Journal of critical care
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Journal of critical care · Apr 2017
Psychometric assessment of the Family Satisfaction in the Intensive Care Unit questionnaire in the United Kingdom.
To establish the psychometric properties of the Family Satisfaction in the Intensive Care Unit 24-item (FS-ICU-24) questionnaire in the United Kingdom. ⋯ The Family Satisfaction in the Intensive Care Unit 24-item questionnaire demonstrated good psychometric properties in the United Kingdom setting. Construct validity could be improved by use of 3 domains and some scope for further improvement was identified.
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Journal of critical care · Apr 2017
Cardiac troponin T is an important predictor of mortality after cardiac surgery.
Serum troponin (cTnT) levels, a commonly measured biomarker of myocardial injury, has rarely been considered in risk models after cardiac surgery. ⋯ We demonstrate that in patients without preoperative myocardial ischemia, the demonstration of myocardial injury (>0.6 ng/mL) in the postoperative period is highly predictive of in-hospital death.
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Journal of critical care · Apr 2017
Observational StudyPlasma adrenomedullin in critically ill patients with sepsis after major surgery: A pilot study.
Adrenomedullin is released by different tissues in hypoxia, oxidative stress, and inflammation and is found in general and medical patients and, recently, in sepsis patients in emergency departments. The aim of this study was to evaluate biologically active adrenomedullin that mirrors directly the active peptide levels in plasma of surgical intensive care unit (ICU) patients with sepsis. ⋯ This is the first study investigating adrenomedullin in patients with sepsis following major surgery. Higher adrenomedullin on admission is associated with increased vasopressor need and mortality after 90 days. Thus, adrenomedullin may be a useful additional parameter in surgical patients with sepsis.
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Journal of critical care · Apr 2017
Sepsis as 2 problems: Identifying sepsis at admission and predicting onset in the hospital using an electronic medical record-based acuity score.
Early identification and treatment improve outcomes for patients with sepsis. Current screening tools are limited. We present a new approach, recognizing that sepsis patients comprise 2 distinct and unequal populations: patients with sepsis present on admission (85%) and patients who develop sepsis in the hospital (15%) with mortality rates of 12% and 35%, respectively. ⋯ This approach yields good to excellent discriminatory performance among adult inpatients for predicting sepsis present on admission or developed within the hospital and may aid in the timely delivery of care.
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Journal of critical care · Apr 2017
A nursing perspective of interprofessional work in critical care: Findings from a secondary analysis.
This article presents a secondary analysis of nurse interviews from a 2-year comparative ethnographic study exploring cultures of collaboration across intensive care units (ICU). Critically ill patients rely on their interprofessional health care team to communicate and problem-solve quickly to give patients the best outcome available. Critical care nurses function at the hub of patient care giving them a distinct perspective of how interprofessional interactions impact collaborative practice. ⋯ Deliberative development of ICU nurses' interprofessional skills is essential if nursing is to move from primary coordinator to active collaborator in patient management.