Journal of intensive care medicine
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J Intensive Care Med · Sep 2014
Critical care in patients undergoing lumbar spine fusion: a population-based study.
Data on the utilization of critical care services (CCSs) among patients who underwent spine fusion are rare. Given the increasing popularity of this procedure, information regarding demographics and risk factors for the use of these advanced services is needed in order to appropriately allocate resources, educate clinical staff, and identify targets for future research. ⋯ Approximately, 10% of the patients undergoing lumbar spine surgery require CCS. Utilizing the present data, critical care physicians and administrators can identify patients at risk, educate clinical staff, identify targets for intervention, and allocate resources to meet the needs of this particular patient population.
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J Intensive Care Med · Sep 2014
Case ReportsFatal case of tension pneumothorax and subcutaneous emphysema after open surgical tracheostomy.
Tracheostomy tube placement remains one of the most commonly performed procedures in the intensive care unit. Its utilization permits ventilation in patients with severe compromise of the airway patency as well as facilitation of liberation of mechanical ventilation in patients with prolonged ventilatory needs. ⋯ We report a case of a surgical tracheostomy complicated with fatal tension pneumothorax and subcutaneous emphysema secondary to an iatrogenic posterior tracheal wall laceration. This complication is barely seen in usual practice, and its recognition and aggressive therapy may avoid fatal outcomes.
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J Intensive Care Med · Sep 2014
Impact of nurse integrated rounds on self-reported comprehension, attitudes, and practices of nurses and resident physicians in a pediatric intensive care unit.
To evaluate the impact of nurse integrated rounds (NIRs) on self-reported comprehension, attitudes, and practices of nurses and resident physicians (RPs) in a pediatric intensive care unit (PICU). ⋯ The NIRs are well accepted by nurses and physicians and are accompanied by self-reported improvements in comprehension, attitudes, and practices of nurses and RPs in the PICU.
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J Intensive Care Med · Jul 2014
Cardiocerebral Resuscitation: An Approach to Improving Survival of Patients With Primary Cardiac Arrest.
Out-of-hospital cardiac arrest (OHCA) is a major public health problem. In the United States, OHCA accounts for more premature deaths than any other cause. For over a half-century, the national "Guidelines" for resuscitation have recommended the same initial treatment of primary and secondary cardiac arrests. ⋯ Each component of CCR is critical for optimal survival of patients with primary OHCA. In each city, county, and state where CCR was instituted, the result was a marked increase in survival of the subgroup of patients with OHCA most likely to survive, for example, those with a shockable rhythm. The purpose of this invited article on CCR is to review this alternative approach to resuscitation of patients with primary cardiac arrest and to encourage its adoption worldwide so that more lives can be saved.
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J Intensive Care Med · Jul 2014
ReviewNew drugs and strategies for management of Clostridium difficile colitis.
Approaches for management of Clostridium difficile infection continually evolve as research reveals shifts in epidemiology, microbial pathogenesis, disease severity states, and response to therapy. These new discoveries significantly impact diagnostic and therapeutic strategies, given the high morbidity associated with this common nosocomial infectious diarrhea. ⋯ Early diagnosis of severe disease state may improve patient outcomes. In this article, we review treatment strategies and new approaches for the management of C. difficile in critically ill patients.