Journal of intensive care medicine
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J Intensive Care Med · Sep 2016
Hypothermia in Adult ICUs: Changing Incidence But Persistent Risk Factor for Mortality.
This study examined whether hypothermia (< 36.0°C) incidence among critically ill patients varied over time, the determinants of change, and the associated risk for ICU mortality. ⋯ The incidence of hypothermia at ICU admission was dependent on medical versus surgical status, and the method of non-invasive temperature measurement, but was persistently associated with ICU mortality.
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J Intensive Care Med · Sep 2016
Observational StudyWhen to Stop CPR and When to Perform Rhythm Analysis: Potential Confusion Among ACLS Providers.
Health care providers nationwide are routinely trained in Advanced Cardiac Life Support (ACLS), an American Heart Association program that teaches cardiac arrest management. Recent changes in the ACLS approach have de-emphasized routine pulse checks in an effort to promote uninterrupted chest compressions. We hypothesized that this new ACLS algorithm may lead to uncertainty regarding the appropriate action following detection of a pulse during a cardiac arrest. ⋯ Confusion exists regarding whether or not CPR and cardiac medications should be continued in the presence of a pulse. Education may be warranted to emphasize avoiding compressions and medications when a palpable pulse is detected.
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J Intensive Care Med · Aug 2016
Comparative StudyComparison of Dexmedetomidine Versus Propofol on Hospital Costs and Length of Stay.
The objective of this evaluation was to compare total hospital costs and length of stay of critically ill patients who received dexmedetomidine versus propofol for sedation in the intensive care unit (ICU). ⋯ In this academic medical center, dexmedetomidine use was associated with higher costs when compared to propofol for sedation in the ICU. Also, use of dexmedetomidine was associated with increased lengths of ICU and hospital stay. Future prospective trials are needed to confirm these findings.
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J Intensive Care Med · Aug 2016
ReviewEmerging Role of Melatonin and Melatonin Receptor Agonists in Sleep and Delirium in Intensive Care Unit Patients.
Delirium, an acute state of mental confusion, can lead to many adverse sequelae in intensive care unit (ICU) patients. Although the etiology of ICU delirium is often multifactorial, and at times not fully understood, sleep deprivation is considered to be a major contributing factor to its development. ⋯ Although few studies evaluating the impact of melatonergic agents on sleep and delirium in the ICU have been completed, some data suggest their potential positive effects on sleep and delirium. However, large-scale randomized controlled trials are warranted to determine the optimal role of melatonergic agents in the prevention of ICU delirium.
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J Intensive Care Med · Aug 2016
Does the Subjective Global Assessment Predict Outcome in Critically Ill Medical Patients?
The Subjective Global Assessment (SGA) is a validated nutrition assessment tool that is not commonly used to evaluate the nutritional status of patients admitted to the intensive care unit (ICU). ⋯ Malnutrition on admission is common in critically ill medical patients. Malnutrition, as assessed by SGA at admission to ICU, is associated with increased mortality and thus can serve as a valuable prognostic tool in the assessment of critically ill patients. Given that that the SGA is a simple bedside assessment, it should be considered for routine use in assessing critically ill patients.