collection
https://read.qxmd.com/read/31881909/driving-pressure-is-not-associated-with-mortality-in-mechanically-ventilated-patients-without-ards
#1
JOURNAL ARTICLE
Michael J Lanspa, Ithan D Peltan, Jason R Jacobs, Jeffrey S Sorensen, Lori Carpenter, Jeffrey P Ferraro, Samuel M Brown, Jay G Berry, Raj Srivastava, Colin K Grissom
BACKGROUND: In patients with acute respiratory distress syndrome (ARDS), low tidal volume ventilation has been associated with reduced mortality. Driving pressure (tidal volume normalized to respiratory system compliance) may be an even stronger predictor of ARDS survival than tidal volume. We sought to study whether these associations hold true in acute respiratory failure patients without ARDS. METHODS: This is a retrospectively cohort analysis of mechanically ventilated adult patients admitted to ICUs from 12 hospitals over 2 years...
December 27, 2019: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/31102609/medical-malpractice-involving-pulmonary-critical-care-physicians
#2
JOURNAL ARTICLE
Laura C Myers, Jillian Skillings, Lisa Heard, Joshua P Metlay, Elizabeth Mort
BACKGROUND: Medical malpractice data can be leveraged to understand specialty-specific risk. METHODS: Malpractice claims were examined from the Comparative Benchmarking System (2007-2016), a national database containing > 30% of claims data in the United States. Claims were identified with either internal medicine or pulmonary/critical care (PCC) physicians as the primary provider involved in the harm. Claim characteristics were compared according to specialty and care setting (inpatient vs outpatient), and multiple regression analysis was performed to predict claim payment...
November 2019: Chest
https://read.qxmd.com/read/17242606/legal-issues-in-the-practice-of-critical-care-medicine-a-practical-approach
#3
REVIEW
James E Szalados
The intensive care unit is characterized by severely ill patients who frequently succumb to their disease, despite complex modern therapies and the best efforts of dedicated care teams. Although critical care is not historically characterized as a high-risk medical specialty with respect to litigation, the urgency, complexity, and invasive nature of intensive care unit care clearly increases legal risk exposure. Physicians do not practice in a vacuum. Instead, the practice of medicine is increasingly affected by government regulation, societal pressures, and pubic expectations...
February 2007: Critical Care Medicine
https://read.qxmd.com/read/30366599/medical-malpractice-claims-within-cardiology-from-2006-to-2015
#4
JOURNAL ARTICLE
Frances Wang, Sandeep K Krishnan
With increasing healthcare costs and the high cost of spending driven by "defensive medicine," shedding light on recent litigation trends is critical for understanding current tort patterns, especially in the field of cardiology, a specialty with higher rates of malpractice suits than average. Understanding the characteristics of these liability claims and common types of patient injuries can aid cardiologists in mitigating malpractice risk and better patient care. Thus, the objective of this study was to characterize current malpractice trends in the field of cardiology and common sources of patient injury...
January 1, 2019: American Journal of Cardiology
https://read.qxmd.com/read/16687715/claims-errors-and-compensation-payments-in-medical-malpractice-litigation
#5
JOURNAL ARTICLE
David M Studdert, Michelle M Mello, Atul A Gawande, Tejal K Gandhi, Allen Kachalia, Catherine Yoon, Ann Louise Puopolo, Troyen A Brennan
BACKGROUND: In the current debate over tort reform, critics of the medical malpractice system charge that frivolous litigation--claims that lack evidence of injury, substandard care, or both--is common and costly. METHODS: Trained physicians reviewed a random sample of 1452 closed malpractice claims from five liability insurers to determine whether a medical injury had occurred and, if so, whether it was due to medical error. We analyzed the prevalence, characteristics, litigation outcomes, and costs of claims that lacked evidence of error...
May 11, 2006: New England Journal of Medicine
https://read.qxmd.com/read/8970259/physical-restraint-use-in-critical-care-legal-issues
#6
REVIEW
M B Kapp
Landmark federal legislation and several other social and clinical forces have induced nursing homes to reduce their use of physical or mechanical restraints on their residents during the past decade. Attention is being paid to the overuse of restraining devices and methods in acute care hospitals, including critical care units, and the need to develop strategies for their reduction or elimination. One of the most serious barriers to accomplishing this objective is anxiety on the part of health professionals and administrators about potential legal liability for patient injury...
November 1996: AACN Clinical Issues
https://read.qxmd.com/read/23610443/25-year-summary-of-us-malpractice-claims-for-diagnostic-errors-1986-2010-an-analysis-from-the-national-practitioner-data-bank
#7
JOURNAL ARTICLE
Ali S Saber Tehrani, HeeWon Lee, Simon C Mathews, Andrew Shore, Martin A Makary, Peter J Pronovost, David E Newman-Toker
BACKGROUND: We sought to characterise the frequency, health outcomes and economic consequences of diagnostic errors in the USA through analysis of closed, paid malpractice claims. METHODS: We analysed diagnosis-related claims from the National Practitioner Data Bank (1986-2010). We describe error type, outcome severity and payments (in 2011 US dollars), comparing diagnostic errors to other malpractice allegation groups and inpatient to outpatient within diagnostic errors...
