Journal of critical care
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Journal of critical care · Aug 2014
Multicenter Study Observational StudyA multicenter population-based effectiveness study of teleintensive care unit-directed ventilator rounds demonstrating improved adherence to a protective lung strategy, decreased ventilator duration, and decreased intensive care unit mortality.
The purpose of the study is to determine if teleintensive care unit (ICU)-directed daily ventilator rounds improved adherence to lung protective ventilation (LPV), reduced ventilator duration ratio (VDR), and ICU mortality ratios. ⋯ Implementation of teleICU-directed ventilator rounds was associated with improved and durable adherence to LPV and significant reductions in both VDR and ICU mortality.
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Journal of critical care · Aug 2014
Multicenter StudyThe views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study.
Selective decontamination of the digestive tract (SDD) as a prophylactic intervention improves hospital-acquired infection and survival rates. Uptake of SDD is low and remains controversial. This study applied the theoretical domains framework to assess intensive care unit clinicians' views about SDD in regions with limited or no adoption of SDD. ⋯ We identified salient beliefs, barriers, and facilitators to SDD adoption and delivery. What participants said about SDD and the way in which they said it demonstrated the degree of clinical caution, uncertainty, and concern that SDD evokes.
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Journal of critical care · Aug 2014
Women are more than twice as likely to die from burns as men in Australia and New Zealand: An unexpected finding of the Burns Evaluation And Mortality (BEAM) Study.
While the risk of death after nonthermal trauma and sepsis may be higher for men, sex differences in outcome after burns are inconsistently reported. The Burns Evaluation And Mortality Study examined the outcomes of all patients admitted after thermal injury to the intensive care unit (ICU) at 8 of 9 burn referral centers in Australia and New Zealand between January 1, 2005, and December 31, 2011. There were 348 women and 1367 men treated for acute burns. ⋯ After adjusting for confounding factors, women had more than double the risk of death compared with men (odds ratio, 2.35; 95% confidence interval, 1.38-4.01; P=.002). Our study conclusively shows worse outcomes for women with burns admitted to ICUs in Australia and New Zealand. Further research is required to determine why this is happening.
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Journal of critical care · Aug 2014
Noninvasive assessment of hemodynamic variables using near-infrared spectroscopy in patients experiencing cardiogenic shock and individuals undergoing venoarterial extracorporeal membrane oxygenation.
The relationship between near-infrared spectroscopy cerebral oximetry (CrSO2), peripheral oximetry (PrSO2) and hemodynamic variables is not fully understood. ⋯ Results of the present study suggest that CrSO2 and PrSO2 in particular can be used for noninvasive estimation and monitoring of global circulatory status in patients experiencing cardiogenic shock and individuals undergoing ECMO.
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Journal of critical care · Aug 2014
Observational StudyFunctional electrical stimulation with cycling in the critically ill: A pilot case-matched control study.
The purpose was to determine (a) safety and feasibility of functional electrical stimulation (FES)-cycling and (b) compare FES-cycling to case-matched controls in terms of functional recovery and delirium outcomes. ⋯ The delivery of FES-cycling is both safe and feasible. The preliminary findings suggest that FES-cycling may improve function and reduce delirium. Further research is required to confirm the findings of this study and evaluate the efficacy of FES-cycling.