Articles: intensive-care-units.
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Annals of intensive care · Mar 2013
An observational study on rhabdomyolysis in the intensive care unit. Exploring its risk factors and main complication: acute kidney injury.
Because neither the incidence and risk factors for rhabdomyolysis in the ICU nor the dynamics of its main complication, i.e., rhabdomyolysis-induced acute kidney injury (AKI) are well known, we retrospectively studied a large population of adult ICU patients (n = 1,769). ⋯ Because it also has extrarenal elimination kinetics, our data suggest that measuring myoglobin in patients at risk for rhabdomyolysis in the ICU may be useful.
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Observational Study
Beyond the bundle - journey of a tertiary care medical intensive care unit to zero central line-associated bloodstream infections.
We set a goal to reduce the incidence rate of catheter-related bloodstream infections to rate of <1 per 1,000 central line days in a two-year period. ⋯ Residual CLA-BSIs, despite strict adherence to central line bundle, may be related to blood culture contamination categorized as CLA-BSIs per CDC/NHSN definition. Efforts to reduce residual CLA-BSIs require a strategic multidisciplinary team approach focused on epidemiologic investigations of practitioner- or unit-specific etiologies.
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Perhaps now more than ever, appropriate nutrition delivery in the ICU is a highly debated issue. Nutrition guidelines for ICU patients by European Society for Clinical Nutrition and Metabolism in Europe, The Canadian Nutrition Guidelines, and American Society for Parenteral and Enteral Nutrition in the USA continue to disagree about the need to feed early and how. Most ICU patients around the world appear to be poorly fed. ⋯ These findings implicate that optimization of protein balance in ICU patients as well as energy balance will improve outcome. In clinical practice, protein targets for patients should be set and achieved. More research is needed to define when and how to best feed the ICU patient.
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J Obstet Gynecol Neonatal Nurs · Mar 2013
Review Comparative StudyUnplanned extubation in the NICU.
Unplanned extubation (UE) in the neonatal intensive care unit (NICU) is a significant patient safety and quality control issue. I describe the implementation of a quality improvement program using multifactorial prevention strategies, including staff education, identification of neonates at risk for UE, extubation and weaning, standardization of procedures, and comprehensive documentation. Additional research on quality improvement with strategies for neonates may prove beneficial in reducing UE rates in neonates.
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Curr Neurol Neurosci Rep · Mar 2013
ReviewElectroencephalographic monitoring in the pediatric intensive care unit.
Continuous electroencephalographic (CEEG) monitoring is used with increasing frequency in critically ill children to provide insight into brain function and to identify electrographic seizures. CEEG monitoring use often impacts clinical management, most often by identifying electrographic seizures and status epilepticus. ⋯ Seizure identification efficiency may be improved by further development of quantitative electroencephalography trends. This review describes the clinical impact of CEEG data, the epidemiology of electrographic seizures and status epilepticus, the impact of electrographic seizures on outcome, the utility of quantitative electroencephalographic trends for seizure identification, and practical considerations regarding CEEG monitoring.