Journal of critical care
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Journal of critical care · Oct 2017
Association between advanced practice nursing and 30-day mortality in mechanically ventilated critically ill patients: A retrospective cohort study.
Little is known about the association between advanced practice nursing and mortality. The aim of this study was to evaluate whether the presence of advanced practice nurses (APN), that is, certified nurse (CN) and certified nurse specialist (CNS) in intensive care, is associated with 30-day mortality for mechanically ventilated critically ill patients. ⋯ Our findings show that APNs may play an important role in improving patient outcome in the adult ICU.
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Journal of critical care · Oct 2017
Mechanical ventilation weaning protocol improves medical adherence and results.
Implementation of a weaning protocol is related to better patient prognosis. However, new approaches may take several years to become the standard of care in daily practice. We conducted a prospective cohort study to investigate the effectiveness of a multifaceted strategy to implement a protocol to wean patients from mechanical ventilation (MV) and to evaluate the weaning success rate as well as practitioner adherence to the protocol. ⋯ A multifaceted strategy consisting of continuing education and regular feedback can increase physician adherence to a weaning protocol for mechanical ventilation.
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Journal of critical care · Oct 2017
Hypoxic hepatitis - its biochemical profile, causes and risk factors of mortality in critically-ill patients: A cohort study of 565 patients.
A retrospective analysis of critically-ill patients with hypoxic hepatitis (HH) to characterize the biochemical profile and to identify predictors of mortality using the Medical Information Mart for Intensive Care III database. ⋯ Older age, higher SAPS-II, LDH, INR and bilirubin levels, concomitant AKI and the need for vasopressors were all factors associated with increased mortality. The diagnosis of HH was an important harbinger of mortality in this population, which appears to be driven mainly by the severity of the underlying conditions.
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Journal of critical care · Oct 2017
Assessment of mechanically ventilated patients intoxicated with organophosphates by a novel surface electromyographic index.
We present a new electromyographic index, named Engagement of Respiratory Muscle (ERM), for assessing the level of participation of respiratory muscles during spontaneous breathing test in patients poisoned with organophosphorus compound. ⋯ The ERM is a promising index to assess the level of participation of respiratory muscle on spontaneous breathing test in patients poisoned with organophosphorus compounds, which could improve the extubation prognosis for these patients.
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Journal of critical care · Oct 2017
Sequential enhanced cleaning eliminates multidrug-resistant organisms in general intensive care unit of a traditional Chinese medicine hospital.
Effective cleaning of surfaces within hospital wards is necessary to reduce pathogen transmission. We investigated the roles of sequential enhanced cleaning by culturing pathogens from high-touch surfaces in a general intensive care unit. ⋯ Adoption of fluorescent markers and adenosine triphosphate bioluminescence reduced environmental contamination. Use of 3 cleaning cloths for 1 patient zone was more effective compared with a single cloth.