Journal of critical care
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Journal of critical care · Feb 2016
Criteria for initiation of invasive ventilation in septic shock: An international survey.
The objective of this study is to record intensivists' beliefs on indications and modalities of ventilatory support in critically ill patients with septic shock. ⋯ This survey highlights the general belief that invasive mechanical ventilation may worsen hemodynamic status in patients with septic shock. There was general agreement with the mandatory need to initiate mechanical ventilation in patients with respiratory failure and coma, but with little respect to hemodynamic criteria.
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Journal of critical care · Feb 2016
Multipronged strategy to reduce routine-priority blood testing in intensive care unit patients.
The purpose of the study is to reduce unnecessary ordering of routine-priority blood tests. ⋯ Sequential interventions to discourage the ordering of routine-priority blood tests in an ICU were associated with a significant decrease in the number of tests ordered.
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Journal of critical care · Feb 2016
Palliative and end-of-life educational practices in US pulmonary and critical care training programs.
To describe educational features in palliative and end-of-life care (PEOLC) in pulmonary/critical care fellowships and identify the features associated with perceptions of trainee competence in PEOLC. ⋯ This survey of PEOLC education in US pulmonary/critical care fellowships identified associations between certain program features and perceived trainee skill in PEOLC. These results generate hypotheses for further study.
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Journal of critical care · Feb 2016
Periarrest intestinal bacterial translocation and resuscitation outcome.
During the periarrest period, intestinal ischemia may result in barrier dysfunction and bacterial translocation, which has clear mechanistic links to inflammation and cascade stimulation, especially in patients who are treated with therapeutic hypothermia. Despite optimal management, periarrest bacterial translocation may worsen the outcome of cardiac arrest victims.
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Journal of critical care · Feb 2016
A modified technique for percutaneous dilatational tracheostomy: A retrospective review of 60 cases.
We describe a modified technique for percutaneous dilatational tracheostomy (PDT) using intermittent bronchoscopy and ultrasound (US). This method requires 1 single physician operator and no special airway adjuncts. Our aim is to reduce the complications associated with the current popular PDT technique, that is, accidental intraprocedural airway loss, intraprocedural bleeding, and hypoventilation associated with use of continuous bronchoscopy. ⋯ Our modified technique demonstrates a potential to reduce accidental intraprocedural airway loss and intraoperative bleeding associated with PDT while possibly improving gas exchange and saving procedural costs. This technique needs to be comparatively studied with current popular PDT technique in a prospective trial to firmly establish associated risks and benefits.