Critical Care Commons^™

Effects Of Sedation Vacations And Sedation Level Quality Improvement Project, Gisele Bazan, Bo Ewing, Cynthia Grissman, April Marpa, August Montgomery, Tana Overman

View All

No abstract provided.

Post-Pyloric Feeding Tube Placement, Patrick Arenivar, Michelle Bradberry, Nikki L. Galaviz, Stephan R Smith, Lauren Johnston, Christi Robnett, Jamie Roney

View All

No abstract provided.

Powder 'Bites The Dust': Elimination Of Body Powder From Patient Care, And Introducing Healthier Alternatives, Janet Thorson-Mador

View All

No abstract provided.

The Use Of Enhanced Recovery After Surgery (Eras) To Decrease Length Of Stay And Increase Patient Satisfaction: An Integrative Research Review, Kelsey Mcmurry

View All

No abstract provided.

Improving Access & Quality Of Care For Rural Inpatients Requiring Hemodialysis, Louise Dyjur, Teresa Mcconnell, Patty Harmon

View All

No abstract provided.

Patient Fall Reduction Quality Improvement Project, Stephanie Dunkle, Lauren English, Alexa Baughman, Casey Hernandez, Sarah Langley, Mindy Starch, Jamie Roney

View All

No abstract provided.

Target Zero: Implementing And Sustaining A Successful Clabsi Prevention Program, Erica Mccartney, Giselle Deibler, Patty Palmer

View All

No abstract provided.

Brushing Away Pathogens: An Oral Care Initiative To Tackle Nv-Hap, Sarah Mcafee, Lari Johnson

View All

No abstract provided.

Multicentre Pilot Randomised Clinical Trial Of Early In-Bed Cycle Ergometry With Ventilated Patients., Michelle E Kho, Alexander J Molloy, France J Clarke, Julie C Reid, Margaret S Herridge, Timothy Karachi, Bram Rochwerg, Alison E Fox-Robichaud, Andrew Je Seely, Sunita Mathur, Vincent Lo, Karen Ea Burns, Ian M Ball, Joseph R Pellizzari, Jean-Eric Tarride, Jill C Rudkowski, Karen Koo, Diane Heels-Ansdell, Deborah J Cook

Articles, Abstracts, and Reports

Introduction: Acute rehabilitation in critically ill patients can improve post-intensive care unit (post-ICU) physical function. In-bed cycling early in a patient's ICU stay is a promising intervention. The objective of this study was to determine the feasibility of recruitment, intervention delivery and retention in a multi centre randomised clinical trial (RCT) of early in-bed cycling with mechanically ventilated (MV) patients.

Methods: We conducted a pilot RCT conducted in seven Canadian medical-surgical ICUs. We enrolled adults who could ambulate independently before ICU admission, within the first 4 days of invasive MV and first 7 days of ICU admission. Following informed consent, …

Features And Outcomes Of Methamphetamine-Associated Pulmonary Arterial Hypertension., Roham T Zamanian, Haley Hedlin, Paul Greuenwald, David M Wilson, Joshua I Segal, Michelle Jorden, Kristina Kudelko, Juliana Liu, Andrew Hsi, Allyson Rupp, Andrew J Sweatt, Rubin Tuder, Gerald J Berry, Marlene Rabinovitch, Ramona L Doyle, Vinicio De Jesus Perez, Steven M Kawut

Articles, Abstracts, and Reports

RATIONALE: Although amphetamines are recognized as "likely" agents to cause drug- and toxin-associated pulmonary arterial hypertension (PAH), (meth)amphetamine-associated PAH (Meth-APAH) has not been well described.

OBJECTIVES: To prospectively characterize the clinical presentation, histopathology, and outcomes of Meth-APAH compared with those of idiopathic PAH (iPAH).

METHODS: We performed a prospective cohort study of patients with Meth-APAH and iPAH presenting to the Stanford University Pulmonary Hypertension Program between 2003 and 2015. Clinical, pulmonary angiography, histopathology, and outcomes data were compared. We used data from the Healthcare Cost and Utilization Project to estimate the epidemiology of PAH in (meth)amphetamine users hospitalized in California. …

Triheptanoin: A Rescue Therapy For Cardiogenic Shock In Carnitine-Acylcarnitine Translocase Deficiency., Sidharth Mahapatra, Amitha Ananth, Nancy Baugh, Mihaela Damian, Gregory M Enns

Articles, Abstracts, and Reports

Carnitine-acylcarnitine translocase (CACT) deficiency is a rare long-chain fatty acid oxidation disorder (LC-FAOD) with high mortality due to cardiomyopathy or lethal arrhythmia. Triheptanoin (UX007), an investigational drug composed of synthetic medium odd-chain triglycerides, is a novel therapy in development for LC-FAOD patients. However, cases of its safe and efficacious use to reverse severe heart failure in CACT deficiency are limited. Here, we present a detailed report of an infant with CACT deficiency admitted in metabolic crisis that progressed into severe cardiogenic shock who was successfully treated by triheptanoin. The child was managed, thereafter, on triheptanoin until her death at 3 …

A Two-Biomarker Model Predicts Mortality In The Critically Ill With Sepsis., Carmen Mikacenic, Brenda L Price, Susanna Harju-Baker, D Shane O'Mahony, Cassianne Robinson-Cohen, Frank Radella, William O Hahn, Ronit Katz, David C Christiani, Jonathan Himmelfarb, W Conrad Liles, Mark M Wurfel

Articles, Abstracts, and Reports

RATIONALE: Improving the prospective identification of patients with systemic inflammatory response syndrome (SIRS) and sepsis at low risk for organ dysfunction and death is a major clinical challenge.

OBJECTIVES: To develop and validate a multibiomarker-based prediction model for 28-day mortality in critically ill patients with SIRS and sepsis.

METHODS: A derivation cohort (n = 888) and internal test cohort (n = 278) were taken from a prospective study of critically ill intensive care unit (ICU) patients meeting two of four SIRS criteria at an academic medical center for whom plasma was obtained within 24 hours. The validation cohort (n = …

Exosomal Microrna For Detection Of Cardiac Sarcoidosis., Elliott D Crouser, Nabeel Y Hamzeh, Lisa A Maier, Mark W Julian, May Gillespie, Mohammad Rahman, David Baxter, Xiaogang Wu, S Patrick Nana-Sinkam, Kai Wang

Articles, Abstracts, and Reports

No abstract provided.

Protocol Adherence For Continuously Titrated Interventions In Randomized Trials: An Overview Of The Current Methodology And Case Study., F Lauzier, N K Adhikari, A Seely, K K Y Koo, E P Belley-Côté, K E A Burns, D J Cook, F D'Aragon, B Rochwerg, M E Kho, S J W Oczkowksi, E H Duan, M O Meade, A G Day, F Lamontagne

Articles, Abstracts, and Reports

BACKGROUND: The standard definition for protocol adherence is the proportion of all scheduled doses that are delivered. In clinical research, this definition has several limitations when evaluating protocol adherence in trials that study interventions requiring continuous titration.

DISCUSSION: Building upon a specific case study, we analyzed a recent trial of a continuously titrated intervention to assess the impact of different definitions of protocol deviations on the interpretation of protocol adherence. The OVATION pilot trial was an open-label randomized controlled trial of higher (75-80 mmHg) versus lower (60-65 mmHg) mean arterial pressure (MAP) targets for vasopressor therapy in shock. In this …