Journal of critical care
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Journal of critical care · Aug 2013
Prescribing nonopioids in mechanically ventilated critically ill patients.
We searched for factors independently associated with the prescription of multimodal (balanced) analgesia in mechanically ventilated critically ill patients. ⋯ In mechanically ventilated patients, the addition of nonopioids to opioids is mostly prescribed for patients with lower illness severity scores and who are able to self-rate their pain intensity. These findings suggest that the concept of multimodal analgesia must be promoted in the intensive care unit.
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Journal of critical care · Aug 2013
Assessing the quality of interdisciplinary rounds in the intensive care unit.
Interdisciplinary rounds (IDRs) in the intensive care unit (ICU) are increasingly recommended to support quality improvement, but uncertainty exists about assessing the quality of IDRs. We developed, tested, and applied an instrument to assess the quality of IDRs in ICUs. ⋯ The quality of IDRs in the ICU can be reliably assessed for patient plan of care and process with the IDR Assessment Scale.
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Journal of critical care · Aug 2013
Coronary artery disease in patients clinically diagnosed with myocardial infarction in the medical intensive care unit.
The purpose of this study is to compare the clinical characteristics and outcomes of patients with and without coronary artery disease (CAD) confirmed by coronary angiography in critically ill patients clinically diagnosed with myocardial infarction. ⋯ Coronary angiography in critically ill patients should only be performed in highly selected patients with predicting factors for CAD.
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Journal of critical care · Aug 2013
Antibiotic resistance patterns in medical and surgical patients in a combined medical-surgical intensive care unit.
Studies have found different rates of antimicrobial resistance among patients in medical and surgical intensive care units (ICUs). We studied whether these differences were a function of geography or differences in the patient populations, by comparing resistance rates among bacteria isolated from a combined medical/surgical ICU. ⋯ Reported differences in resistance patterns among bacteria cultured from medical and surgical patients may be due to geographic separation of the ICUs as opposed to differences in the patient characteristics. This study suggests that ICU-specific antibiograms remain a useful tool to guide the choice of antimicrobial therapy, even in medical/surgical ICUs.
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Journal of critical care · Aug 2013
Relationships between mortality, morbidity, and physical function in adults who survived a period of prolonged mechanical ventilation.
This study aimed to report mortality, morbidity, and the relationship between these outcomes with physical function in patients who survived prolonged mechanical ventilation during an intensive care unit (ICU) admission. ⋯ For survivors of prolonged mechanical ventilation, physical function during acute care was associated with hospitalization over the following 12 months.