blood glucose below 6.1 mmol/l throughout intensive care The observation by Vogelzang and coworkers [1] of a slightly better AUC of the ROC when the ... ideally a continuous or close to continuous blood glucose reading over time Secondly, in order to compare blood glucose control in two patient groups using the HGI, the sampling interval in the two...
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Báo cáo khoa học: "Bench-to-bedside review: Treating acid–base abnormalities in the intensive care unit – the role of buffers" ppt
... it is misleading to assume that [HCO3–] is an independent determinant of [H+] In fact, the independent determinants of [H+] in the blood are the strong ion difference [SID], the total concentration ... the net difference in their charges The [SID] is defined as the difference between the sum of the major cations (Na+, K+, Ca2+, Mg2+) and the sum of the major anions (Cl–, SO4–, lactate) in the ... examining the effects of bicarbonate infusion on intracellular pH are variable, with intracellular [H+] rising [36], falling [37,38,43–48], not changing [4,14,34,35], or either rising or falling...
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Báo cáo y học: " A stronger approach to weakness in the intensive care unit" doc
... vasculitis.) A flow chart giving an approach to generalized weakness and/or ventilatory failure in the intensive care unit CK, creatine kinase; CSF, cerebrospinal fluid; GBS, Guillain–Barré syndrome; EMG, ... membranopathy/necrotizing varieties or creatine kinase may not be significantly elevated in cases with loss of myosin filaments To determine the relative contributions of nerve versus muscle disease in explaining ... Bolton and Young [16] in the cerebrospinal fluid Biochemical screening for porphyria during acute attacks should be positive Other conditions, such as inflammatory myopathies or unrecognized motor...
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Báo cáo khoa học: "Cystatin C: unsuited to use as a marker of kidney function in the intensive care unit" pot
... tetraiodothyronine and normal thyroid-stimulating hormone, which confounds extrapolation of published data in this population We feel that future studies to evaluate this issue are warranted Competing interests ... Critical Care October 2005 Vol No Wulkan et al from the study ‘Nonthyroidal illness’ is common in critically ill patients This disorder typically presents with low free triiodothyronine values, ... warranted Competing interests The author(s) declare that they have no competing interests References 532 Villa P, Jiménez M, Soriano MC, Manzanares J, Casasnovas P: Serum cystatin C as a marker of acute...
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Báo cáo khoa học: "Bench-to-bedside review: Antimicrobial utilization strategies aimed at preventing the emergence of bacterial resistance in the intensive care unit" pps
... isolates from inpatients and outpatients in the United States: increasing importance of the intensive care unit Clin Infect Dis 1997, 24:211-215 Sieradzki K, Roberts RB, Haber SW, Tomasz A: The development ... M: The prevalence of nosocomial infection in intensive care units in Europe: results of the European Prevalence of Infection in Intensive Care (EPIC) Study; EPIC International Advisory Committee ... resistance in the intensive care unit Curr Opin Infect Dis 2004, 17:309-316 Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, NicolasChanoin MH, Wolff M, Spencer RC, Hemmer M: The prevalence...
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Báo cáo khoa học: "A research algorithm to improve detection of delirium in the intensive care unit" pdf
... Skrobik Y: Delirium in an intensive care unit: a study of risk factors Intensive Care Med 2001, 27:1297-1304 26 Truman B, Ely EW: Monitoring delirium in critically ill patients Using the confusion ... delirium in the intensive care unit: comparison of confusion assessment method for the intensive care unit with confusion assessment method ratings J Am Geriatr Soc 2005, 53:495-500 10 Lin SM, ... Method for the Intensive Care Unit; CI, confidence interval Sedation assessment The research nurse conducted a sedation assessment using the RASS each time the CAM-ICU rating was completed In addition,...
