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Post-intensive care syndrome

Asuka Tanaka, Takashi Onoe, Kohei Ishiyama, Kentaro Ide, Hirotaka Tashiro, Hideki Ohdan
INTRODUCTION: Transient Left Ventricular Apical Balloon Syndrome (LV-ABS) is an unknown acute dysfunction of the left ventricle, which develops under emotional or physical stress events like the major surgical postoperative period. PRESENTATION OF CASE: A 68-year-old woman diagnosed with hepatitis C cirrhosis was admitted for living donor liver transplantation (LDLT). No evidence for underlying cardiac or pulmonary disease was found. LDLT was performed, and her intra and post-operative course was uneventful...
February 10, 2019: International Journal of Surgery Case Reports
Raphael Ezeagu, Titilope Olanipekun
No abstract text is available yet for this article.
March 2019: Critical Care Medicine
N Beghdadi, A Soprani, A Kraemer, P Bucur, C Barrat, L Genser
BACKGROUND: Severe post-operative malnutrition (SM) is a dreaded complication after gastric bypass often related to the short bowel syndrome consecutive limb length mismeasurement or intestinal resections. Patients with rapid weight loss or malnutrition can experience liver failure with cirrhosis and require liver transplantation (LT). Malnutrition can constitute a contraindication to LT since it negatively impacts on postoperative morbidity. RYGB reversal is an effective option to consider when nutritional support has failed...
February 11, 2019: Obesity Surgery
R Grotelüschen, W Bergmann, M N Welte, M Reeh, J R Izbicki, K Bachmann
BACKGROUND: Acute mesenteric ischemia (AMI) is associated with a mortality of 60-80%. Early diagnosis and rapid treatment have a decisive influence on therapy. The aim of this study was to evaluate the prognostic value of AMI markers on mortality, in order to better anticipate the clinical course and to initiate therapeutic steps at an early stage. STUDY DESIGN: An analysis from our prospective database of 302 consecutive patients with AMI who were treated surgically in the Department of General Surgery between February 2003 and October 2014 was performed...
February 8, 2019: Journal of Visceral Surgery
Sydne Muratore, Alexandria Coughlan, James K Glover, Catherine L Statz, Craig Weinert, Susan E Kline, Gregory J Beilman
BACKGROUND: Our center initiated an electronic Sepsis Best Practice Alert (sBPA) protocol to aid in early sepsis detection and treatment. However, surgery alters peri-operative physiology, which may trigger an sBPA for noninfectious causes. This study aimed to provide early evaluation of automated sBPA utility in surgical patients. METHODS: This study was a retrospective review of the outcomes of patients admitted to the University of Minnesota Medical Center (but not to the intensive care unit) from August 2015-March 2016 and compared how the sBPA performed in those having and not having surgery...
February 6, 2019: Surgical Infections
Manuel Albornoz-Cabello, Jose Antonio Sanchez-Santos, Rocio Melero-Suarez, Alberto Marcos Heredia-Rizo, Luis Espejo-Antunez
Subacromial pain syndrome (SAPS) is a prevalent condition that results in loss of function. Surgery is indicated when pain and functional limitations persist after conservative measures, with scarce evidence about the most-appropriate post-operative approach. Interferential therapy (IFT), as a supplement to other interventions, has shown to relieve musculoskeletal pain. The study aim was to investigate the effects of adding IFT electro-massage to usual care after surgery in adults with SAPS. A randomized, single-blinded, controlled trial was carried out...
February 2, 2019: Journal of Clinical Medicine
Paweenus Rungwattanakit, Tarnkamon Sondtiruk, Akarin Nimmannit, Busara Sirivanasandha
Study Design: A retrospective case-control study. Purpose: To evaluate the effect of nitrous oxide and anesthetic and operative factors associated with severe pain in the early postoperative period after thoracolumbar spine surgery. Overview of Literature: Thoracolumbar spine surgery is the most common procedure in spine surgery, and up to 50% of the patients suffer from moderate to severe pain. Nitrous oxide has analgesic, anxiolytic, and anesthetic effects; nevertheless, its benefits for early postoperative pain control and opioid consumption remain to be established...