August 2013: BMJ Quality & Safety
https://read.qxmd.com/read/31500925/use-of-meropenem-to-treat-valproic-acid-overdose
#8
JOURNAL ARTICLE
Diane Dreucean, Kevin Beres, Afton McNierney-Moore, Dante Gravino
Overdose of valproic acid (VPA) or its derivatives can cause significant toxicities such as hyperammonemia or altered mental status. While levocarnitine has been used historically to manage VPA-associated hyperammonemia, no standard of therapy exists to manage VPA toxicity. We present a case of VPA overdose managed with meropenem in addition to levocarnitine. A 38-year old female presented to the emergency department after intentionally ingesting 20 tablets of extended release divalproex sodium. She received a 4-gram loading dose of levocarnitine...
November 2019: American Journal of Emergency Medicine
https://read.qxmd.com/read/31490206/emergent-airway-management-of-the-critically-ill-patient-current-opinion-in-critical-care
#9
REVIEW
Michael C Sklar, Michael E Detsky
PURPOSE OF REVIEW: To describe techniques to facilitate safe intubation in critically ill patients. RECENT FINDINGS: Despite advances in the treatment of critically ill patients, endotracheal intubation remains a high-risk procedure associated with complications that can lead to appreciable morbidity and mortality. In addition to the usual anatomical factors that can predict a difficult intubation, incorporating pathophysiological considerations and crisis resource management may enhance safety and mitigate risk...
December 2019: Current Opinion in Critical Care
https://read.qxmd.com/read/31210778/2019-wses-guidelines-for-the-management-of-severe-acute-pancreatitis
#10
REVIEW
Ari Leppäniemi, Matti Tolonen, Antonio Tarasconi, Helmut Segovia-Lohse, Emiliano Gamberini, Andrew W Kirkpatrick, Chad G Ball, Neil Parry, Massimo Sartelli, Daan Wolbrink, Harry van Goor, Gianluca Baiocchi, Luca Ansaloni, Walter Biffl, Federico Coccolini, Salomone Di Saverio, Yoram Kluger, Ernest Moore, Fausto Catena
Although most patients with acute pancreatitis have the mild form of the disease, about 20-30% develops a severe form, often associated with single or multiple organ dysfunction requiring intensive care. Identifying the severe form early is one of the major challenges in managing severe acute pancreatitis. Infection of the pancreatic and peripancreatic necrosis occurs in about 20-40% of patients with severe acute pancreatitis, and is associated with worsening organ dysfunctions. While most patients with sterile necrosis can be managed nonoperatively, patients with infected necrosis usually require an intervention that can be percutaneous, endoscopic, or open surgical...
2019: World Journal of Emergency Surgery: WJES
https://read.qxmd.com/read/28825511/variation-in-blood-transfusion-and-coagulation-management-in-traumatic-brain-injury-at-the-intensive-care-unit-a-survey-in-66-neurotrauma-centers-participating-in-the-collaborative-european-neurotrauma-effectiveness-research-in-traumatic-brain-injury-study
#11
JOURNAL ARTICLE
Jilske A Huijben, Mathieu van der Jagt, Maryse C Cnossen, Marieke J H A Kruip, Iain K Haitsma, Nino Stocchetti, Andrew I R Maas, David K Menon, Ari Ercole, Marc Maegele, Simon J Stanworth, Giuseppe Citerio, Suzanne Polinder, Ewout W Steyerberg, Hester F Lingsma
Our aim was to describe current approaches and to quantify variability between European intensive care units (ICUs) in patients with traumatic brain injury (TBI). Therefore, we conducted a provider profiling survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The ICU Questionnaire was sent to 68 centers from 20 countries across Europe and Israel. For this study, we used ICU questions focused on 1) hemoglobin target level (Hb-TL), 2) coagulation management, and 3) deep venous thromboembolism (DVT) prophylaxis...
January 15, 2018: Journal of Neurotrauma
https://read.qxmd.com/read/26494153/fluid-balance-and-mortality-in-critically-ill-patients-with-acute-kidney-injury-a-multicenter-prospective-epidemiological-study
#12
JOURNAL ARTICLE
Na Wang, Li Jiang, Bo Zhu, Ying Wen, Xiu-Ming Xi
INTRODUCTION: Early and aggressive volume resuscitation is fundamental in the treatment of hemodynamic instability in critically ill patients and improves patient survival. However, one important consequence of fluid administration is the risk of developing fluid overload (FO), which is associated with increased mortality in patients with acute kidney injury (AKI). We evaluated the impact of fluid balance on mortality in intensive care unit (ICU) patients with AKI. METHODS: The data were extracted from the Beijing Acute Kidney Injury Trial...
October 23, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/26507493/a-rational-approach-to-fluid-therapy-in-sepsis
#13
REVIEW
P Marik, R Bellomo
Aggressive fluid resuscitation to achieve a central venous pressure (CVP) greater than 8 mm Hg has been promoted as the standard of care, in the management of patients with severe sepsis and septic shock. However recent clinical trials have demonstrated that this approach does not improve the outcome of patients with severe sepsis and septic shock. Pathophysiologically, sepsis is characterized by vasoplegia with loss of arterial tone, venodilation with sequestration of blood in the unstressed blood compartment and changes in ventricular function with reduced compliance and reduced preload responsiveness...
