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Adult cvicu

Silas P Trumbo, Wade T Iams, Heather M Limper, Kathryn Goggins, Jayme Gibson, Lauren Oliver, David L Leverenz, Lauren R Samuels, Donald W Brady, Sunil Kripalani
BACKGROUND: Choosing Wisely® is a national initiative to deimplement or reduce low-value care. However, there is limited evidence on the effectiveness of strategies to influence ordering patterns. OBJECTIVE: We aimed to describe the effectiveness of an intervention to reduce daily chest X-ray (CXR) ordering in two intensive care units (ICUs) and evaluate deimplementation strategies. DESIGN: We aimed to describe the effectiveness of an intervention to reduce daily chest X-ray (CXR) ordering in two intensive care units (ICUs) and evaluate deimplementation strategies...
February 2019: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Lukasz A Myc, Jonathan G Stine, Rinita Chakrapani, Alexandra Kadl, Curtis K Argo
AIM: To examine patient-centered outcomes with vasopressin (AVP) use in patients with cirrhosis with catecholamine-refractory septic shock. METHODS: We conducted a single center, retrospective cohort study enrolling adult patients with cirrhosis treated for catecholamine-resistant septic shock in the intensive care unit (ICU) from March 2011 through December 2013. Other etiologies of shock were excluded. Multivariable regression models were constructed for seven and 28-d mortality comparing AVP as a second-line therapy to a group of all other vasoactive agents...
January 18, 2017: World Journal of Hepatology
Alisa Arunamata, David M Axelrod, Alaina K Kipps, Doff B McElhinney, Andrew Y Shin, Frank L Hanley, Inger L Olson, Stephen J Roth, Elif Seda Selamet Tierney
OBJECTIVES: To review current institutional practice and describe factors contributing to variation in inpatient postoperative imaging surveillance after congenital heart surgery. STUDY DESIGN: We reviewed records of all children who underwent congenital heart surgery from June to December 2014. Number and primary indications for postoperative transthoracic echocardiograms (TTEs), providers involved, cardiovascular intensive care unit (CVICU) and total hospital length of stay, and Risk-Adjustment for Congenital Heart Surgery-1 scores were recorded...
January 2017: Journal of Pediatrics
Anne Miller, Chad E Wagner, Yanna Song, Kathleen Burns, Rashid Ahmad, C Lee Parmley, Matthew B Weinger
OBJECTIVE: To test the effect of a high reliability organization (HRO) intervention on patient lengths of stay in the CVICU and hospital. The authors proposed that (1) higher safety related evidence based protocol (SREBP) team compliance scores and (2) lower SREBP milestone scores are associated with shorter lengths of CVICU and hospital stay. DESIGN: A prospective, longitudinal observational evaluation was used to assess the effects of SREBP-focused rounding processes and a milestone-tracking tool...
June 2014: Journal of Cardiothoracic and Vascular Anesthesia
Jennifer K Hansen, David G Anthony, Liang Li, David Wheeler, Daniel I Sessler, C Allen Bashour
PURPOSE: Postoperative positive end-expiratory pressure (PEEP) selection in patients who are mechanically ventilated after cardiac operations often seems random. The aim of this investigation was to compare the 2 most common postoperative initial PEEP settings at our institution, 8 and 5 cm H2O, on postoperative initial tracheal intubation time (primary outcome); cardiovascular intensive care unit (CVICU); hospital length of stay (LOS); occurrence of pneumonia; and hospital mortality (secondary outcomes)...
September 2015: Journal of Intensive Care Medicine
Jennifer Rude, Komola Azimova, Cristina Dominguez, Jerzy Sarosiek, Stanley Edlavitch, Debabrata Mukherjee
Depression is a predictor of length of stay (LOS) and adverse outcomes in patients with cardiac disease. Our objective was to assess the impact of depression on LOS in a Hispanic population admitted to a cardiovascular intensive care unit (CVICU). This was a prospective study of 151 consecutive patients admitted to the CVICU. Patients were administered the Center for Epidemiologic Studies Depression (CES-D) scale survey within 24 hours of admission. Patients were followed until discharge to determine LOS and adverse outcomes...
