Journal of critical care
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With advances in critical care and organ donation, diagnosis of brain death is gaining importance. We aimed to assess potential brain death confounders from the literature, elucidating clinical presentation and diagnostic approaches in these cases. ⋯ Brain death confounders are infrequently reported and formal studies are lacking. Mainly younger patients with polyneuritis and intoxications are described. As outcome, especially in the latter, is often favourable, high awareness and strict adherence to guidelines is crucial. The importance of identifying pathologies compatible with extensive and irreversible brain damage before proceeding to diagnostic tests should be emphasized.
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Journal of critical care · Oct 2019
Multicenter Study Comparative StudyComparative validation of three screening instruments for posttraumatic stress disorder after intensive care.
Aim of the present study was to compare the validity of three screening instruments to assess symptoms of posttraumatic stress disorder (PTSD) after intensive care of sepsis. ⋯ Compared to PTSS-10 and PCL-5, PTSS-14 appeared more appropriate for post-ICU PTSD screening when validated against a DSM-5 diagnostic interview.
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Journal of critical care · Oct 2019
Randomized Controlled TrialLong term follow-up of quality of life and functional ability in patients with ICU acquired Weakness - A post hoc analysis.
ICU acquired Weakness (ICUaW) is a common complication of critical illness. The aim of our study was the assessment of quality of life (QoL) and functional ability of patients with ICUaW, 6 months post hospital discharge. ⋯ ICUaW is associated with persistent deficiencies in functional ability and Qol leading to a prolonged period of recovery. Further research is needed in the field of prevention and targeted rehabilitation of functionality in this patient group.
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Journal of critical care · Oct 2019
Multicenter StudyQuality of life assessment following amputation for septic shock: a long-term descriptive survey after symmetric peripheral gangrene.
To assess health-related quality of life (HRQOL) following rehabilitation of amputees suffering symmetric peripheral gangrene (SPG) after septic shock. ⋯ ICU survivors referred to rehabilitation centers after SPG-related amputations had impaired HRQOL. At the time of HRQOL assessment, they considered themselves in good health and preferred to be treated again despite disability. Appraisal of long-term functional outcome should not be used to guide end-of-life decision-making in this situation.
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Journal of critical care · Oct 2019
Observational StudyWhat determines do-not-resuscitate status in critically ill HIV-infected patients admitted to ICU?
To identify factors associated with do-not-resuscitate (DNR) status in critically ill patients infected with human immunodeficiency virus (HIV) admitted to the Intensive Care Unit (ICU) in the era of combination antiretroviral therapy (cART). ⋯ One in four patients had a DNR designation. Illness acuity, selected comorbidity, previous opportunistic infection and HIV duration were associated with DNR designation.