6 results on '"Bracco D"'
Search Results
2. Volatile agents for ICU sedation?
- Author
-
Bracco D and Donatelli F
- Subjects
- Anesthesia, Inhalation, Conscious Sedation standards, Dexmedetomidine administration & dosage, Dexmedetomidine therapeutic use, Humans, Hypnotics and Sedatives therapeutic use, Midazolam administration & dosage, Midazolam therapeutic use, Propofol administration & dosage, Propofol therapeutic use, Intensive Care Units, Volatile Organic Compounds therapeutic use
- Published
- 2011
- Full Text
- View/download PDF
3. The thin line between life and death.
- Author
-
Bracco D, Noiseux N, and Hemmerling TM
- Subjects
- Animals, Heart Arrest mortality, Humans, Prognosis, Cardiopulmonary Resuscitation, Death, Extracorporeal Membrane Oxygenation, Heart Arrest therapy
- Published
- 2007
- Full Text
- View/download PDF
4. Single rooms may help to prevent nosocomial bloodstream infection and cross-transmission of methicillin-resistant Staphylococcus aureus in intensive care units.
- Author
-
Bracco D, Dubois MJ, Bouali R, and Eggimann P
- Subjects
- Aged, Cross Infection epidemiology, Female, Humans, Male, Middle Aged, Quebec epidemiology, Staphylococcal Infections epidemiology, Cross Infection prevention & control, Infection Control methods, Intensive Care Units, Methicillin Resistance, Patients' Rooms organization & administration, Staphylococcal Infections prevention & control
- Abstract
Objective: Nosocomial infections remain a major problem in intensive care units. Several authorities have recommended housing patients in single rooms to prevent cross-transmission of potential pathogens, but this issue is currently debated. The aim of the present study was to compare the rate of nosocomial cross-contamination between patients hosted in single rooms versus bay rooms., Design: Prospective observational data acquisition over 2.5 years., Setting: A 14-bed medico-surgical ICU, composed of six single-bed rooms plus a six-bed and a two-bed bay room served by the same staff., Patients and Participants: All patients admitted from 1 July 2002 to 31 December 2004., Interventions: None., Measurements and Results: Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in admitted patients was 1.1% and acquisition rate 2.4%. The incidence density of MRSA acquisition was 4.1 [95% CI 2.7-6.3]/1,000 patient-days in bay rooms versus 1.3 [0.5-3.4]/1,000 patient-days in single rooms (p<0.001). Pseudomonas spp. acquisition rate was 3.9 [2.5-6.1]/1,000 patient-days in bay rooms versus 0.7 [0.2-2.4]/1,000 patient-days in single rooms (p<0.001), and Candida spp. colonization was 38.4 [33.3-44.1]/1,000 patient-days in bay rooms versus 13.8 [10.2-18.6]/1,000 patient-days (p<0.001). By multivariate analysis, the relative risk of MRSA, Pseudomonas aeruginosa and Candida spp. acquisition in single rooms or cubicles versus bay rooms was 0.65, 0.61 and 0.75 respectively., Conclusions: These data suggest that in an institution where MRSA is not hyperendemic, infection control measures may be more effective to prevent cross-transmission of microorganisms in patients housed in single rooms.
