Journal of critical care
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Journal of critical care · Dec 2015
Intensive care unit capacity strain and adherence to prophylaxis guidelines.
The purpose of the study is to examine the relationship between different measures of capacity strain and adherence to prophylaxis guidelines in the intensive care unit (ICU). ⋯ Rising capacity strain in the ICU reduces the odds that patients will receive appropriate VTEP but not SUP. The variability among different types of ICUs in the extent to which strain degraded VTEP use suggests opportunities for systems improvement.
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Journal of critical care · Dec 2015
Estimating duration of central venous catheter at time of insertion: Clinician judgment and clinical predictors.
The aim of this study was to investigate whether clinicians can estimate the length of time a central venous catheter (CVC) will remain in place and to identify variables that may predict CVC duration. ⋯ Our results suggest a low correlation between clinician prediction and actual CVC duration. We did not find any strong predictors of long CVC duration identifiable at the time of insertion.
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Journal of critical care · Dec 2015
Postoperative patients in the intensive care unit: Identifying those who do not really need it.
We evaluated severity-scoring systems as predictors of intensive care unit (ICU) need and created a new model for identifying postoperative patients who do not really need ICU. ⋯ The new model can predict LRPs more accurately than each scoring system alone. The care of LRPs in intermediate care units can prevent overuse of ICUs. But the lack of outcome comparison for predicted LRPs in ICUs vs intermediate care units is the most important limitation of our study.
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Journal of critical care · Dec 2015
The Surgical Optimal Mobility Score predicts mortality and length of stay in an Italian population of medical, surgical, and neurologic intensive care unit patients.
We validated the Italian version of Surgical Optimal Mobility Score (SOMS) and evaluated its ability to predict intensive care unit (ICU) and hospital length of stay (LOS), and hospital mortality in a mixed population of ICU patients. ⋯ The first-morning SOMS on ICU admission predicted ICU and hospital LOS in a mixed population of ICU patients. SOMS improvement was associated with reduced hospital mortality but increased hospital LOS, suggesting the need of optimizing hospital trajectories after ICU discharge.
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Journal of critical care · Dec 2015
Clinical TrialEffects of ketanserin on microcirculatory alterations in septic shock: An open-label pilot study.
Microcirculatory alterations in sepsis are associated with increased morbidity and mortality. These alterations occur despite macrohemodynamic resuscitation. Alternative pro-microcirculatory strategies, including vasodilatory drugs, have been suggested to improve capillary blood flow. Ketanserin, a serotonin receptor antagonist, is an attractive candidate because of its vasodilatory, antithrombotic, and anti-inflammatory effects. ⋯ An improvement in microcirculatory perfusion was observed during ketanserin administration in patients with septic shock after macrohemodynamic resuscitation. This finding needs further exploration in a placebo-controlled setting.