Journal of critical care
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Journal of critical care · Aug 2013
Intensive care unit-acquired hypernatremia is an independent predictor of increased mortality and length of stay.
The purpose of this study is to examine the impact of hypernatremia acquired after intensive care unit (ICU) admission on mortality and length of stay (LOS). ⋯ Hypernatremia developed following ICU admission in 4.3% of patients. Hypernatremia was independently associated with a 40% increase in risk for hospital mortality and a 28% increase in ICU LOS. Severity, but not duration of ICU-acquired hypernatremia was associated with hospital mortality.
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Journal of critical care · Aug 2013
The clinical quandary of counseling the moribund critical care patient-a registry analysis of postsurgical outcomes.
To provide outcomes data to intensivists and surgeons for counseling patients and family members when considering a surgical intervention in a moribund patient. ⋯ The moribund patient is not as grave as once thought and surgery on these patients may not be futile given the 47% survival rate at 30 days. Postoperative complication rates are high. The data presented provide a meaningful tool for the clinicians in counseling patients and families on the expectations when considering a surgical intervention for moribund patients.
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Journal of critical care · Aug 2013
A narrative-based study on communication by family members in intensive care unit.
This study investigates how informative stories are, as written by patients' families in an intensive care unit (ICU) guest book, in terms of families' emotional responses, needs, perceptions, and satisfaction with the quality of care supplied. ⋯ The study suggests that ICU guest books can be an effective and simple means of communication between the family, the patient, and the ICU staff. Families shared thoughts, feelings, or opinions, which were meant to be supportive for the patients or rewarding for the staff.
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Journal of critical care · Aug 2013
Low-tidal volume mechanical ventilation in patients with acute respiratory distress syndrome caused by pandemic influenza A/H1N1 infection.
Low-tidal volume (TV) mechanical ventilation is an important manipulation in managing patients with acute respiratory distress syndrome (ARDS). However, there is no definite evidence to support the use of this intervention in patients with viral etiologies. ⋯ Low-TV mechanical ventilation still benefits patients with ARDS caused by viral pneumonia.
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Journal of critical care · Aug 2013
Comparative StudyAccuracy of the chest radiograph to identify bilateral pulmonary infiltrates consistent with the diagnosis of acute respiratory distress syndrome using computed tomography as reference standard.
The purpose of the study is to evaluate the diagnostic accuracy of the anteroposterior chest radiograph to detect pulmonary abnormalities consistent with acute respiratory distress syndrome (ARDS). ⋯ The accuracy of the portable chest radiograph to detect pulmonary abnormalities consistent with ARDS is significantly limited. These findings suggest that the use of the chest radiograph results mainly in underrecognition of the syndrome, particularly when disease is not diffusely distributed, but also in overdiagnosis.