Journal of critical care
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Journal of critical care · Feb 2013
Attributable costs of patients with candidemia and potential implications of polymerase chain reaction-based pathogen detection on antifungal therapy in patients with sepsis.
The purposes of this study were to calculate attributable costs of candidemia in patients with severe sepsis and to obtain preliminary data regarding the potential effects of polymerase chain reaction-based pathogen detection on antifungal therapy for these patients. ⋯ Candidemia increases costs of care in patients with septic shock. Polymerase chain reaction-based pathogen detection significantly reduces the time to initiation of antifungal therapy. This might impact on the clinical course of the disease but need to be confirmed in further trials.
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Journal of critical care · Feb 2013
Parental satisfaction, involvement, and presence after pediatric intensive care unit admission.
To describe satisfaction, involvement, presence, and preferences of parents following their child's admission to an intensive care unit (ICU). ⋯ Overall, parental satisfaction ratings were high, lower in parents of children receiving more ICU therapies, and not associated with presence during resuscitation. These data contrast the American Heart Association's recommendation and suggestion of benefit from parental presence during periods of intensive therapies.
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Journal of critical care · Feb 2013
Multicenter StudySafety climate in 5 intensive care units: a nationwide hospital survey using the Greek-Cypriot version of the safety attitudes questionnaire.
Patient safety is considered an antecedent of quality of hospital care. The explicit need to focus on quality of care underpins the aim of the study to evaluate the safety culture and teamwork climate in the public intensive care units (ICUs) of the 5 regional public hospitals in Cyprus as measured by a validated safety attitudes tool. ⋯ Considerable safety climate variations between the ICUs of the regional hospitals of Cyprus have been verified. Age, infrastructure, the severity of cases, and the nurse skill mix are variables that affect the patient safety culture in an ICU environment.
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Journal of critical care · Feb 2013
Muscle strength assessment in critically ill patients with handheld dynamometry: an investigation of reliability, minimal detectable change, and time to peak force generation.
Dynamometry is an objective tool for volitional strength evaluation that may overcome the limited sensitivity of the Medical Research Council scale for manual muscle tests, particularly at grades 4 and 5. The primary aims of this study were to investigate the reliability, minimal detectable change, and time to peak muscle force, measured with portable dynamometry, in critically ill patients. ⋯ Dynamometry can provide reliable measurements in alert critically ill patients, but moderate changes in strength may be required to overcome measurement error, during the acute recovery period. Deficits in force timing may reflect impaired neuromuscular control.
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Journal of critical care · Feb 2013
Comparative StudyA comparison of the rapid shallow breathing index and complexity measures during spontaneous breathing trials after cardiac surgery.
Extubation failure is associated with worse outcomes. Physicians use respiratory parameters to help them to decide to extubate or not. The purpose of this study is to determine if novel measures of respiratory physiology such as complexity and variability can identify patients who will tolerate extubation. ⋯ Patients who successfully tolerate extubation have longer interbreath interval with greater complexity and variability of that series. Although the V(T) was similar between the Extub-Success and the SBT-Fail groups, the Extub-Success group had greater long-term complexity with no difference in short-term complexity. This implies that the respiratory controllers are differently impacted in patients tolerating or not tolerating extubation.