Journal of critical care
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Journal of critical care · Dec 2015
Interobserver agreement in the evaluation of B-lines using bedside ultrasound.
We evaluated agreement among trained emergency physicians assessing the degree of B-line presence on bedside ultrasound in patients presenting to the emergency department (ED) with acute undifferentiated dyspnea. We also determined which thoracic zones offered the highest level of interobserver reliability for sonographic B-line assessment. ⋯ Interrater agreement was best in the anterior/superior thoracic zones followed by the lateral/superior zones for both expert/expert and expert/novice pairs. Agreement in the lateral/inferior lung zones was overall inferior. Intrarater agreement was highest at extreme high or low numbers of B-lines.
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Journal of critical care · Dec 2015
Atelectasis and mechanical ventilation mode during conservative oxygen therapy: A before-and-after study.
The purpose of the study is to assess the effect of a conservative oxygen therapy (COT) (target SpO2 of 90%-92%) on radiological atelectasis and mechanical ventilation modes. ⋯ In mechanically ventilated intensive care unit patients, COT might be associated with decreased radiological evidence of atelectasis, earlier weaning from mandatory ventilation modes, and earlier first trial of spontaneous ventilation.
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Journal of critical care · Dec 2015
Key stakeholders' perspectives on a Web-based advance care planning tool for advanced lung disease.
There is a paucity of scalable advance care planning strategies that achieve the diverse goals of patients, families, and clinicians. We convened key stakeholders to gain their perspectives on developing a Web-based advance care planning tool for lung disease. ⋯ There is strong stakeholder support for the development of a Web-based advance care planning tool for lung disease.
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Journal of critical care · Dec 2015
Creatinine kinase isoenzyme-MB: A simple prognostic biomarker in patients with pulmonary embolism treated with thrombolytic therapy.
Creatinine kinase isoenzyme-MB (CK-MB) is a biomarker for detecting myocardial injury. The aim of this study was to evaluate the association between admission CK-MB levels and in-hospital and long-term clinical outcomes in pulmonary embolism (PE) patients treated with thrombolytic tissue-plasminogen activator. ⋯ Creatinine kinase isoenzyme-MB is a simple, widely available, and useful biomarker for predicting adverse in-hospital clinical outcomes in PE.
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Journal of critical care · Dec 2015
Observational StudyA quality improvement project to decrease emergency department and medical intensive care unit transfer times.
To reduce transfer time of critically ill patients from the emergency department (ED) to the medical intensive care unit (MICU). ⋯ A team made up of frontline health care professionals using a structured quality improvement process and implementing multifaceted, multistage interventions, reduced transfer delays, and length of stay. Added benefits included engagement among members of the 2 microsystems and a more cohesive approach to patient care.