August 2014: Angiology
Carolyn A Maidl, Jane S Leske, Annette E Garcia
The primary aim was to examine the influence of "quiet time" in critical care. A dual-unit, nonrandomized, uncontrolled trial of a quiet time (QT) protocol was completed. A sample of adult patients from the Neurosciences Intensive Care Unit (NICU) and Cardiovascular Intensive Care Unit (CVICU) participated. Environmental stressors were reduced and patient rest promoted prior to QT. One hundred twenty-nine patients participated in 205 QTs. A one-way, repeated measure analysis of covariance (ANCOVA) was calculated comparing Richards-Campbell Sleep Questionnaire scores, pain and anxiety over three consecutive QTs...
October 2014: Clinical Nursing Research
Genevieve Echeta, Brady S Moffett, Paul Checchia, Mary Kay Benton, Leda Klouda, Fred H Rodriguez, Wayne Franklin
BACKGROUND: Adults with congenital heart disease (CHD) are often cared for at pediatric hospitals. There are no data describing the incidence or type of medication prescribing errors in adult patients admitted to a pediatric cardiovascular intensive care unit (CVICU). METHODS: A review of patients >18 years of age admitted to the pediatric CVICU at our institution from 2009 to 2011 occurred. A comparator group <18 years of age but >70 kg (a typical adult weight) was identified...
March 2014: Congenital Heart Disease
Chetan Chandulal Shah, Leann Linam, S Bruce Greenberg
BACKGROUND: An appropriate clinical history improves the perception and interpretation of radiographic examinations in children and adults. However, clinical history provided on radiology request has not been studied for its appropriateness and frequency of cloned clinical history. OBJECTIVE: The purpose of this study was to determine the frequency of inappropriate histories and cloned histories at a tertiary-care children's hospital. MATERIALS AND METHODS: We analyzed radiology request forms of 388 outpatient and inpatient radiographic examinations obtained on 3 days during the same month at a tertiary-care children's hospital...
October 2013: Pediatric Radiology
Samuel E Crockett, Jorge Suarez-Cavelier, Kevin D Accola, Lori A Hadas, Darcey L Harnage, Paul R Garrett, Kathy A Butler, Zuber D Mulla
OBJECTIVE: To evaluate the safety and efficacy of replacing a paper-based protocol with a computer-guided glucose management system (CGMS) for the treatment of postoperative hyperglycemia in the cardiovascular intensive care unit (CVICU). METHODS: With use of a before-and-after analysis, adult patients (≥18 years) discharged from the CVICU and treated with the paper protocol were compared with patients discharged from the CVICU and treated with the CGMS. Of the 1,648 patients analyzed, 991 were in the CGMS group...
July 2012: Endocrine Practice
Ioanna Lola, Stamatina Levidiotou, Anastasios Petrou, Helen Arnaoutoglou, Efstratios Apostolakis, George S Papadopoulos
BACKGROUND: Nosocomial infections after cardiac surgery represent serious complications associated with substantial morbidity, mortality and economic burden. This study was undertaken to evaluate the frequency, characteristics, and risk factors of microbiologically documented nosocomial infections after cardiac surgery in a Cardio-Vascular Intensive Care Unit (CVICU). METHODS: All patients who underwent open heart surgery between May 2006 and March 2008 were enrolled in this prospective study...
2011: Journal of Cardiothoracic Surgery
Sandra L Staveski, Sonja Avery, David N Rosenthal, Stephen J Roth, Gail E Wright
BACKGROUND: Young children supported on a ventricular assist device (VAD) can have prolonged hospitalizations awaiting heart transplantation. The adult VAD literature demonstrates that comprehensive programs optimize transplantation outcomes. The goal of this intervention was to create an interdisciplinary program to optimize care coordination and delivery in young children requiring a VAD. METHOD: This study was a case review. RESULTS: We have supported 8 infants and young children with Berlin Heart VAD...