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Báo cáo khoa học: " Development of liver dysfunction under artificial nutrition: a reason to modify nutrition therapy in the intensive care unit" docx
... can occur within to weeks of PN/EN therapy and in most cases these return to normal even when PN is continued; a chronic liver dysfunction is generally not to be expected Competing interests Parts ... live-saving treatment and must therefore be an integral component of modern medical therapy In many cases the primary disease is the decisive cause of the development of liver dysfunction; intravenous ... avoiding bacterial overgrowth, endotoxemia, and abnormal bile acid metabolism [4] It is therefore surprising that Grau and colleagues [1] still observed, in 18% of their patients receiving EN,...
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Báo cáo khoa học: "Re-examining ethical obligations in the intensive care unit: HIV disclosure to surrogates" ppt
... beneficence to their patients is therefore relevant to the decision to disclose because doing so may ultimately serve the patients’ interests in avoiding needless suffering [5] In general, disclosure ... that the patient can be expected to gain outweighs any harms, costs, or burdens that others are likely to incur In case 1, the physicians ideally would have obtained more information regarding the ... maintain the patient’s confidentiality, and their duty to the surrogate to provide all necessary information to make an informed decision that served the patient’s interests By contrast, in case 2, the...
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Báo cáo y học: "Bench-to-bedside review: Leadership and conflict management in the intensive care unit" docx
... because they are proud to belong to the group The leader is wise to stimulate and intensify such feelings Nevertheless, the leader must maintain balance and keep the ICU service in a mediating position; ... satisfaction in neonatal intensive care units Nurs Res 1984, 33:97-101 Vincent P, Billings C: Unit management as a factor in stress among intensive care nursing personnel Focus Crit Care 1988, ... will be inclined to use such potential, to accept the individual diversity of their coworkers and try to utilise it positively in relation to the team, in disputes and discussions, in planning and...
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Báo cáo y học: "Bench-to-bedside review: Candida infections in the intensive care unit" ppsx
... predicted in intensive care unit patients with peritonitis? Crit Care Med 2003, 31:752-757 45 Ostrosky-Zeichner L: New approaches to the risk of Candida in the intensive care unit Curr Opin Infect ... surgery, and insertion of indwelling intravascular and urinary catheters) The gastrointestinal tract, the skin and the urogenital tract are the main portals of entry for Candida infections Colonization ... Gaynes RP: Nosocomial infections in combined medical-surgical intensive care units in the United States Infect Control Hosp Epidemiol 2000, 21: 510-515 Rangel-Frausto MS, Wiblin T, Blumberg HM,...
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Báo cáo y học: "Bench-to-bedside review: Rare and common viral infections in the intensive care unit – linking pathophysiology to clinical presentatio" ppt
... shock-inducing mechanisms thought to be due to the release of kinins and cytokines [106,107] The syndrome’s clinical presentation, rapid resolution, and histopathologic findings of interstitial infiltrates ... common to the adenovirus family Upon infection, respiratory epithelial cells express these capsid proteins on their surface, leading to direct CD8+ cytotoxic T-cell MHC class killing of these ... Critical Care Vol 12 No Stollenwerk et al (75% to 90%) than Marburg (25% to 40%) virus being the only major difference between them The initial incubation period after exposure to the virus is to days,...
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Báo cáo y học: "Renal failure in the intensive care unit: acute kidney injury compared to end-stage renal failure" pptx
... organ failure while in the ICU Competing interests The authors declare that they have no competing interests Authors’ contributions Mr R Chang is in charge of the Riyadh Intensive Care Program database ... Ikizler A, Paganini EP, Chertow GM, for the Program of Improve Care in Acute Renal Disease: Spectrum of acute renal failure in the intensive care unit: the PICARD experience Kidney Int 2004, 66:1613-1621 ... admitted to the intensive care unit Mayo Clin Proc 2004, 79:1385-1390 Uchino S, Morimatsu H, Bellomo R, Silvester W, Cole L: Endstage renal failure patients requiring renal replacement therapy in the...