March 2016: British Journal of Anaesthesia
https://read.qxmd.com/read/26378980/lactic-acidosis-in-sepsis-it-s-not-all-anaerobic-implications-for-diagnosis-and-management
#14
REVIEW
Bandarn Suetrong, Keith R Walley
Increased blood lactate concentration (hyperlactatemia) and lactic acidosis (hyperlactatemia and serum pH < 7.35) are common in patients with severe sepsis or septic shock and are associated with significant morbidity and mortality. In some patients, most of the lactate that is produced in shock states is due to inadequate oxygen delivery resulting in tissue hypoxia and causing anaerobic glycolysis. However, lactate formation during sepsis is not entirely related to tissue hypoxia or reversible by increasing oxygen delivery...
January 2016: Chest
https://read.qxmd.com/read/26210381/can-vasopressors-safely-be-administered-through-peripheral-intravenous-catheters-compared-with-central-venous-catheters
#15
EDITORIAL
J Michael Brewer, Michael A Puskarich, Alan E Jones
No abstract text is available yet for this article.
December 2015: Annals of Emergency Medicine
https://read.qxmd.com/read/26261773/steps-to-consider-in-the-approach-and-management-of-critically-ill-patient-with-spontaneous-intracerebral-hemorrhage
#16
REVIEW
Daniel Agustin Godoy, Gustavo Rene Piñero, Patricia Koller, Luca Masotti, Mario Di Napoli
Spontaneous intracerebral hemorrhage is a type of stroke associated with poor outcomes. Mortality is elevated, especially in the acute phase. From a pathophysiological point of view the bleeding must traverse different stages dominated by the possibility of re-bleeding, edema, intracranial hypertension, inflammation and neurotoxicity due to blood degradation products, mainly hemoglobin and thrombin. Neurological deterioration and death are common in early hours, so it is a true neurological-neurosurgical emergency...
August 4, 2015: World Journal of Critical Care Medicine
https://read.qxmd.com/read/26398835/potential-strategies-to-prevent-ventilator-associated-events
#17
REVIEW
Michael Klompas
The Centers for Disease Control and Prevention (CDC) released ventilator-associated event (VAE) definitions in 2013. The new definitions were designed to track episodes of sustained respiratory deterioration in mechanically ventilated patients after a period of stability or improvement. More than 2,000 U.S. hospitals have reported their VAE rates to the CDC, but there has been little guidance to date on how to prevent VAEs. Existing ventilator-associated pneumonia prevention bundles are unlikely to be optimal insofar as pneumonia accounts for only a minority of VAEs...
December 15, 2015: American Journal of Respiratory and Critical Care Medicine
https://read.qxmd.com/read/26152849/experts-recommendations-for-the-management-of-adult-patients-with-cardiogenic-shock
#18
JOURNAL ARTICLE
Bruno Levy, Olivier Bastien, Bendjelid Karim, Alain Cariou, Tahar Chouihed, Alain Combes, Alexandre Mebazaa, Bruno Megarbane, Patrick Plaisance, Alexandre Ouattara, Christian Spaulding, Jean-Louis Teboul, Fabrice Vanhuyse, Thierry Boulain, Kaldoun Kuteifan
Unlike for septic shock, there are no specific international recommendations regarding the management of cardiogenic shock (CS) in critically ill patients. We present herein recommendations for the management of cardiogenic shock in adults, developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF)), with the participation the French Society of Anesthesia and Intensive Care (SFAR), the French Cardiology Society (SFC), the French Emergency Medicine Society (SFMU), and the French Society of Thoracic and Cardiovascular Surgery (SFCTCV)...
December 2015: Annals of Intensive Care
https://read.qxmd.com/read/26316210/early-goal-directed-resuscitation-of-patients-with-septic-shock-current-evidence-and-future-directions
#19
REVIEW
Ravi G Gupta, Sarah M Hartigan, Markos G Kashiouris, Curtis N Sessler, Gonzalo M L Bearman
Severe sepsis and septic shock are among the leading causes of mortality in the intensive care unit. Over a decade ago, early goal-directed therapy (EGDT) emerged as a novel approach for reducing sepsis mortality and was incorporated into guidelines published by the international Surviving Sepsis Campaign. In addition to requiring early detection of sepsis and prompt initiation of antibiotics, the EGDT protocol requires invasive patient monitoring to guide resuscitation with intravenous fluids, vasopressors, red cell transfusions, and inotropes...
August 28, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/25845606/what-is-the-clinical-utility-of-bedside-ultrasonography-in-the-diagnosis-of-acute-cardiogenic-pulmonary-edema-in-the-undifferentiated-dyspneic-patient
#20
REVIEW
Michael Gottlieb, John Bailitz
No abstract text is available yet for this article.
September 2015: Annals of Emergency Medicine
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