Journal of critical care
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Journal of critical care · Oct 2014
Low tissue oxygen saturation at emergency center triage is predictive of intensive care unit admission.
Timely recognition of critical patients by emergency center triage is an ongoing challenge. Peripheral tissue oxygen saturation (StO2) measurement has been used to monitor shock patients' responses to resuscitation. Interest has developed in evaluating StO2 as a triage tool, but limited studies have addressed critically ill patients. ⋯ In this patient population, an StO2 less than 70% significantly increased the risk of ICU admission. Tissue oxygen saturation at triage identifies critical patients who may not be recognized by vital signs alone. Tissue oxygen saturation measurement could help providers make earlier decisions regarding hospital resource allocation.
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Journal of critical care · Oct 2014
Cost savings with interventions to reduce aerosolized bronchodilator use in mechanically ventilated patients.
The purpose of this evaluation is to describe the cost savings associated with multimodal interventions aimed at reducing aerosolized bronchodilator use in mechanically ventilated patients without adversely affecting costs associated with length of stay (LOS). ⋯ Multimodal efforts to restrict aerosolized bronchodilator therapy in mechanically ventilated patients were successful and led to sustained reductions in use that was associated with substantial reductions in cost, without affecting LOS.
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Journal of critical care · Oct 2014
Polymyxin B-immobilized fiber column hemoperfusion removes endotoxin throughout a 24-hour treatment period.
The purpose of this study was to evaluate the extent of endotoxin adsorption by polymyxin B-immobilized fiber column hemoperfusion (PMX) performed for a 24-hour treatment period in patients with septic shock. ⋯ These findings suggest that 24-hour PMX treatment was effective in removing endotoxin continuously throughout the entire treatment period.
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Journal of critical care · Oct 2014
Observational StudyInterruptions experienced by cardiovascular intensive care unit nurses: An observational study.
Intensive care unit (ICU) nurses get interrupted frequently. Although interruptions take cognitive resources from a primary task and may hinder performance, they may also convey critical information. Effective management of interruptions in ICUs requires the understanding of interruption characteristics, the context in which interruption happens, and interruption content. ⋯ Mitigation strategies other than blocking should also be explored. In addition, interrupters might have evaluated primary task severity before interrupting. Therefore, making task severity more transparent may help others modulate when and how they interrupt a nurse.
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Journal of critical care · Oct 2014
Non-English speaking is a predictor of survival after admission to intensive care.
The relationship between English proficiency and health care outcomes in intensive care has rarely been examined. This study aimed to determine whether being a non-English speaker would predict mortality in a critical care setting. Secondary end points were intensive care unit (ICU) and hospital length of stay. ⋯ Contrary to expectations, this large single-center study shows a consistent relationship between non-English-speaking status and increased survival after admission to ICU.