Journal of critical care
-
Journal of critical care · Apr 2018
Intensive care unit drug costs in the context of total hospital drug expenditures with suggestions for targeted cost containment efforts.
To assess costs of intensive care unit (ICU) related pharmacotherapy relative to hospital drug expenditures, and to identify potential targets for cost-effectiveness investigations. We offer the unique advantage of comparing ICU drug costs with previously published data a decade earlier to describe changes over time. ⋯ Growth rates of costs per year have declined but still drug expenditures in the ICU are consistently a significant driver in this resource intensive environment with a high impact on hospital drug expenditures.
-
Journal of critical care · Apr 2018
Apnea testing using the oxygen insufflation method for diagnosis of brain death may compromise pulmonary function.
The aim of our study was to compare the reliability and safety of the classical I-AT with the continuous positive airway pressure apnea test (CPAP-AT). ⋯ Our study indicates that I-AT may compromise pulmonary function and this may support the recommendation of safer CPAP-AT alternative.
-
Journal of critical care · Apr 2018
Incidence, outcomes and outcome prediction of unplanned extubation in critically ill children: An 11year experience.
Unplanned extubation represents loss of control in the ICU, is associated with harm and is used as a measure of quality of care. We evaluated the rates and consequences of unplanned extubation. ⋯ Unplanned extubation was associated with both significant and no morbidity. Modification of factors including more consistent nurse staffing, restraint use, and increased vigilance in patients with previous events may potentially reduce rates and adverse consequences of unplanned extubation.
-
Journal of critical care · Apr 2018
Observational StudyWhich one is a better predictor of ICU mortality in septic patients? Comparison between serial serum lactate concentrations and its removal rate.
To predict 28-day mortality with serum lactate and oxygenation profile in sepsis. ⋯ Serial measurements of serum lactate with special emphasis on its concentration at 24hour after admission remains the most predictive of short-term mortality in the ICU. Other predictors of mortality are relatively inferior and must be used collectively in context to better predict the clinical outcome of sepsis.
-
Journal of critical care · Apr 2018
Observational StudyExposure keratopathy: Incidence, risk factors and impact of protocolised care on exposure keratopathy in critically ill adults.
We aimed to determine the rate of exposure keratopathy (EK) in critically ill patients, identify risk factors for developing EK and ascertain the effectiveness of a protocol to prevent EK. ⋯ EK is common in critically ill patients and a simple protocol substantially reduces the incidence of EK and is easily achieved in clinical practice.