January 29, 2019: Asian Spine Journal
Son Q Duong, Justin Godown, Jonathan H Soslow, Cary Thurm, Matt Hall, Sandeep Sainathan, Victor O Morell, Debra A Dodd, Brian Feingold
OBJECTIVES: Identify pediatric heart transplant (HT) recipients with heterotaxy and other complex arrangements of cardiac situs (heterotaxy/situs anomaly) and compare mortality, morbidities, length of stay (LOS), and costs to recipients with congenital heart disease without heterotaxy/situs anomaly. METHODS: Using linked registry data (2001-2016), we identified 186 HT recipients with heterotaxy/situs anomaly and 1254 with congenital heart disease without heterotaxy/situs anomaly...
February 2019: Journal of Thoracic and Cardiovascular Surgery
Lalida Kongkiattikul, Maryse Dagenais, Ni Ruo, Patricia Fontela, Tanya Di Genova, Samara Zavalkoff
OBJECTIVES: This study aims to assess the impact of a quality improvement initiative to increase assessments of pain, agitation, and iatrogenic withdrawal syndrome, on the use of sedative and analgesic medication in a pediatric intensive care unit. DESIGN AND SETTING: This is a retrospective pre- and post, observational, quality improvement study conducted in an eighteen-bed medical-surgical-cardiac, tertiary intensive care unit. PATIENTS: We included patients consecutively admitted from October 1- March 31 (pre period 2015-2016, post period 2016-2017) who were mechanically ventilated beyond 48 hours...
January 21, 2019: Paediatric Anaesthesia
A Fuchsia Howard, Leanne Currie, Vicky Bungay, Margaret Meloche, Robert McDermid, Sarah Crowe, Andrea Ryce, William Harding, Gregory Haljan
BACKGROUND: While 80% of critically ill patients treated in an intensive care unit (ICU) will survive, survivors often suffer a constellation of new or worsening physical, cognitive, and psychiatric complications, termed post-intensive care syndrome. Emerging evidence paints a challenging picture of complex, long-term complications that are often untreated and culminate in substantial dependence on acute care services. Clinicians and decision-makers in the Fraser Health Authority of British Columbia are working to develop evidence-based community healthcare solutions that will be successful in the context of existing healthcare services...
January 8, 2019: Systematic Reviews
Adrien Bouglé, Arthur Le Gall, Florence Dumas, Guillaume Geri, Isabelle Malissin, Sebastian Voicu, Bruno Mégarbane, Alain Cariou, Nicolas Deye
BACKGROUND: Post cardiac arrest shock (PCAS) occurring after resuscitated cardiac arrest (CA) is a main cause of early death. Extracorporeal life support (ECLS) could be useful pending recovery from myocardial failure. AIM: To describe our PCAS population, and the factors associated with initiation of ECLS. METHODS: This analysis included 921 patients admitted to two intensive care units between 2005 and 2014 for CA and PCAS; 43 of these patients had ECLS initiated...
January 3, 2019: Archives of Cardiovascular Diseases
Peter I Agbonrofo, John E Osakue
Background: Neuroleptic malignant syndrome is a rare but life-threatening idiosyncratic complication following the use of antipsychotic agents, anaesthesia and surgery. It is characterized by hyperthermia, muscle rigidity, autonomic disturbances and mental state alterations. Case: A 31 year old female weighing 60kg received a depot preparation of Fluphenazine on account of depression with psychotic features observed two days prior to elective Cholecystectomy under general anaesthesia...
September 2018: African Health Sciences
Stephanie A Esses, Sara Small, Ashley Rodemann, Mary E Hartman
BACKGROUND: Targeted education to help parents and caregivers recognize the signs and symptoms of post-intensive care syndrome may increase their awareness and willingness to seek support during their child's admission. The optimal strategy for this education has not been established. METHODS: A pilot study to test 3 educational strategies for caregivers of pediatric intensive care unit patients. The 3 strategies were compared using the Practical, Robust Implementation and Sustainability Model framework for effectiveness of the education, the effect of each educational intervention on the intensive care unit nursing environment, and costs...
January 2019: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Sophia Wang, Duane Allen, Anthony Perkins, Patrick Monahan, Sikandar Khan, Sue Lasiter, Malaz Boustani, Babar Khan
BACKGROUND: Post-intensive care syndrome is defined as the long-term cognitive, physical, and psychological impairments due to critical illness. OBJECTIVE: To validate the self-report version of the Healthy Aging Brain Care Monitor as a clinical tool for detecting post-intensive care syndrome. METHODS: A total of 142 patients who survived a stay in an intensive care unit completed the Healthy Aging Brain Care Monitor Self-report and standardized assessments of cognition, psychological symptoms, and physical functioning...
