Journal of critical care
-
Journal of critical care · Feb 2018
Factors associated with in-hospital mortality among critically ill surgical patients with multidrug-resistant Gram-negative infections.
Multidrug-resistant (MDR) Gram-negative infection increases risk of mortality, other complications, and costs. The objective of this study was to determine the prevalence of and identify factors associated with in-hospital mortality among critically ill surgical patients. ⋯ MDR Gram-negative infection is associated with significant in-hospital mortality among critically ill surgical patients. Source control, along with prior ICU LOS, mechanical ventilation status, vasopressor use, and definitive antibiotic choice, are important predictors of survival in this population.
-
Journal of critical care · Feb 2018
Effects of staff training and electronic event monitoring on long-term adherence to lung-protective ventilation recommendations.
To investigate long-term effects of staff training and electronic clinical decision support (CDS) on adherence to lung-protective ventilation recommendations. ⋯ Staff training effectively improves adherence to lung-protective ventilation strategies. The observed CDS effect seemed less pronounced, although it can easily be adapted to new recommendations. Both interventions, which futures studies could deploy in combination, promise to improve the precision of mechanical ventilation.
-
Journal of critical care · Feb 2018
Elevated modified shock index in early sepsis is associated with myocardial dysfunction and mortality.
The aim of this study was to explore the association of an elevated modified shock index (MSI) in sepsis and myocardial dysfunction. ⋯ Elevated modified shock index during early sepsis is associated with the development of myocardial dysfunction and depression, SOFA score and mortality.
-
Journal of critical care · Feb 2018
Delirium characteristics and outcomes in medical and surgical lnpatients: A subgroup analysis.
Persistent delirium can negatively affect patients, increase healthcare costs, and extend the length of hospital stays. This investigation was undertaken to explore associations between patient characteristics and delirium outcomes. ⋯ The findings that patient type and timing of postoperative delirium are associated with differential delirium outcomes suggest that targeted screening and intervention approaches may be needed. Medical patients were more likely to be discharged before recovery from delirium compared with surgical patients. Differences in underlying chronic medical conditions may account for the observed differences in discharge condition between medical and surgical patients with delirium.
-
Journal of critical care · Feb 2018
The impact of a daily "medication time out" in the Intensive Care Unit.
Medical errors play a large role in preventable harms within our health care system. Medications administered in the ICU can be numerous, complex and subject to daily changes. We describe a method to identify medication errors with the potential to improve patient safety. ⋯ A daily medication time out should be considered as an additional mechanism for patient safety in the ICU.