- Published
- 2007
- Full Text
- View/download PDF
5. Progression rate of self-propelled feeding tubes in critically ill patients.
- Author
-
Berger MM, Bollmann MD, Revelly JP, Cayeux MC, Pilon N, Bracco D, and Chioléro RL
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Analysis of Variance, Female, Humans, Logistic Models, Male, Middle Aged, Polyurethanes, Prospective Studies, Respiration, Artificial, Severity of Illness Index, Treatment Outcome, Critical Illness, Enteral Nutrition instrumentation, Intubation, Gastrointestinal methods
- Abstract
Objective: Gaining postpyloric access in ventilated, sedated ICU patients usually requires time-consuming procedures such as endoscopy. Recently, a feeding tube has been introduced that migrates spontaneously into the jejunum in surgical patients. The study aimed at assessing the rate of migration of this tube in critically ill patients., Design: Prospective descriptive trial., Setting: Surgical ICU in a tertiary University Hospital., Patients: One hundred and five consecutive surgical ICU patients requiring enteral feeding were enrolled, resulting in 128 feeding-tube placement attempts., Methods: A self-propelled tube was used and followed up for 3 days: progression was assessed by daily contrast-injected X-ray. Severity of illness was assessed with SAPS II and organ failure assessed with SOFA score., Results: The patients were aged 55+/-19 years (mean+/-SD) with SAPS II score of 45+/-18. Of the 128 tube placement attempts, 12 could not be placed in the stomach; eight were accidentally pulled out while in gastric position due to the necessity to avoid fixation during the progression phase. Among organ failures, respiratory failure predominated, followed by cardiovascular. By day 3, the postpyloric progression rate was 63/128 tubes (49%). There was no association between migration and age, or SAPS II score, but the progression rate was significantly poorer in patients with hemodynamic failure. Use of norepinephrine and morphine were negatively associated with tube progression (P<0.001), while abdominal surgery was not. In ten patients, jejunal tubes were placed by endoscopy., Conclusion: Self-propelled feeding tubes progressed from the stomach to the postpyloric position in 49% of patients, reducing the number of endoscopic placements: these tubes may facilitate enteral nutrient delivery in the ICU.
- Published
- 2002
- Full Text
- View/download PDF
6. Human errors in a multidisciplinary intensive care unit: a 1-year prospective study.
- Author
-
Bracco D, Favre JB, Bissonnette B, Wasserfallen JB, Revelly JP, Ravussin P, and Chioléro R
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Analysis of Variance, Child, Child, Preschool, Female, Hospital Costs, Hospital Mortality, Humans, Length of Stay, Male, Medical Errors economics, Middle Aged, Multivariate Analysis, Prospective Studies, Risk, Switzerland epidemiology, Task Performance and Analysis, Intensive Care Units standards, Medical Errors statistics & numerical data
- Abstract
Objectives: To determine the incidence and identify risk factors of critical incidents in an ICU., Design: Prospective observational study of consecutive patients admitted over 1 year to an ICU. Critical incidents were recorded using predefined criteria. Their causes and consequences were analysed. The causes were classified as technical failure, patient's underlying disease, or human errors (subclassified as planning, execution, or surveillance). The consequences were classified as lethal, leading to sequelae, prolonging the ICU stay, minor, or without consequences. The correlation between critical incidents and specific factors including patient's diagnosis and severity score, use of monitoring and therapeutic modalities was analysed by uni- and multivariate analysis., Setting: An 11-bed multidisciplinary ICU in a non-university teaching hospital., Patients: 1,024 consecutive patients admitted to the ICU., Intervention: None., Measurements and Main Results: The median length of ICU stay by the 1,024 patients was 1.9 days. Of the 777 critical incidents reported 2% were due to technical failure and 67 % to secondary to underlying disease. There were 241 human errors (31%) in 161 patients, evenly distributed among planning (n = 75), execution (n = 88), and surveillance (n = 78). One error was lethal, two led to sequelae, 26 % prolonged ICU stay, and 57 % were minor and 16 % without consequence. Errors with significant consequences were related mainly to planning. Human errors prolonged ICU stay by 425 patient-days, amounting to 15 % of ICU time. Readmitted patients had more frequent and more severe critical incidents than primarily admitted patients., Conclusions: Critical incidents add morbidity, workload, and financial burden. A substantial proportion of them are related to human factors with dire consequences. Efforts must focus on timely, appropriate care to avoid planning and execution mishaps at the beginning of the ICU stay; surveillance intensity must be maintained, specially after the fourth day.
- Published
- 2001
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.