Journal of critical care
-
Journal of critical care · Jun 2015
Quadrimodal distribution of death after trauma suggests that critical injury is a potentially terminal disease.
Patterns of death after trauma are changing due to advances in critical care. We examined mortality in critically injured patients who survived index hospitalization. ⋯ ICU LOS during index hospitalization is associated with post-discharge mortality. Patients with prolonged ICU stays after surviving critical injury may benefit from detailed discussions about goals of care after discharge.
-
Journal of critical care · Jun 2015
Clinical TrialProkinetic drugs for gastric emptying in critically ill ventilated patients: Analysis through breath testing.
The prupose was to identify, through the BreathID automatic breath-testing device, the best prokinetic therapy to enhance gastric-emptying rate (GER) in ventilated intensive care unit patients. ⋯ Combined metoclopramide-continuous low-dose erythromycin was found to be the best protocol in the current study to increase GER in ventilated patients. It should be tested as a first-line prokinetic therapy in ventilated patients with poor gastric emptying in further randomized controlled studies. The breath-test device presented in this study can be a user-friendly and practical method to monitor GER, enabling individual tailoring of prokinetic therapy. Further studies to explore its utility are warranted.
-
Journal of critical care · Jun 2015
Observational StudyPsychological experience of patients 3 months after a stay in the intensive care unit: A descriptive and qualitative study.
The purpose was to describe psychological experiences of patients 3 months after a stay in the intensive care unit (ICU) using qualitative methods. ⋯ Our study highlights the need to investigate patients' memories of ICU and the coping strategies used by patients to improve their ICU experience. Our findings suggest that a systematic follow-up consultation after ICU discharge would be useful for monitoring of post-ICU psychological outcomes.
-
Journal of critical care · Jun 2015
Risk factors for postoperative delirium in patients after coronary artery bypass grafting: A prospective cohort study.
This study was designed to identify the incidence and independent perioperative risk factors associated with postoperative delirium of patients who underwent coronary artery bypass grafting (CABG) in a large intensive care unit setting in China. ⋯ Delirium is a frequent complication. Factors independently associated with delirium are preoperative atrial fibrillation, elevated European system for cardiac operative risk evaluation and cognitive impairment, longer surgery duration, postoperative poor quality of sleep, and electrolyte disturbance. The study may be helpful in decreasing the incidence of postoperative delirium after CABG by treating these predictors properly.
-
Journal of critical care · Jun 2015
Disease heterogeneity and risk stratification in sepsis-related occult hypoperfusion: A retrospective cohort study.
Occult hypoperfusion is associated with increased mortality in patients with sepsis. We sought to determine the practice patterns and outcomes of patients with sepsis-related occult hypoperfusion and introduce a potential method for risk stratification. ⋯ Patients defined as having occult hypoperfusion comprise a heterogeneous group with a varied degree of illness severity. Identifying those with low risk of clinical deterioration may be important for titration of care.