scholarly journals Increase Intensive Care Staff Comfort and Proficiency With Emergent Re-sternotomy in the Post-Open-Heart Patient by Using SynDaver® Simulation

Cureus ◽  
2022 ◽  
Author(s):  
Darlene R Deters ◽  
John Hunninghake ◽  
Judy Ruiz ◽  
Deborah J Marquez ◽  
Deborah J Ramirez ◽  
...  
Keyword(s):  
Author(s):  
Thomas J. Smith ◽  
Sandra Clayton ◽  
Kathleen Schoenbeck

This report summarizes findings from a human factors evaluation of a change in the design of a neonatal intensive care unit (NICU) from an open bay (OBNICU) to a private room (PRNICU) patient care environment. The objective was to compare and contrast effects of this design change on the perceptions and performance of NICU patient care staff. Results indicate that, relative to work on the OBNICU, staff perceived that work on the PRNICU resulted in notable improvements in the quality of physical environmental conditions, their jobs, patient care and patient safety, interaction with parents of NICU patients, interaction with patient care technology and their life off-the-job. In contrast, staff perceived that the quality of interaction among different members of the NICU patient care team worsened substantially after the move to the PRNICU. The latter finding prompted the recommendation that a virtual open bay environment be implemented in the PRNICU.


2003 ◽  
Vol 9 (10) ◽  
pp. 1205-1210 ◽  
Author(s):  
Damon C. Scales ◽  
Karen Green ◽  
Adrienne K. Chan ◽  
Susan M. Poutanen ◽  
Donna Foster ◽  
...  

2017 ◽  
Vol 176 (3) ◽  
pp. 423-427 ◽  
Author(s):  
Thomas Brick ◽  
◽  
Rachel S. Agbeko ◽  
Patrick Davies ◽  
Peter J. Davis ◽  
...  

Author(s):  
Nim Pathmanathan ◽  
Paul Nixon

This chapter is centred on a case study of sedation and delirium. This topic is one of the key challenging areas in critical care medicine and one that all intensive care staff will encounter. The chapter is based on a detailed case history, ensuring clinical relevance, together with relevant images, making this easily relatable to daily practice in the critical care unit. The chapter is punctuated by evidence-based, up-to-date learning points, which highlight key information for the reader. Throughout the chapter, a topic expert provides contextual advice and commentary, adding practical expertise to the standard textbook approach and reinforcing key messages.


Author(s):  
Juan G. Ripoll Sanz ◽  
Robert A. Ratzlaff

Cardiothoracic surgical (CTS) critical care responsibilities have progressively shifted away from surgeons and toward intensivists in the past several decades. CTS patients present unique challenges, and optimal patient care in the intensive care unit is a main factor for the prevention of deaths after any type of open heart surgery.


Author(s):  
Abdul Rauf ◽  
Reena K. Joshi ◽  
Neeraj Aggarwal ◽  
Mridul Agarwal ◽  
Manendra Kumar ◽  
...  

Background: There is a paucity of literature regarding the association of high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB) and outcomes, and no consensus exists regarding the composition of optimal CPB priming solution. This study aimed to examine the impact of high oncotic pressure priming by the addition of 20% human albumin on outcomes. Methods: Double-blinded, randomized controlled study was done in the pediatric cardiac intensive care unit of a tertiary care hospital. Consecutive children with congenital heart diseases admitted for open-heart surgery were randomized into two groups, where the study group received an additional 20% albumin to conventional blood prime before CPB initiation. Results: We enrolled 39 children in the high oncotic prime (added albumin) group and 37 children in the conventional prime group. In the first 24-hour postoperative period, children in the albumin group had significantly lower occurrence of hypotension (28.2% vs 54%, P = .02), requirement of fluid boluses (25.6% vs 54%, P = .006), and lactate clearance time (6 vs 9 hours, P < .001). Albumin group also had significantly higher platelet count (×103/µL) at 24 hours (112 vs 91, P = .02). There was no significant difference in intra-CPB hemodynamic parameters and incidence of acute kidney injury. In subgroup analysis based on risk category, significantly decreased intensive care unit stay (4 vs 5 days, P = .04) and hospital stay (5 vs 7 days, P = .002) were found in the albumin group in low-risk category. Conclusion: High oncotic pressure CPB prime using albumin addition might be beneficial over conventional blood prime, and our study does provide a rationale for further studies.


2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Daniele Roberto Giacobbe ◽  
Antonio Salsano ◽  
Filippo Del Puente ◽  
Ambra Miette ◽  
Antonio Vena ◽  
...  

Abstract Background Candida species are among the most frequent causative agents of health care–associated bloodstream infections, with mortality &gt;40% in critically ill patients. Specific populations of critically ill patients may present peculiar risk factors related to their reason for intensive care unit admission. The primary objective of the present study was to assess the predictors of candidemia after open heart surgery. Methods This retrospective, matched case–control study was conducted in 8 Italian hospitals from 2009 to 2016. The primary study objective was to assess factors associated with the development of candidemia after open heart surgery. Results Overall, 222 patients (74 cases and 148 controls) were included in the study. Candidemia developed at a median time (interquartile range) of 23 (14–36) days after surgery. In multivariable analysis, independent predictors of candidemia were New York Heart Association class III or IV (odds ratio [OR], 23.81; 95% CI, 5.73–98.95; P &lt; .001), previous therapy with carbapenems (OR, 8.87; 95% CI, 2.57–30.67; P = .001), and previous therapy with fluoroquinolones (OR, 5.73; 95% CI, 1.61–20.41; P = .007). Crude 30-day mortality of candidemia was 53% (39/74). Septic shock was independently associated with mortality in the multivariable model (OR, 5.64; 95% CI, 1.91–16.63; P = .002). No association between prolonged cardiopulmonary bypass time and candidemia was observed in this study. Conclusions Previous broad-spectrum antibiotic therapy and high NYHA class were independent predictors of candidemia in cardiac surgery patients with prolonged postoperative intensive care unit stay.


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