Journal of critical care
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Journal of critical care · Sep 2009
Multicenter StudyTime series analysis of use patterns for common invasive technologies in critically ill patients.
Critically ill patients are frequently managed with invasive technologies as part of their medical care. Little is known about use patterns. We examined use trends for invasive technologies used in critically ill patients. ⋯ The use of invasive technologies in critically ill patients is changing and may have important implications for resource use, clinician education, and patient care. Initiatives should be considered for ensuring clinician competency during technology transitions.
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Journal of critical care · Sep 2009
Influence of mild therapeutic hypothermia on the inflammatory response after successful resuscitation from cardiac arrest.
Although animal studies document conflicting data on the influence of hypothermia on cytokine release in various settings, no data exist if hypothermia affects the inflammatory response after successful cardiopulmonary resuscitation. ⋯ In this observational study, hypothermia influenced the inflammatory response after cardiopulmonary resuscitation and lead to a higher rate of bacterial colonization without altering ultimate neurologic recovery.
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Journal of critical care · Sep 2009
The impact of time to tracheostomy on mechanical ventilation duration, length of stay, and mortality in intensive care unit patients.
This study examined the potential effects of time to tracheostomy on mechanical ventilation duration, intensive care unit (ICU), and hospital length of stay (LOS), and ICU and hospital mortality. ⋯ Time to tracheostomy was independently associated with increased mechanical ventilation duration, ICU LOS, and hospital LOS, but was not associated with increased mortality. Performing tracheostomy earlier in the course of ICU stay may have an effect on ICU resources and could entail significant cost-savings without adversely affecting patient mortality.
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Journal of critical care · Sep 2009
Reliability of intensive care unit admitting and comorbid diagnoses, race, elements of Acute Physiology and Chronic Health Evaluation II score, and predicted probability of mortality in an electronic intensive care unit database.
Although reliability of severity of illness and predicted probability of hospital mortality have been assessed, interrater reliability of the abstraction of primary and other intensive care unit (ICU) admitting diagnoses and underlying comorbidities has not been studied. ⋯ Reliability for ICU diagnoses and elements of the APACHE II score is related to the objectivity of primary data in the medical charts.
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Journal of critical care · Sep 2009
Effect of interhospital transfer on resource utilization and outcomes at a tertiary pediatric intensive care unit.
The study aimed to examine the effect of interhospital transfer on resource utilization and clinical outcomes at a tertiary pediatric intensive care unit (PICU) among patients with sepsis or respiratory failure. ⋯ Interhospital transfer, particularly inter-PICU transfer, was associated with significant hospital resource consumption that often correlated with admission illness severity. Future prospective studies should identify determinants of pretransfer illness severity and investigate decision making underlying interhospital transfer.