Journal of critical care
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Journal of critical care · Apr 2014
Case ReportsHypotensive resuscitation in a head-injured multi-trauma patient.
The concept of permissive hypotension is a controversial topic in trauma care. While driving blood pressure to "normal" levels with large volume crystalloid infusions is not appropriate, definitive data on the target blood pressure for hypotensive resuscitation are lacking. ⋯ The controversies highlighted herein call attention to the role of the intensivist in managing a continuing resuscitation while coordinating the care of other physicians whose therapies can run at cross-purposes to one another. The challenges of the practice of critical care in the 21st century are no more apparent than in the care of a complex trauma patient.
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Journal of critical care · Apr 2014
Multicenter StudyWhat stops us from following sedation recommendations in intensive care units? A multicentric qualitative study.
The purpose of the study is to explore health care professionals' (HCPs) perceptions regarding sedation recommendations. ⋯ Barriers impairing implementation of sedation recommendations vary according to the type of HCP and the choice of strategy targeting light sedation (protocolized sedation vs DSI). Improvement strategies must target HCPs separately and tailored to specific recommendation choices.
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Journal of critical care · Apr 2014
Comparative StudyComputerized physician order entry in the cardiac intensive care unit: Effects on prescription errors and workflow conditions.
To evaluate the effects of a computerized physician order entry (CPOE) system in the cardiac intensive care unit by detecting prescription errors (PEs) and also to assess the impact on working conditions. ⋯ Computerized physician order entry in the cardiac intensive care unit proved to be a safe and effective strategy in reducing PEs and was globally well received by professionals.
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Journal of critical care · Apr 2014
Evaluating the obtunded patient after cardiac surgery: The role of continuous electroencephalography.
This prospective study was designed to evaluate the role of continuous electroencephalography (EEG) in the management of adult patients with neurological dysfunction early after cardiac surgery. ⋯ Non-convulsive status epilepticus may be an under-recognized cause of obtundation early after cardiac surgery. Continuous EEG monitoring is a non-invasive test that can identify patients that may benefit from anti-epileptic medication. Larger comparative studies are required to establish whether this leads to significant improvements in patient outcomes.
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Journal of critical care · Apr 2014
Multicenter StudyEffect of preadmission sunlight exposure on intensive care unit-acquired delirium: A multicenter study.
It is assumed that there is a relation between light exposure and delirium incidence. The aim of our study was to determine the effect of prehospital light exposure on the incidence of intensive care unit (ICU)-acquired delirium. ⋯ The incidence of delirium does not differ per season and prior sunlight exposure does not play a role of importance in the development of ICU-acquired delirium.