Journal of critical care
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Journal of critical care · Apr 2017
Observational StudyAssociation between ventilatory settings and development of acute respiratory distress syndrome in mechanically ventilated patients due to brain injury.
In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury. ⋯ In a cohort of brain-injured patients the development of ARDS was not common. Driving pressure was associated with the development of this disease.
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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
Observational StudyEffect of daily use of electronic checklist on physical rehabilitation consultations in critically ill patients.
In intensive care unit (ICU) practice, great emphasis is placed on the functional stabilization of the major organ systems, sometimes at the expense of physical rehabilitation. Checklists have shown to be an effective tool for standardizing care models. Our aim was to the study the effect of the use of an electronic checklist on occupational therapy/physical therapy (OT-PT) consults in critically ill patients. ⋯ The use of the electronic checklist in the ICU was associated with increased number of the OT-PT consults.
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Journal of critical care · Apr 2017
Predictors of clinicians' underuse of daily sedation interruption and sedation scales.
The purpose of the study is to identify predictors of underuse of sedation scales and daily sedation interruption (DSI). ⋯ Workload considerations hamper utilization of sedation scales. Poor familiarity, for nurses, and negative perception of impact on patients' comfort, for physicians, both reduce DSI utilization. Targeting these obstacles is essential while designing quality improvement strategies to minimize sedative use.