Journal of critical care
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Journal of critical care · Dec 2013
Randomized Controlled Trial Comparative StudyDexmedetomidine preserves attention/calculation when used for cooperative and short-term intensive care unit sedation.
Differential effects on cognition were recently demonstrated between dexmedetomidine (DEX) and propofol (PRO) when used for cooperative sedation. Propofol was found to reduce cognition, whereas DEX improved cognition. To further discriminate these effects, we evaluated the effect of PRO vs DEX in selected areas of cognition. ⋯ Our findings indicate that DEX improved ACE attention/calculation subscale in awake patients receiving cooperative sedation. This is in contrast to the deterioration in all mean ACE subscale scores observed using PRO, suggesting DEX preserved cognitive function with specific preservation of focus and attention and allows for greater cognition compared with PRO across all cognitive domains.
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Journal of critical care · Dec 2013
Comparative StudyRisk prediction of hospital mortality for adult patients admitted to Australian and New Zealand intensive care units: Development and validation of the Australian and New Zealand Risk of Death model.
The purpose of this study is to develop and validate a new mortality prediction model (Australian and New Zealand Risk of Death [ANZROD]) for Australian and New Zealand intensive care units (ICUs) and compare its performance with the existing Acute Physiology and Chronic Health Evaluation (APACHE) III-j. ⋯ The ANZROD has better calibration; discrimination compared with the APACHE III-j. Further research is required to validate performance over time and in specific subgroups of ICU population.
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Journal of critical care · Dec 2013
Multicenter StudyMortality after in-hospital cardiopulmonary resuscitation: Multicenter analysis in Korea.
The purpose of this study is to evaluate factors associated with the mortality of patients admitted to intensive care units (ICUs) after in-hospital cardiopulmonary resuscitation (CPR) and the impact of a hospital rapid response system (RRS) on patient mortality in Korea. ⋯ Various physiologic and laboratory parameters were associated with the mortality of post-CPR ICU admitted patients, and the presence of an RRS did not reduce mortality of these patients in our study.
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Journal of critical care · Dec 2013
Observational StudyElectronic bed weighing vs daily fluid balance changes after cardiac surgery.
The purpose of this study is to establish the validity and reliability of measuring weight in critically ill patients with electronic weighing beds. ⋯ Body weight measured by electronic weighing beds does not seem sufficiently robust or accurate to replace daily FB in ICU. The clinical value of purchasing such beds remains uncertain.
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Journal of critical care · Dec 2013
Randomized Controlled Trial Multicenter StudyImplementation of a protocol for integrated management of pain, agitation, and delirium can improve clinical outcomes in the intensive care unit: A randomized clinical trial.
Inappropriate diagnosis and treatment of pain, agitation, and delirium (PAD) in intensive care settings results in poor patient outcomes. We designed and used a protocol for systematic assessment and management of PAD by the nurses to improve clinical intensive care unit (ICU) outcomes. ⋯ The current randomized trial provided evidence for a substantial reduction in the duration of need to ventilatory support, length of ICU stay, and mortality rates in ICU-admitted patients through protocol-directed management of PAD.