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A Comparison Between Customized and Premixed Parenteral Nutrition: Cost Really Matters 定制和预混肠外营养的比较:成本真的很重要
ICU director Pub Date : 2013-10-11 DOI: 10.1177/1944451613506745
S. Sathyanarayana, G. Deutsch, Narendra C. Singh, R. Barrera
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引用次数: 5
A Nutrition Algorithm Incorporating Early Initiation of Nutrition With Higher Feeding Rates, Percentage of Gastric Residual Volume, Small-Bowel Feedings, and Compensatory Nighttime Feeds Leads to Reduced Energy Deficit in Critically Ill Patients 一种营养算法结合了早期开始营养，更高的摄食率，胃残余体积百分比，小肠喂养和夜间补偿性喂养，可以减少危重患者的能量不足
ICU director Pub Date : 2013-09-30 DOI: 10.1177/1944451613505864
N. Martella, Thomas Bily, R. Jose, B. Zaidman, R. Barrera
{"title":"A Nutrition Algorithm Incorporating Early Initiation of Nutrition With Higher Feeding Rates, Percentage of Gastric Residual Volume, Small-Bowel Feedings, and Compensatory Nighttime Feeds Leads to Reduced Energy Deficit in Critically Ill Patients","authors":"N. Martella, Thomas Bily, R. Jose, B. Zaidman, R. Barrera","doi":"10.1177/1944451613505864","DOIUrl":"https://doi.org/10.1177/1944451613505864","url":null,"abstract":"Background/Objective. A discrepancy often emerges between nutritional goals and actual delivery. This study assesses the relationship between energy balance and length of stay (LOS) in surgical intensive care unit (SICU) patients. SICU patients are frequently catabolic and at risk of underfeeding. We set forth to identify if a nutritional algorithm will improve energy delivery and outcomes. Methods. A prospective observational study conducted in surgical critical care patients was performed. After implementation of a nutrition algorithm; demographic data, initiation of feeding, acquiring caloric goal, caloric deficit, LOS, and mortality were recorded. Cumulative energy balance was calculated as energy delivery minus daily target. Data are presented as mean ± standard deviation. Results. In all, 100 patients aged 66 ± 17 years (45% female and 55% male) admitted to the SICU were evaluated. All were nutritionally compromised, with 72% being NPO (nothing by mouth), 9% orally fed, and 9% enterally fed. SICU LO...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"11 1","pages":"285-290"},"PeriodicalIF":0.0,"publicationDate":"2013-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613505864","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65898348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Expanding Roles for Noninvasive Ventilation in Perioperative Care 无创通气在围手术期护理中的作用不断扩大
ICU director Pub Date : 2013-09-16 DOI: 10.1177/1944451613503008
J. Aldrich, C. Yost
{"title":"Expanding Roles for Noninvasive Ventilation in Perioperative Care","authors":"J. Aldrich, C. Yost","doi":"10.1177/1944451613503008","DOIUrl":"https://doi.org/10.1177/1944451613503008","url":null,"abstract":"Over the past several years, less invasive methods of providing ventilatory support have arisen to help support patients with respiratory insufficiency and airway obstruction. The application of noninvasive ventilation (NIV) in these situations can provide short- to medium-term aid for certain patient populations without introducing the risks associated with endotracheal intubation. In this article, we review the basics of NIV, discuss the accepted indications for NIV in the ICU, explore the perioperative indications for NIV, including use in patients with obstructive sleep apnea, and finally, provide practical tips for implementing NIV in the ICU and anesthesia recovery areas.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"13 1","pages":"296-300"},"PeriodicalIF":0.0,"publicationDate":"2013-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613503008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65898710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dexmedetomidine Applications During Fiberoptic Tracheal Intubation of the Patient With a Difficult Airway 右美托咪定在气道困难患者纤维气管插管中的应用
ICU director Pub Date : 2013-09-01 DOI: 10.1177/1944451613499369
J. Tobias, David B. Tulman, S. Bergese
{"title":"Dexmedetomidine Applications During Fiberoptic Tracheal Intubation of the Patient With a Difficult Airway","authors":"J. Tobias, David B. Tulman, S. Bergese","doi":"10.1177/1944451613499369","DOIUrl":"https://doi.org/10.1177/1944451613499369","url":null,"abstract":"Objective. To provide a general descriptive account and review of the literature regarding the use of dexmedetomidine for sedation during fiberoptic bronchscopic (FOB) intubation. Data Source. A co...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"232-241"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613499369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65897801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Acute on Chronic 急性与慢性
ICU director Pub Date : 2013-09-01 DOI: 10.1177/1944451613501245
C. S. Yost
{"title":"Acute on Chronic","authors":"C. S. Yost","doi":"10.1177/1944451613501245","DOIUrl":"https://doi.org/10.1177/1944451613501245","url":null,"abstract":"","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"215-216"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613501245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65898632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 27
Analgesic Management of Chronic Pain Patients in the ICU ICU慢性疼痛患者的镇痛管理
ICU director Pub Date : 2013-09-01 DOI: 10.1177/1944451613496817
Xiaobing Yu
{"title":"Analgesic Management of Chronic Pain Patients in the ICU","authors":"Xiaobing Yu","doi":"10.1177/1944451613496817","DOIUrl":"https://doi.org/10.1177/1944451613496817","url":null,"abstract":"","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"42 1","pages":"217-222"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613496817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65898038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
A Common Presentation With an Uncommon Diagnosis 常见的表现和不常见的诊断
ICU director Pub Date : 2013-09-01 DOI: 10.1177/1944451613498896
N. Bajaj, Debabrata Bandhyopadhyay, Madhu Sasidhar, Akhil Parashar, A. Kapoor
