Journal of critical care
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Journal of critical care · Jun 2009
Passive decision-making preference is associated with anxiety and depression in relatives of patients in the intensive care unit.
The objectives were to describe the decision-making preferences of relatives (family members) of patients in intensive care units (ICUs), to determine whether the relatives had symptoms of anxiety and depression while the patients were in the ICU, and to determine whether there was a relationship between the relatives' preferences and symptoms. ⋯ The relatives who preferred a passive decision-making role were the most likely to be anxious and depressed.
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Journal of critical care · Jun 2009
The impact of do-not-resuscitate order on triage decisions to a medical intensive care unit.
To determine whether the presence of a do-not-resuscitate (DNR) order impacts on triage decisions to a medical intensive care unit (MICU) of an academic medical center. ⋯ The presence of a DNR order at the time of MICU consultation was significantly associated with the decision to refuse a patient to the MICU.
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Journal of critical care · Jun 2009
Positive end-expiratory pressure alters the severity and spatial heterogeneity of ventilator-induced lung injury: an argument for cyclical airway collapse.
Ventilator-induced lung injury (VILI) is a recognized complication of mechanical ventilation. Although the specific mechanism by which mechanical ventilation causes lung injury remains an active area of study, both alveolar overdistension and cyclical airway collapse and recruitment have been suggested as contributing causes. We hypothesized that mechanical ventilation in the absence of positive end-expiratory pressure (PEEP) causes VILI to be more severe and regionally variable as compared with PEEP = 8 cm H(2)O. ⋯ These results suggest that VILI is regionally heterogeneous and spatially correlates with regions in which cyclical airway collapse and recruitment is most likely to occur.
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Journal of critical care · Jun 2009
Characteristics of discussions on cardiopulmonary resuscitation between physicians and surrogates of critically ill patients.
In the intensive care unit (ICU), critically ill patients are often unable to participate in discussions about cardiopulmonary resuscitation (CPR), and decisions on CPR are often made by surrogate decision makers. The objective of this study is to determine the prevalence, content, and perceptions of CPR discussions between critically ill patients' surrogates and ICU physicians and their effect on resuscitation decisions. ⋯ Only half of critically ill patients' surrogates participated in CPR discussions. For those who did participate, most reported good understanding of resuscitation techniques, but less than half recalled the core components of CPR.
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Journal of critical care · Jun 2009
Continuous end-tidal carbon dioxide monitoring in pediatric intensive care units.
End-tidal carbon dioxide (ETCO(2)) monitoring has a variety of clinical applications in critically ill pediatric patients. This study was designed to explore the current availability and utilization patterns for continuous ETCO(2) monitoring in pediatric intensive care units. ⋯ End-tidal carbon dioxide monitoring is widely available and used for intubated patients. However, it could be applied more frequently in other clinical situations in pediatric intensive care units.