Journal of critical care
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Journal of critical care · Feb 2016
Decreasing maintenance fluids in normotensive trauma patients may reduce intensive care unit stay and ventilator days.
The purpose of the study is to determine if excessive fluid administration is associated with a prolonged hospital course and worse outcomes. ⋯ A protocol that encourages admission basal fluid rate of TKO or 30 mL/h in normotensive trauma patients is safe, reduces fluid intake, and may be associated with a shorter intensive care unit course and fewer ventilator days.
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Journal of critical care · Feb 2016
Observational StudyThe implementation of a nonpharmacologic protocol to prevent intensive care delirium.
The purpose was to determine if the implementation of an evidence-based nonpharmacologic protocol reduced the percentage of time patients spent delirious in a medical intensive care unit (MICU) that already uses a sedation and mobility protocol. ⋯ The implementation of a nonpharmacologic delirium prevention protocol resulted in a significant decrease in the percentage of time spent delirious in the MICU while reducing the risk of delirium development. Additional studies with more rigorous study designs need to be completed to further the research of nonpharmacologic interventions with appropriate sedation and mobility protocols.
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Journal of critical care · Feb 2016
The prognostic significance of troponin I elevation in acute ischemic stroke.
The significance of cardiac troponin I (TnI) levels in patients with acute ischemic stroke remains unclear. ⋯ Positive TnI greater than or equal to 0.5 μg/L in patients with acute ischemic stroke was independently associated with worse outcomes. Patients with diagnosis of MI represent a particularly high-risk subgroup.
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Journal of critical care · Feb 2016
Do cost savings from reductions in nosocomial infections justify additional costs of single-bed rooms in intensive care units? A simulation case study.
Evidence shows that single-patient rooms can play an important role in preventing cross-transmission and reducing nosocomial infections in intensive care units (ICUs). This case study investigated whether cost savings from reductions in nosocomial infections justify the additional construction and operation costs of single-bed rooms in ICUs. ⋯ This case study shows that although single-patient rooms are more costly to build and operate, they can result in substantial savings compared with open-bay rooms by avoiding costs associated with nosocomial infections.
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Severe sepsis continues to be a significant burden on society. ⋯ The incidence of severe sepsis continues to increase, whereas mortality decreases. However, one third of patients (those with ≥3 organ system failures) account for two thirds of the total number of deaths. More people are discharged home, whereas stable numbers go to facilities.