Journal of critical care
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Journal of critical care · Aug 2017
Comparative StudyTime delays associated with vasoactive medication preparation and delivery in simulated patients at risk of cardiac arrest.
To compare, quantify, and describe the time-delays associated with four common methods of adrenaline administration in the simulated setting of impending cardiac arrest. ⋯ We highlight potentially dangerous delays with administration of life-saving medications by all four methods. We should prioritize boluses, and focus on improving drug preparation times and human performance, more than drug delivery and equipment.
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Journal of critical care · Aug 2017
Managing sepsis: Electronic recognition, rapid response teams, and standardized care save lives.
Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. ⋯ A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.
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Journal of critical care · Aug 2017
Clinical TrialVentilation distribution and lung recruitment with speaking valve use in tracheostomised patient weaning from mechanical ventilation in intensive care.
Speaking valves (SV) are used infrequently in tracheostomised ICU patients due to concerns regarding their putative effect on lung recruitment. A recent study in cardio-thoracic population demonstrated increased end-expiratory lung volumes during and post SV use without examining if the increase in end-expiratory lung impedance (EELI) resulted in alveolar recruitment or potential hyperinflation in discrete loci. ⋯ These findings indicate that hyperinflation did not occur with SV use, which is supported by previously published data on respiratory parameters. These data along with obvious psychological benefits to patients are encouraging towards safe use of SVs in this critically ill cardio-thoracic patient population.
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Journal of critical care · Aug 2017
Laboratory and clinical predictors of 30-day survival for patients on Extracorporeal Membrane Oxygenation (ECMO): 8-Year experience at Albert Einstein College of Medicine, Montefiore Medical Center.
Survival of patients on ECMO has remained stable in every population. Laboratory values predictors of survival are required to improve patient care. ⋯ Laboratory markers identified herein may guide the management of patients on ECMO.