Journal of critical care
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Journal of critical care · Aug 2014
Multicenter StudyDuration of oral endotracheal intubation is associated with dysphagia symptoms in acute lung injury patients.
The purpose of this study is to evaluate demographic and clinical factors associated with self-reported dysphagia after oral endotracheal intubation and mechanical ventilation in patients with acute lung injury (ALI). ⋯ In ALI survivors, patient-reported, postexubation dysphagia at hospital discharge was significantly associated with upper gastrointestinal comorbidity and a longer duration of oral endotracheal intubation during the first 6 days of intubation.
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Journal of critical care · Aug 2014
Multicenter Study Observational StudyPulse pressure variations to guide fluid therapy in donors: A multicentric echocardiographic observational study.
Preload responsiveness parameters could be useful in the hemodynamic management of septic shock. ⋯ A ΔPP threshold of 13% is insufficient to guide volume expansion in donors. The best threshold is 20%. Fluid responsiveness monitoring could enhance organ harvesting.
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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 StudyEffects of etomidate on vasopressor use in patients with sepsis or severe sepsis: A propensity-matched analysis.
The safety of single-bolus etomidate to facilitate intubation in septic patients is controversial due to its potential to suppress adrenal steroidogenesis. The purpose of this study was to evaluate the effects of etomidate on the development of shock when used as an induction agent to facilitate intubation in septic patients. ⋯ The use of etomidate for intubation in septic patients did not increase vasopressor requirements within 72 hours after intubation.
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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.