Journal of critical care
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Journal of critical care · Apr 2015
Changing support needs of survivors of complex critical illness and their family caregivers across the care continuum: A qualitative pilot study of Towards RECOVER.
Survivors of complex critical illness and their family caregivers require support during their recovery, rehabilitation, and return to community living; however, the nature of these supports and how they may change over time remain unclear. Using the Timing It Right framework as a conceptual guide, this qualitative pilot study explored survivors' and caregivers' needs during the episode of critical illness through their return to independent living. ⋯ Interventions designed to improve family outcomes after critical illness should address both survivors' and caregivers' support needs as they change across the illness and recovery trajectory. Providing early intervention and support and clarifying expectations for transitions in care and recovery may decrease fears of the unknown for both caregivers and survivors. Ongoing family-centered follow-up programs may also help survivors regain independence and help caregivers manage their perceived responsibility for the patients' health. Using these insights for intervention development could ultimately improve long-term outcomes for both survivors and caregivers.
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Journal of critical care · Apr 2015
Anxiety, depression, and satisfaction in close relatives of patients in an open visiting policy intensive care unit in Brazil.
The purpose of the study is to evaluate the satisfaction and symptoms of anxiety and depression in family members in an open visiting intensive care unit (ICU). ⋯ Family members in an open visit ICU reported low rates of symptoms of anxiety and depression and high satisfaction. Visiting hours were associated with the satisfaction score and were a protective factor for family members with higher HADS score.
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Journal of critical care · Apr 2015
Comparative StudySatisfaction with care and decision making among parents/caregivers in the pediatric intensive care unit: A comparison between English-speaking whites and Latinos.
Because of previously documented health care disparities, we hypothesized that English-speaking Latino parents/caregivers would be less satisfied with care and decision making than English-speaking non-Latino white (NLW) parents/caregivers. ⋯ No disparities in ICU satisfaction with care and decision making between English-speaking NLW and Latino parents/caregivers were found.
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Journal of critical care · Apr 2015
Observational StudyCytomegalovirus reactivation in a general, nonimmunosuppressed intensive care unit population: Incidence, risk factors, associations with organ dysfunction, and inflammatory biomarkers.
Cytomegalovirus (CMV) reactivation, a significant cause of morbidity and mortality in immunosuppression, may affect "immunocompetent" seropositive critically ill patients. The aim of this prospective, observational study was to define the incidence, risk factors, and the association with morbidity and mortality of CMV reactivation in a general population of critically ill immunocompetent patients. We also studied the relationship between reactivation and patients' inflammatory response, as expressed by cytokine levels and stress up-regulation by salivary cortisol. ⋯ Cytomegalovirus reactivation occurred in 13.75% of critically ill, immunocompetent patients. The degree of inflammation and the total number of transfused red blood cells units constituted risk factors. Cytomegalovirus reactivation was associated with more severe of organ dysfunction, but not with a worse clinical outcome.
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Journal of critical care · Apr 2015
Sonographic patterns of lung consolidation in mechanically ventilated patients with and without ventilator-associated pneumonia: A prospective cohort study.
Thoracic ultrasound (TUS) has been successfully used in the diagnosis of community-acquired pneumonia. Little is known about its diagnostic potential in ventilator-associated pneumonia (VAP). The purpose of this study was to systematically describe the morphology and temporal changes of sonographic patterns in mechanically ventilated patients and to evaluate the diagnostic performance characteristics of TUS-based VAP diagnoses. ⋯ Sonographic patterns of abnormal aeration are frequently observed in mechanically ventilated patients. If sonographic lung consolidation with either static or dynamic air bronchograms is absent, VAP is highly unlikely. The presence of these sonographic patterns in patients with signs and symptoms suggestive of pneumonia significantly increases the probability of VAP.