Journal of critical care
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Journal of critical care · Oct 2017
Treatment outcomes after implementation of an adapted WHO protocol for severe sepsis and septic shock in Haiti.
The World Health Organization (WHO) has developed a simplified algorithm specific to resource-limited settings for the treatment of severe sepsis emphasizing early fluids and antibiotics. However, this protocol's clinical effectiveness is unknown. We describe patient outcomes before and after implementation of an adapted WHO severe sepsis protocol at a community hospital in Haiti. ⋯ Use of a simplified sepsis protocol based primarily on physiologic parameters allows for substantial improvements in process measures in the care of severely septic patients in a resource-constrained setting.
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Journal of critical care · Oct 2017
Observational StudyLow brain tissue oxygenation contributes to the development of delirium in critically ill patients: A prospective observational study.
To test the hypothesis that poor brain tissue oxygenation (BtO2) during the first 24h of critical illness correlates with the proportion of time spent delirious. We also sought to define the physiological determinants of BtO2. ⋯ Poor cerebral oxygenation during the first 24 hours of critical illness contributes to the development of delirium.
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Journal of critical care · Oct 2017
Concurrent intravenous drug administration to critically ill children: Evaluation of frequency and compatibility.
To evaluate the frequency of concurrent drug administration and drug-drug incompatibility of concurrently administered drugs in critically ill children based on available references. ⋯ Concurrent IV-drug administration is frequent in critically ill children. Known incompatible concurrent administration occurs, however the compatibilities of many drug-drug pairs were unknown - adding complexity to routine bedside management and identifying information gaps for future research.
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Journal of critical care · Oct 2017
Effect of high-dose furosemide on the prognosis of critically ill patients.
Diuretics are used frequently in critically ill patients. We investigated the effects of furosemide on the prognosis. ⋯ Early high-dose furosemide use is associated with ICU mortality, particularly in non-oliguric patients. We suggest that furosemide should be used with caution even in non-oliguric critically ill patients until the safety is confirmed in powered study.
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Journal of critical care · Oct 2017
A comparison of pre ICU admission SIRS, EWS and q SOFA scores for predicting mortality and length of stay in ICU.
The 2015 sepsis definitions suggest using the quick SOFA score for risk stratification of sepsis patients among other changes in sepsis definition. Our aim was to validate the q sofa score for diagnosing sepsis and comparing it to traditional scores of pre ICU admission sepsis outcome prediction such as EWS and SIRS in our setting in order to predict mortality and length of stay. ⋯ In conclusion, we find that in our setting, EWS is better than SIRS and q SOFA for predicting mortality and perhaps length of stay as well. The q Sofa score remains validated for diagnosis of sepsis.