Journal of critical care
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Journal of critical care · Apr 2017
Effectiveness of 7.5% hypertonic saline in children with severe traumatic brain injury.
Hyperosmolar therapies aim at controlling increased intracranial pressure (ICP) in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the effect of 7.5% hypertonic saline (HTS) on ICP and cerebral perfusion pressure (CPP) in children with severe TBI. ⋯ In our study, 7.5% HTS infusion as a second-tier osmotic therapy was associated with significant reduction of ICP and increase of CPP in children with severe TBI.
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Journal of critical care · Apr 2017
Development and validation of the new ICNARC model for prediction of acute hospital mortality in adult critical care.
To develop and validate an improved risk model to predict acute hospital mortality for admissions to adult critical care units in the UK. ⋯ The risk model developed in this study showed excellent discrimination and calibration and when validated on a different period of time and across different types of critical care unit. This in turn allows improved accuracy of comparisons between UK critical care providers.
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Journal of critical care · Apr 2017
Noninvasive ventilation during acute respiratory distress syndrome in patients with cancer: Trends in use and outcome.
The objectives of our study were to describe the outcome of patients with malignancies treated for acute respiratory distress syndrome (ARDS) with noninvasive ventilation (NIV) and to evaluate factors associated with NIV failure. ⋯ Noninvasive ventilation failure in ARDS patients with malignancies is frequent and related to ARDS severity, SOFA score, and pulmonary infection-related ARDS. Noninvasive ventilation failure is associated with in-hospital mortality.
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Journal of critical care · Apr 2017
Clinical utility of methicillin-resistant Staphylococcus aureus nasal polymerase chain reaction assay in critically ill patients with nosocomial pneumonia.
This study investigated the diagnostic performance characteristics of a methicillin-resistant Staphylococcus aureus (MRSA) nasal polymerase chain reaction (PCR) assay in critically ill patients with nosocomial pneumonia. ⋯ In critically ill patients, an MRSA nasal PCR assay has a high NPV for nosocomial pneumonia and can be used to guide vancomycin de-escalation.
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Journal of critical care · Apr 2017
Opportunities for interprofessional input into nurse and physician hand-off communication.
Hand-offs are vulnerable times for hospitalized patients. Nurses and physicians routinely engage in hand-off communication but their communications remains siloed. Our objectives were to identify key information from each profession that would be of use to the other's hand-off process, and to identify facilitators and barriers to obtaining that input. ⋯ There are key areas of content that both physicians and nurses would like from the other profession to enhance intensive care unit hand-off communication. Interventions designed to increase interdisciplinary communication should focus on these key areas of content.