Journal of critical care
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Journal of critical care · Apr 2019
Non-clinical delays in transfer out of the surgical ICU are associated with increased hospital length of stay and delayed progress of care.
The impact of non-clinical transfer delay (TD) from the ICU to a general care unit on the progress of the patient's care is unknown. We measured the association between TD and: (1) the patient's subsequent hospital length of stay (LOS); (2) the timing of care decisions that would advance patient care. ⋯ TD is associated with longer LOS and delays in milestone clinical decisions that progress care. Eliminating delays in milestones could mitigate TD's impact on LOS.
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Journal of critical care · Apr 2019
Airway pressure release ventilation does not increase intracranial pressure in patients with traumatic brain injury with poor lung compliance.
The use of Airway Pressure Release Ventilation (APRV) in patients with traumatic brain injury (TBI) remains controversial. Some believe that elevated mean airway pressures transmitted to the thorax may cause clinically significant increases in Central Venous Pressure (CVP) and intracranial pressure (ICP) from venous congestion. We perform a retrospective review from 2009 to 2015 of traumatically injured patients who were transitioned from traditional ventilator modes to APRV and also had an ICP monitor in place. ⋯ Individually, only 4 patients had ICP values >20 in the first hour after transitioning to APRV and the rate of ICP elevations was similar between the two modes of ventilation. These data show that APRV is a viable mode of ventilation in patients with TBI who have low lung compliance. The increased CVP of this mode of ventilation did not affect ICP or hemodynamic parameters.
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To evaluate the characteristics and practice of predatory journals in critical care medicine (CCM). ⋯ We found a relevant number of probable predatory CCM journals. Scientists should carefully check journal's characteristics to avoid selecting predatory journals as editorial target.
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Journal of critical care · Apr 2019
Review Meta AnalysisEffects of antiplatelet therapy on the mortality rate of patients with sepsis: A meta-analysis.
Abnormal platelet activation plays an important role in the development of sepsis. The effect of antiplatelet drugs on the outcome of patients with sepsis remains unclear. This meta-analysis aimed to determine the effect of antiplatelet drugs on the prognosis of patients with sepsis. ⋯ Antiplatelet drugs, particularly aspirin, could be used to effectively reduce mortality in patients with sepsis.