Journal of critical care
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Journal of critical care · Oct 2012
ReviewFever in non-neurological critically ill patients: a systematic review of observational studies.
There is no recommendation on how increased body temperature should be treated in non-neurological critically ill patients. To understand the epidemiology of fever and its association with mortality, we conducted a systematic review of the literature to search for data related to the association between fever and mortality. ⋯ The limited evidence available suggests that the recommended definition of fever (38.3°C) might be too low to predict increased mortality. Because fever is common in the intensive care unit, there is an urgent need for more studies in this field.
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Journal of critical care · Oct 2012
ReviewNoise in hospital intensive care units--a critical review of a critical topic.
The aims of the study were to examine the studies related to hospital noise in intensive care units (ICUs) to understand the sources and effects of noise and to describe best practices and common problems in the varying methods commonly applied to reduce the noise level. ⋯ Significant opportunities exist to improve methodologies to study noise levels to reduce noise in hospital ICUs. Many previous studies have used inconsistent methodologies with poorly defined parameters that make it difficult to compare results. Our work points out common pitfalls in the recording and sharing of hospital acoustic parameters and also points to the paucity of important economic considerations in extant studies. These results can be helpful for future research in this area. Many past salutary interventions--including educational noise reduction programs, behavioral modification using sound detection equipment, and low- as well as high-cost environmental alterations--do not generally appear to be adequate to minimize noise to levels for hospital rooms specified by international agencies. But a potentially important clue for future work involves the finding that as the number of patients and staff of the ICU increases, noise levels appear to also increase.
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Journal of critical care · Oct 2012
African American race, obesity, and blood product transfusion are risk factors for acute kidney injury in critically ill trauma patients.
Acute kidney injury (AKI) is a common source of morbidity after trauma. We sought to determine novel risk factors for AKI, by Acute Kidney Injury Network (AKIN) criteria, in critically ill trauma patients. ⋯ Acute kidney injury in critically ill trauma patients is associated with substantial mortality. The findings of African American race, obesity, and blood product administration as independent risk factors for AKI deserve further study to elucidate underlying mechanisms.
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Journal of critical care · Oct 2012
High-flow nasal therapy in adults with severe acute respiratory infection: a cohort study in patients with 2009 influenza A/H1N1v.
The experience with high-flow nasal cannula (HFNC) oxygen therapy in severe acute respiratory infection (SARI) is limited. The objective was to assess the effectiveness of HFNC oxygen therapy in adult patients with SARI by confirmed 2009 influenza A/H1N1v infection (by real-time reverse transcription polymerase chain reaction testing). ⋯ High-flow nasal cannula O(2) therapy appears to be an innovative and effective modality for early treatment of adults with SARI.
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Journal of critical care · Oct 2012
Impact of pattern of admission on outcomes after aneurysmal subarachnoid hemorrhage.
Patients with aneurysmal subarachnoid hemorrhage (aSAH) require management in centers with neurosurgical expertise necessitating emergent interhospital transfer (IHT). Our objective was to compare outcomes in aSAH IHTs to our institution with aSAH admissions from our institutional emergency department (ED). ⋯ Our institutional ED SAH admissions had significantly better outcomes than did IHTs, suggesting that delays in optimizing care before transfer could deleteriously impact outcomes.