Journal of critical care
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Journal of critical care · Dec 2019
A pilot study evaluating a simple cardiac dysfunction score to predict complications and survival among critically-ill patients with traumatic brain injury.
To describe the frequency of cardiovascular complications and cardiac dysfunction in critically-ill patients with moderate-severe traumatic brain injury (msTBI) and cardiac factors associated with in-hospital survival. ⋯ Cardiac dysfunction was common in patients with msTBI and independently associated with more severe brain injury and a reduction in hospital survival in this population. Further research is needed to validate the CDI and create more precise scoring tools.
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Journal of critical care · Dec 2019
Observational StudyHemorrhagic complications during extracorporeal membrane oxygenation - The role of anticoagulation and platelets.
Hemorrhagic complications during extracorporeal membrane oxygenation are frequent and have a negative impact on outcome. We studied the association between activated partial thromboplastin time or platelet count and the occurrence of hemorrhagic complications. The secondary objective was to determine risk factors for hemorrhagic complications. ⋯ Higher activated partial thromboplastin time is associated with the occurrence of hemorrhagic complications.
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Journal of critical care · Dec 2019
Comparative Study Observational StudyComparison of the sepsis-2 and sepsis-3 definitions in severely injured trauma patients.
To evaluate the performance of the new SOFA-based sepsis definition in trauma patients. ⋯ The sepsis-3 definition identifies much fewer patients and is more strongly associated with adverse outcomes than the sepsis-2 definition. The sepsis-3 definition seems to be useful in the post trauma setting.
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Journal of critical care · Dec 2019
Multicenter StudyCommunication with patients' families in the intensive care unit: A point prevalence study.
We aimed to describe point of care communication encounters with patients' families in centers with open visitation practices. ⋯ ICUs adopt multiple ways of communicating with family members of critically ill patients. Significant interactions occur outside of traditional family meetings, in a less formal and more frequent fashion. Our study supports development of tools to support best practices within contemporary communication paradigms to support provider, patients and family needs.
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Journal of critical care · Dec 2019
ReviewP-values and significance: The null hypothesis that they are not related is correct.
False signals and therapeutic optimism have led medicine down many a wrong pathway. Apart from the unnecessary costs of care and redundant research expenditure and efforts this has caused, therapies which were eventually discontinued may have come at a staggering cost of lives lost. Still most statistical information in the medical literature is presented with its p-values and little else. ⋯ Data that should always be presented in conjunction with the p-value are the Confidence Intervals, which illustrate the uncertainty inherent to the results, and the Fragility Index, which reflects result robustness. Multiple RCTs should be the standard for implementing change. Ideally these studies should consistently demonstrate p-values <0.005, study and control groups with well separated 95% CIs and high fragility indices.