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Báo cáo y học: "An artificial intelligence tool to predict fluid requirement in the intensive care unit: a proof-of-concept study" docx
... treatment of infectious diseases in intensive care units Lancet Infect Dis 2005, 5:305-312 The information obtained from the model may be useful in supplementing a clinician's knowledge base and intuition ... recorded The distribution of the total fluid intake during the second day in the ICU, the outcome variable, was skewed towards the lower values (Figure 1) The values were therefore log transformed to ... purposes) Artificial intelligence at the point-of -care in the ICU ICU cial intelligence tools applied to empiric data The first is to supplement clinical knowledge to support decisions in specialised,...
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Báo cáo y học: "Computer says 2.5 litres - how best to incorporate intelligent software into clinical decision making in the intensive care unit" doc
... they are locally generated [6,10] Conclusion There may be far-reaching implications of the incorporation of intelligence systems into clinical care Medicolegal challenges to nonadherence to the ... predicts the decisions of the clinicians who looked after the patients in the first place Of course, the incorporation of expert clinician fluid assessment into the original Bayesian network may ... difference in clinical opinion In addition, there is a tendency to concur with a definite-looking computer-generated answer rather than trust one’s own intuition There are many aspects of the management...
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Báo cáo y học: "Two devils: hypernatremia and hyponatremia can show faces to the same patient in the intensive care unit" pps
... Zygun D, Shahpori R, Laupland K: The epidemiology of intensive care unit- acquired hyponatremia and hypernatremia in medical–surgical intensive care units Crit Care 2008, 12:R162 Page of (page ... Critical Care Vol 13 No Eghtesadi-Araghi et al Competing interests The authors declare that they have no competing interests Reference Stelfox HT, Ahmed SB, Khandwala...
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Báo cáo y học: "Bedside diagnostic laparoscopy to diagnose intraabdominal pathology in the intensive care unit" pot
... laparoscopy in the intensive care patient Avoiding the nontherapeutic laparotomy Surg Endosc 1993, 7:168-172 13 Iberti TJ, Salky BA, Onofrey D: Use of bedside laparoscopy to identify intestinal ischemia ... established by noradrenaline (0.1 to μg/kg/minute) and/ or dobutamine (2 to μg/kg/minute) infusion Results Overall population During the 30-month study period, 32 patients fulfilled the indication criteria ... trocar was inserted through a portion of the laparotomy incision, as previously described [8] Pneumoperitoneum was achieved by inflating the abdominal cavity with carbon dioxide at to 15 mmHg...
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Báo cáo y học: "Bench-to-bedside review: Mobilizing patients in the intensive care unit – from pathophysiology to clinical trials" pot
... shift toward increased production of anti-inflammatory cytokines [9] Typically, IL-6 (which has anti-inflammatory properties) is the first cytokine to rise during exercise, increasing up to 100-fold ... FOXO signaling pathways, resulting in protein loss, possibly through the ubiquitin-proteasome pathway [40] This increase in ROS and imbalance in the cytokine profile can further disrupt the balance ... and then declines shortly after discontinuation of exercise (
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Báo cáo y học: "Health technology assessment review: Computerized glucose regulation in the intensive care unit - how to create artificial control" ppsx
... levels and insulin dosing according to a ‘sliding scale’ protocol (a predetermined amount of insulin is administered according to the actual BG) or ‘dynamic’ protocol (the dosage of insulin is changed ... II 4.0 to 7.5 4.4 to 7.2 5.4 to 7.1 4.4 to 6.1 5.0 to 8.3 4.0 to 7.0 4.4 to 6.1 4.4 to 6.1 8.0 to 10.0 4.5 to 6.0 4.4 to 6.1 4.5 to 7.5 4.5 to 7.2 4.4 to 6.1 4.4 to 6.1 4.4 to 6.7 4.4 to 6.1 ... adapting the control parameter (insulin) using a linear combination of absolute deviation, trend, and the sum of past deviations In fact, a PID controller has already been used in the BioStator, the...
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