Pressure injury treatment by intermittent electrical stimulation (PROTECT-2): protocol for a multicenter randomized clinical trial.

Background: Pressure ulcers account for a substantial fraction of hospital-acquired pathology, with consequent morbidity and economic cost. Treatments are largely focused on preventing further injury, whereas interventions that facilitate healing remain limited. Intermittent electrical stimulation (IES) increases local blood flow and redistributes pressure from muscle-bone interfaces, thus potentially reducing ulcer progression and facilitating healing.

Wearable sensors for monitoring the internal and external workload of the athlete.

The convergence of semiconductor technology, physiology, and predictive health analytics from wearable devices has advanced its clinical and translational utility for sports. The detection and subsequent application of metrics pertinent to and indicative of the physical performance, physiological status, biochemical composition, and mental alertness of the athlete has been shown to reduce the risk of injuries and improve performance and has enabled the development of athlete-centered protocols and treatment plans by team physicians and trainers. Our discussions in this review include commercially available devices, as well as those described in scientific literature to provide an understanding of wearable sensors for sports medicine.

Wearable sensors for monitoring the physiological and biochemical profile of the athlete.

Athletes are continually seeking new technologies and therapies to gain a competitive edge to maximize their health and performance. Athletes have gravitated toward the use of wearable sensors to monitor their training and recovery. Wearable technologies currently utilized by sports teams monitor both the internal and external workload of athletes.

"Wishes Unknown: " A Case Report.

We report the case of a 55-year-old woman who required extracorporeal membrane oxygenation for extreme respiratory distress after a liver transplant and eventually died. As is so often the case, this patient's values and wishes were not documented before she had a risky surgical procedure. Anesthesiologists, in partnership with surgeons, can participate in preoperative discussions exploring wishes and values and document them in advance directives which will help clinicians respect patients' preferences.

Dose of Early Therapeutic Mobility: Does Frequency or Intensity Matter?

Objective: Investigate the feasibility of a nurse-led mobility protocol and compare the effects of once- versus twice-daily episodes of early therapeutic mobility (ETM) and low- versus moderate-intensity ETM on serum biomarkers of inflammation and selected outcomes in critically ill adults.

Design: Randomized interventional study with repeated measures and blinded assessment of outcomes.

Setting: Four adult intensive care units (ICUs) in two academic medical centers.

Wearable Devices for Sports: New Integrated Technologies Allow Coaches, Physicians, and Trainers to Better Understand the Physical Demands of Athletes in Real time.

Elite-level athletes and professional sports teams are continually searching for opportunities to improve athletic performance and gain a competitive advantage on the field. Advances in technology have provided new avenues to maximize player health and safety. Over the last decade, time?motion analysis systems, such as video recording and computer digitization, have been used to measure human locomotion and improve sports performance.

Complexity Analysis of Decision-Making in the Critically Ill.

Rationale: Despite multiple trials of interventions to improve end-of-life care of the critically ill, there is a persistent lack of understanding of factors associated with barriers to decision-making at the end of life.

Objective: To apply the principles of complexity science in examining the extent to which transitions to end-of-life care can be predicted by physician, family, or patient characteristics; outcome expectations; and the evaluation of treatment effectiveness.

Methods: A descriptive, longitudinal study was conducted in 3 adult intensive care units (ICUs).

Permissible Intraabdominal Hypertension following Complex Abdominal Wall Reconstruction.

Background: Repair of hernias with loss of domain can lead to elevated intraabdominal pressure. The authors aimed to characterize the effects of elective hernia repair on intraabdominal pressure, as well as its predictors and association with negative outcomes.

Methods: Patients undergoing elective hernia repair requiring myofascial release had intraabdominal and pulmonary plateau pressures measured preoperatively, postoperatively, and on the morning of the first postoperative day.

VINSIA: visual navigator for surgical information access.

Information access at the point of care presents a different set of requirements than those for traditional search engines. Critical care in remote (e.g.

Hemodynamic and related challenges: monitoring and regulation in the postoperative period.

The clinician caring for patients in the immediate postoperative period must maintain a high index of suspicion for the development of complications. Evolving illness manifests itself throughout the continuum of care and must be recognized and aggressively managed to ensure optimal outcome. This article discusses common hemodynamic problems encountered in the postanesthesia care unit.

Predicting severe postoperative respiratory complications following abdominal wall reconstruction.

Background: Patients undergoing abdominal wall reconstruction are at risk of developing major postoperative respiratory complications. The authors attempted to identify factors predictive of respiratory complications following abdominal wall reconstruction.

Methods: All patients who underwent complex abdominal wall reconstruction over a 2-year period were reviewed.

Examining the positive effects of exercise in intubated adults in ICU: a prospective repeated measures clinical study.

Background: Determining the optimal timing and progression of mobility exercise has the potential to affect functional recovery of critically ill adults. This study compared standard care with care delivered using a mobility protocol. We examined the effects of exercise on vital signs and inflammatory biomarkers and the effects of the nurse-initiated mobility protocol on outcomes.

Effectiveness trial of an intensive communication structure for families of long-stay ICU patients.

Background: Formal family meetings have been recommended as a useful approach to assist in goal setting, facilitate decision making, and reduce use of ineffective resources in the ICU. We examined patient outcomes before and after implementation of an intensive communication system (ICS) to test the effect of regular, structured formal family meetings on patient outcomes among long-stay ICU patients.

Methods: One hundred thirty-five patients receiving usual care and communication were enrolled as the control group, followed by enrollment of intervention patients (n = 346), from five ICUs.

Steroids and risk factors for airway compromise in multilevel cervical corpectomy patients: a prospective, randomized, double-blind study.

Study Design: Prospective, randomized, double-blind study.

Objective: To evaluate intravenous corticosteroids in preventing delayed extubation after multilevel corpectomy and strut graft reconstructive procedures and to identify risk factors for delayed extubation in these patients.

Summary Of Background Data: We performed a prospective, randomized double-blind study in patients undergoing multilevel cervical corpectomy procedures.

Risk factors for delayed extubation after single-stage, multi-level anterior cervical decompression and posterior fusion.

Airway difficulties after single-stage, multilevel anterior and posterior cervical surgery are potentially life-threatening complications. Although extubation delays can occur, overnight intubation can reduce the risk of postoperative airway emergencies. Our protocol was as follows: all patients were kept intubated overnight in an intensive care unit and examined by the intensive care unit staff each morning.