Journal of critical care
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Journal of critical care · Jun 2019
ReviewSelecting and evaluating decision-making strategies in the intensive care unit: A systematic review.
Many patients in the Intensive Care Unit (ICU) die after a decision to withhold or withdraw treatment. To ensure that for each patient the appropriate decision is taken, a careful decision-making process is required. This review identifies strategies that can be used to optimize the decision-making process for continuing versus limiting life sustaining treatment of ICU patients. ⋯ The decision-making process in the ICU can be enhanced by frequent family-meetings with predefined topics. Ethical and palliative support is useful in specific situations. These interventions can reduce non-beneficial ICU treatment days.
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Journal of critical care · Jun 2019
Acute kidney injury following contrast media administration in the septic patient: A retrospective propensity-matched analysis.
To determine the risk for acute kidney injury (AKI) attributable to intravenous contrast media (CM) administration in septic patients. ⋯ Sepsis is a medical emergency proven to benefit from early diagnosis and rapid initiation of treatment, which is often aided by CECT. Our findings argue against withholding CM for fear of precipitating AKI in potentially septic patients.
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Journal of critical care · Jun 2019
Implementation of a structured communication tool improves family satisfaction and expectations in the intensive care unit.
Intensive care unit (ICU) physicians should provide relatives of critically ill patients with appropriate and clear information, regarding prognosis, treatment options and expectations. ⋯ A structured communication tool was associated with improved family satisfaction with communication and expectations regarding hospital survival. Further research is required to evaluate this promising intervention.