Journal of critical care
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Journal of critical care · Oct 2019
Adhering to the procalcitonin algorithm allows antibiotic therapy to be shortened in patients with ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) increases exposure to antibiotics. Physicians are however reluctant to shorten treatment, arguing this could lead to failures and worse outcome. Monitoring procalcitonin (PCT) has proven effective for decreasing exposure to antibiotics in randomized controlled trials, but additional "real-life" studies are needed. ⋯ PCT-guided ABT adherence appears safe for patients with VAP and is likely to reduce exposure to antibiotics.
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Journal of critical care · Oct 2019
Case ReportsAcute hyperammonemic encephalopathy due to a portosystemic shunt in a non-cirrhotic adult patient.
To report a successfully treated hyperammonemia due to a portosystemic shunt in adult patient. ⋯ Hyperammonemia is not always related to liver failure in critically ill patients, but should be considered in all unknown origins of an altered mental status. A portosystemic shunt can be the responsible for this phenomenon, and it has a newly treatment technique named plug-assisted retrograde transvenous obliteration (PARTO), which can be quickly performed with high technical success rate and clinical efficacy for the treatment of the splenorenal and/or gastrorenal shunt.
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Journal of critical care · Oct 2019
Sleep quality and daytime sleepiness among Polish anaesthesiologists and intensivists.
We aimed to investigate sleep quality (SQ), daytime sleepiness (DS), and their relation with subject- and work-related factors among Polish anaesthesiologists. ⋯ Poor SQ and excessive DS are frequently occurring phenomena. Since sleep disturbances are also related to the nature of their profession, the problem could be reduced by introducing organisational changes at work.
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Journal of critical care · Oct 2019
Observational StudyMoral distress in intensive care unit personnel is not consistently associated with adverse medication events and other adverse events.
To examine the association between moral distress in ICU personnel, and medication errors and adverse events, and other adverse events. ⋯ Moral distress in ICU personnel is generally not associated with medication errors or adverse events, or other adverse events, but it may be associated with both hyper-vigilance and distraction.
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Journal of critical care · Oct 2019
Multicenter Study Observational StudyWould you like to be admitted to the ICU? The preferences of intensivists and general public according to different outcomes.
Intensivists hold different views on their own thresholds for intensive care admission versus those they hold for patients.
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