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Purpose: To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research., Materials and Methods: We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions were rated in 3 successive rounds on a scale from 1 to 7. Median score was used to rate each item's priority, with 5 or more indicating "essential priority," 4 or 5 "moderate priority" and 3 or less "low priority." Interquartile range (IQR) was used to measure consensus, with IQR of 1 indicating "high" consensus, 2 "moderate" consensus, and 3 or greater "low" consensus., Results: Six items were rated essential elements for facilitating PFCC with high consensus (flexible visiting hours, family participation in bedside care, trained family support person, interventions to facilitate continuity of care, staff education to support families, continuity of staff assignments). Three items were rated essential research topics: interventions to facilitate continuity of care following ICU discharge (moderate consensus), family participation in bedside care (low consensus), and decision aids for end of life decision-making (low consensus)., Conclusions: Stakeholders identified clear and distinct priorities for PFCC in clinical care and research, though there was greater consensus for clinical care., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Purpose: To determine the incidence of postintubation hypotension (PIH) and associated outcomes in critically ill patients requiring endotracheal intubation., Materials and Methods: Medical records were reviewed for 479 consecutive critically ill adult patients who required intubation by an intensive care unit (ICU) service at 1 of 4 academic tertiary care hospitals. The primary outcome measure was the incidence of PIH. Secondary outcome measures included mortality, ICU length of stay, requirement for renal replacement therapy, and a composite end point consisting of overall mortality, ICU length of stay greater than 14 days, duration of mechanical ventilation longer than 7 days, and renal replacement therapy requirement., Results: Overall, the incidence of PIH among ICU patients requiring intubation was 46% (218/479 patients). On univariate analysis, patients who developed PIH had increased ICU mortality (37% PIH vs 28% no PIH, P = .049) and overall mortality (39% PIH vs 30% no PIH, P = .045). After adjusting for important risk factors, development of PIH was associated with the composite end point of major morbidity and mortality (odds ratio, 2.00; 95% confidence interval, 1.30-3.07; P = .0017)., Conclusions: The development of PIH is common in ICU patients requiring emergency airway control and is associated with poor patient outcomes., (Copyright © 2015 Elsevier Inc. All rights reserved.)

We examined changes in contractility of jejunal longitudinal muscle from rats infected 8 days previously with the enteric parasite Nippostrongylus brasiliensis. In uninfected control rats, carbachol-induced contraction was maximal at 1 microM carbachol. In muscle from infected rats, there was no change in ED50 for carbachol, but contraction induced by 1 microM carbachol was increased greater than 75% over that in control rats. No significant differences were observed in muscarinic receptor binding characteristics in smooth muscle cells from control and infected rats when [3H]QNB was used as radioligand. Contraction induced by 5-hydroxytryptamine was also substantially greater in muscle from infected rats. In control rats, carbachol-induced contraction was largely independent of extracellular Ca2+, whereas in muscle from infected rats, withdrawing extracellular Ca2+ reduced contraction to below control levels. Furthermore, whereas adding nitrendipine in the presence of extracellular Ca2+ had no effect on carbachol-induced contraction in control rats, it significantly inhibited contraction in muscle from infected rats.