January 2019: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Rashmi D'Souza, Tassos Grammatikopoulos, Akhilesh Pradhan, Harry Sutton, Abdel Douiri, Mark Davenport, Anita Verma, Anil Dhawan
OBJECTIVES: Acute-on-chronic liver failure (ACLF) is an acute decompensation of cirrhosis complicated by other organ failure and is associated with increased mortality and morbidity. ACLF has not been studied in children with biliary atresia (BA), which is the commonest indication for pediatric liver transplantation (LT) worldwide. This study aims to evaluate ACLF and outcomes in children with BA while awaiting deceased donor LT. METHODS: This was a subanalysis of the dataset from a prospective cohort study of patients aged 0-18 years who underwent portoenterostomy for BA and were listed for LT at King's College Hospital, London, between 1999 and 2003...
December 30, 2018: Pediatric Transplantation
Philip Fernandes, Michael O'Neil, Samantha Del Valle, Anita Cave, Dave Nagpal
A 44-year-old male with ongoing chest pain and left ventricular ejection fraction <20% was transferred from a peripheral hospital with intra-aortic balloon pump placement following a non-ST-elevation myocardial infarction (STEMI). The patient underwent emergent multi-vessel coronary artery bypass grafting requiring veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) on post-operative day (POD)#9 secondary to cardiogenic shock with biventricular failure. Due to clot formation, an oxygenator change-out was necessary shortly after initiation...
December 25, 2018: Perfusion
Lisa M Daniels, Andrea B Johnson, Patrick J Cornelius, Catherine Bowron, Andrea Lehnertz, Mitch Moore, YongChun Shen, Philip J Schulte, Richard S Pendegraft, Kristin R Hall, Philippe R Bauer
Objective: To improve quality of life (QOL) in patients at risk for post-intensive care syndrome (PICS). Patients and Methods: We conducted a mixed-method, prospective, observational, pre-post interventional study in an adult medical and mixed medical/surgical/transplant intensive care unit (ICU) at a tertiary academic hospital. Preintervention included patients admitted from October 1 through October 31, 2016, and postintervention included patients admitted from January 15 through February 14, 2017...
December 2018: Mayo Clinic proceedings. Innovations, quality & outcomes
Victoria Sadick, Stuart Lane, Eddy Fischer, Ian Seppelt, Anita Shetty, Anthony McLean
Catastrophic antiphospholipid syndrome is a rare multisystem autoimmune condition characterised by rapid development of widespread thrombotic disease and subsequent multi-organ failure. It is the most severe complication of antiphospholipid syndrome, carrying significant morbidity and mortality. We report a patient with post-partum catastrophic antiphospholipid syndrome with cardiac, hepatic, renal and cutaneous manifestations. The diagnostic challenges in establishing a definitive diagnosis in catastrophic antiphospholipid syndrome is discussed, along with the difficulties in managing these patients in the intensive care unit...
November 2018: Journal of the Intensive Care Society
Barbara Riegel, Liming Huang, Mark E Mikkelsen, Ann Kutney-Lee, Alexandra L Hanlon, Christopher M Murtaugh, Kathryn H Bowles
BACKGROUND/OBJECTIVES: New or worsened disabilities in functional, cognitive, or mental health following an intensive care unit (ICU) stay are referred to as post-intensive care syndrome (PICS). PICS has not been described in older adults receiving home care. Our aim was to examine the relationship between length of ICU stay and PICS among older adults receiving home care. We expected that patients in the ICU for 3 days or longer would demonstrate significantly more disability in all three domains on follow-up than those not in the ICU...
November 30, 2018: Journal of the American Geriatrics Society
Maja Dolanc Merc, Miha Lučovnik, Andreja Trojner Bregar, Ivan Verdenik, Nataša Tul, Isaac Blickstein
Objective To determine the association between pre-gravid obesity and stillbirth. Methods A retrospective study of a population-based dataset of births at ≥34 weeks' gestation. We excluded fetal deaths due to lethal anomalies and intrapartum fetal deaths. We calculated the incidence of stillbirths, neonatal respiratory distress syndrome (RDS) and neonatal intensive care unit (NICU) admissions per ongoing pregnancies for each gestational week in the two body mass index (BMI) categories (≥30 vs.<30). Results Pre-pregnancy obesity (BMI≥30), pre-pregnancy diabetes, oligo- and polyhydramnios, being small for gestational age (SGA) and preeclampsia were significantly associated with stillbirth...
November 29, 2018: Journal of Perinatal Medicine
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