{"title":"A Common Presentation With an Uncommon Diagnosis","authors":"N. Bajaj, Debabrata Bandhyopadhyay, Madhu Sasidhar, Akhil Parashar, A. Kapoor","doi":"10.1177/1944451613498896","DOIUrl":"https://doi.org/10.1177/1944451613498896","url":null,"abstract":"High anion gap metabolic acidosis (HAGMA) is a frequently observed laboratory finding in critically ill patients. Usually HAGMA occurs as a result of common disease processes. However, rare diseases often manifest themselves by mimicking common disease processes with subtle differences, occasionally making the diagnosis challenging. In the following case, the metabolic workup of a patient revealed HAGMA acidosis. After ruling out the usual causes, diligent investigation by our team of subtle laboratory clues revealed a rare cause for HAGMA.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"252-256"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613498896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65898120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Updates in Critical Care 2012-2013 2012-2013年重症监护最新进展
ICU director Pub Date : 2013-08-21 DOI: 10.1177/1944451613500986
E. Seeley
{"title":"Updates in Critical Care 2012-2013","authors":"E. Seeley","doi":"10.1177/1944451613500986","DOIUrl":"https://doi.org/10.1177/1944451613500986","url":null,"abstract":"Important advances in treating critically ill patients often proceed in fits and starts. Thematic studies are often published in clusters and concordant negative or positive results can accelerate shifts in clinical practice. The past few years have seen several important studies that address key knowledge gaps in treating critically ill patients. In this article, 6 studies that address key questions in the implementation of lung-protective ventilation, the use of oscillatory ventilation in severe acute respiratory distress syndrome, transfusion practices during upper gastrointestinal bleeds, and the use of total parenteral nutrition in critically ill patients are reviewed. These studies should shift the way we ventilate, transfuse, and nourish patients in the ICU.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"317-321"},"PeriodicalIF":0.0,"publicationDate":"2013-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613500986","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65898207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Understanding the nature of interprofessional collaboration and patient family involvement in intensive care settings: A study protocol 了解重症监护环境中跨专业合作和患者家庭参与的本质:一项研究方案
ICU director Pub Date : 2013-07-31 DOI: 10.1177/1944451613498897
S. Reeves, Elise Paradis, Myles Leslie, S. Kitto, H. Aboumatar, M. Gropper
{"title":"Understanding the nature of interprofessional collaboration and patient family involvement in intensive care settings: A study protocol","authors":"S. Reeves, Elise Paradis, Myles Leslie, S. Kitto, H. Aboumatar, M. Gropper","doi":"10.1177/1944451613498897","DOIUrl":"https://doi.org/10.1177/1944451613498897","url":null,"abstract":"Although effective interprofessional collaboration is a key component of patient safety and quality improvement initiatives, little is known about the nature of collaboration in ICU settings. Through ethnographic research, this study will explore interprofessional care in 8 ICUs (6 based in the United States and 2 based in Canada), develop an empirically based readiness/diagnostic tool to assess the quality of team-based care delivery, and develop interventions to strengthen team-based care and patient family involvement. Our study has 3 iterative phases and will involve: a scoping review of the literature on team dynamics in the ICU, an ethnographic study (observation, shadowing, interviews) across 8 sites over 2 years and the collection of clinical outcomes data to inform the development of a “diagnostics” tool for interprofessional collaboration and family member involvement in ICU care, as well as interprofessional intervention development. The importance of ethnographic and other forms of qualitative...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"242-247"},"PeriodicalIF":0.0,"publicationDate":"2013-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613498897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65898190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Macrophage Activation Syndrome in a Patient With Adult Still’s Disease Following Rituximab: Presenting With “Pseudo-Septic Shock” 成人Still病患者服用利妥昔单抗后出现巨噬细胞激活综合征:表现为“假性感染性休克”
ICU director Pub Date : 2013-07-15 DOI: 10.1177/1944451613494792
K. Fischbach, B. Coe, M. Radwan, Julio Rodríguez, J. Carter, M. Rumbak
{"title":"Macrophage Activation Syndrome in a Patient With Adult Still’s Disease Following Rituximab: Presenting With “Pseudo-Septic Shock”","authors":"K. Fischbach, B. Coe, M. Radwan, Julio Rodríguez, J. Carter, M. Rumbak","doi":"10.1177/1944451613494792","DOIUrl":"https://doi.org/10.1177/1944451613494792","url":null,"abstract":"Objective. To present the first case report of macrophage activation syndrome presenting as systemic inflammatory response syndrome secondary to rituximab. Design. Case report with review of the literature. Setting. Intensive care unit of university hospital. Patient. A 21-year-old female, who was diagnosed at age 19 with adult Still’s disease after having recurrent fevers, salmon-colored rash, polyarthralgias, and ferritin level of 24 000 ng/mL, was admitted to the hospital with fever, tachycardia, hypotension, leukocytosis, lethargy, and diarrhea. Intervention. The use of anakinra in the setting of systemic inflammatory response syndrome and macrophage activation syndrome. Results. The use of anakinra in patients with macrophage activation syndrome reduced inflammatory markers, lowered ferritin levels, and improved the patient’s symptoms as well as aided in recovery from cytokine-induced cardiomyopathy. Conclusions. This case illustrates this rare, but potentially life-threatening, side effect of rituxi...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"248-251"},"PeriodicalIF":0.0,"publicationDate":"2013-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613494792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65897911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
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