May 2011: Journal of Cardiovascular Nursing
Henry Thomas Stelfox, Sofia B Ahmed, David Zygun, Farah Khandwala, Kevin Laupland
PURPOSE: Although intensive care unit (ICU) acquired sodium disturbances are common in critically ill patients, few studies have examined sodium disturbances in patients following cardiac surgery. The objective of this study was to describe the epidemiology of ICU-acquired hyponatremia and hypernatremia in patients following cardiac surgery. METHODS: We identified 6,727 adults (> or =18 yr) who were admitted consecutively to a regional cardiovascular intensive care unit (CVICU) from January 1, 2000 to December 31, 2006 and were documented as having normal serum sodium levels (133 to 145 mmol...
July 2010: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Amy O Calvin, Cheryl M Lindy, Stefanie L Clingon
PURPOSE: Nurses in the cardiovascular intensive care unit (CVICU) informally expressed moral angst when caring for patients who are approaching the end of life. The purpose of this study was to better understand CVICU nurses' perceptions about their roles and responsibilities in the decision-making process about change in intensity of care and end-of-life care for patients within the CVICU setting. PARTICIPANTS AND METHODS: Nineteen nurses from one CVICU consented to being interviewed individually regarding their experiences caring for patients approaching the end of life, and specifically regarding the initiation of a change in code status...
August 2009: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Maryrose Reyes, Louise Jensen, Janice Stewart, William T Kidd
BACKGROUND: Maintaining blood glucose levels (BGL) within normoglycemic range has been shown to reduce morbidity and mortality in critically ill patients. However, there is little evidence that maintenance of normoglycemic BGL is beneficial for diabetic and non-diabetic patients who undergo cardiac surgery. PURPOSE: To examine the relationship between BGL and length of stay (LOS) of cardiac surgical patients. METHODS: Data were obtained from the Safer Healthcare Now Project database in the cardiovascular intensive care unit (CVICU) at the Foothills Medical Centre, Calgary, Alberta, and included two BGL from cardiac surgery patients: BGL 1 was collected within four hours preoperatively, BGL 2 was collected postoperatively 24 hours after BGL 1...
2008: Dynamics: the Official Journal of the Canadian Association of Critical Care Nurses
Mirela Ovreiu, Bala G Nair, Meng Xu, Mohamed H Bakri, Liang Li, Oussama Wazni, Tamer Fahmy, John Petre, Norman J Starr, Daniel I Sessler, C Allen Bashour
BACKGROUND: Electrocardiographic (ECG) characteristics were analyzed in postoperative cardiac surgery patients in an attempt to predict development of new-onset postoperative atrial fibrillation (AF). METHODS: Nineteen ECG characteristics were analyzed using computer-based algorithms. The parameters were retrospectively analyzed from ECG signals recorded in postoperative cardiac surgery patients while they were in the cardiovascular intensive care unit (CVICU) at our institution...
November 2008: Pacing and Clinical Electrophysiology: PACE
M Y Rady, T Ryan, N J Starr
OBJECTIVE: To define the clinical characteristics and outcome of preoperative hypoalbuminemia in adult cardiovascular surgery. STUDY: Inception cohort. SETTING: Adult cardiovascular intensive care unit (CVICU). PATIENTS: Admissions to CVICU between January 1 and December 31, 1993. INTERVENTION: Preoperative hypoalbuminemia (serum albumin < or = 3.5 g/dL) was classified by the presence of malnutrition cachexia (body mass index of < or = 20 kg/m2), liver insufficiency (serum bilirubin > or = 2...
March 1997: JPEN. Journal of Parenteral and Enteral Nutrition
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