Journal of critical care
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Journal of critical care · Dec 2014
The Durban World Congress Ethics Round Table: III. Withdrawing Mechanical ventilation-the approach should be individualized.
The purpose of this study is to determine the approaches used in withdrawing mechanical ventilator support. ⋯ Withdrawing of ventilator support is not universal. However, even when withdrawing mechanical ventilation is acceptable, the approach to achieve this end point is highly variable and individualized.
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Journal of critical care · Dec 2014
The impact of an interdisciplinary electroencephalogram educational initiative for critical care trainees.
The purpose of this study is to evaluate the effectiveness of an interdisciplinary electroencephalogram (EEG) educational module for critical care training. Electroencephalogram is increasingly used for diagnosis, monitoring, and treatment decisions in critically ill patients with neurologic and nonneurologic disorders. Continuous EEG monitoring has an expanded role in the intensive care unit as an additional evaluation tool for critically ill patients with altered mental status. ⋯ An interdisciplinary approach was effective for increasing EEG knowledge in critical care fellows as measured by the assessment tools. As an added potential benefit, the pulmonary fellows also learned about sleep disorder-related EEG. This model can be replicated in other institutions for trainees of other specialties interested in critical care.
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Journal of critical care · Dec 2014
Is pressure-regulated volume control mode appropriate for severely obstructed patients?
Management of mechanical ventilation in severely obstructed patients remains controversial. Pressure-regulated volume control ventilation (PRVCV) has been suggested to be the best option, as it should ensure a prefixed tidal volume at the lowest peak inspiratory pressure. We sought to determine the accuracy of the delivered volume, compared with the programmed volume, when using PRVCV. ⋯ In high-resistance simulations, the delivered volume was lower when using PCV or PRVCV modes than VCV mode. Pressure control ventilation or PRVCV may fail to provide programmed TV, ultimately leading to hypoventilation of the patient.
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Journal of critical care · Dec 2014
Intensivist perceptions of family-centered rounds and its impact on physician comfort, staff involvement, teaching, and efficiency.
Our goal was to examine intensivists' perception of comfort, staff satisfaction, teaching, and efficiency with family-centered rounds (FCR). ⋯ Participation in FCR is associated with an increase in perceived physician comfort, positive impact on staff involvement, and positive impact on patient outcome. Concerns over teaching and efficiency remain.