Journal of critical care
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Journal of critical care · Aug 2015
Multicenter Study Observational StudyPharmacist's review and outcomes: Treatment-enhancing contributions tallied, evaluated, and documented (PROTECTED-UK).
The purpose was to describe clinical pharmacist interventions across a range of critical care units (CCUs) throughout the United Kingdom, to identify CCU medication error rate and prescription optimization, and to identify the type and impact of each intervention in the prevention of harm and improvement of patient therapy. ⋯ This observational study demonstrated that both medication error resolution and pharmacist-led optimization rates were substantial. Almost 1 in 6 prescriptions required an intervention from the clinical pharmacist. The error rate was slightly lower than an earlier UK prescribing error study (EQUIP). Two thirds of the interventions were of moderate to high impact.
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Journal of critical care · Aug 2015
Comparative StudyComparative evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems in patients admitted to the cardiac intensive care unit.
To assess and compare the performance of Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores in the cardiac intensive care unit (CICU). ⋯ Both APACHE II and SOFA scores have good and comparable discriminative ability for predicting outcome. Calibration and accuracy indices are superior for APACHE II.
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Journal of critical care · Aug 2015
Sample entropy predicts lifesaving interventions in trauma patients with normal vital signs.
Heart rate complexity, commonly described as a "new vital sign," has shown promise in predicting injury severity, but its use in clinical practice is not yet widely adopted. We previously demonstrated the ability of this noninvasive technology to predict lifesaving interventions (LSIs) in trauma patients. This study was conducted to prospectively evaluate the utility of real-time, automated, noninvasive, instantaneous sample entropy (SampEn) analysis to predict the need for an LSI in a trauma alert population presenting with normal vital signs. ⋯ In trauma patients with normal presenting vital signs, decreased SampEn is an independent predictor of the need for LSI. Real-time SampEn analysis may be a useful adjunct to standard vital signs monitoring. Adoption of real-time, instantaneous SampEn monitoring for trauma patients, especially in resource-constrained environments, should be considered.
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Journal of critical care · Aug 2015
Neutrophil-to-lymphocyte ratio: A novel and simple prognostic marker for infective endocarditis.
Infective endocarditis is a life-threatining infectious disease characterized by high morbidity and mortality. Leukocytes play a main role in infectious diseases. Neutrophils and lymphocytes are subgroup of leukocytes, and they are routinely measured as a part of automated complete blood count test. The neutrophil-to-lymphocyte ratio is an independent predictor of unfavorable clinical outcomes in infectious and cardiovascular diseases.
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Journal of critical care · Aug 2015
Observational StudyFemoral venous oxygen saturation and central venous oxygen saturation in critically ill patients.
To investigate the relationship between central venous oxygen saturation (ScvO(2)) and femoral venous oxygen saturation (SfvO(2)) in a large group of critically ill patients. ⋯ Central venous oxygen saturation was not representative of the whole systemic circulation in critically ill patients. Central venous oxygen saturation alone might be misleading in goal-directed therapy.