Journal of critical care
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Journal of critical care · Apr 2020
ReviewPrevention and early treatment of driveline infections in ventricular assist device patients - The DESTINE staging proposal and the first standard of care protocol.
Mechanical circulatory support (MCS) using left ventricular assist devices (LVAD) have considerably improved the quality of life and survival rate of patients with end-stage heart failure. Despite substantial technological progress, major challenges with regard to VAD-specific and VAD-related infections have hitherto hindered the broader application of this promising therapy approach. Driveline infections (DLI) range among the main adverse events experienced in LVAD patients. ⋯ An advanced wound staging approach was defined with recommended actions for prevention, early detection and stage-related management of DLI. Broad consensus was reached on the fact that an interdisciplinary approach both in DLES care and DLES healing disorder awareness is required to prolong infect-free survival times on MCS as well as to ensure high patient compliance and quality of life. In conclusion, a new detailed SOP for appropriate DLES care and an advanced wound staging approach for prevention and management of DLI were defined on an expert level applicable for VAD clinicians, practitioners and care givers in Central Europe.
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Journal of critical care · Apr 2020
Observational StudyA novel prediction equation of resting energy expenditure for Japanese septic patients.
Estimating nutrient consumption and administering appropriate nutritional therapy is essential for improving clinical outcomes in critically ill patients. Various equations, such as the Harris-Benedict equation, have been developed to estimate the required calories. Previous equations, however, targeted Westerners, whose physical characteristics are likely different from those of Asians. ⋯ The prediction error of our novel equations were smaller than those of other conventional equations. We further confirmed the accuracy of our equations and that they were unaffected by patient age and disease severity by using data obtained from another patient group. The current study suggested that these equations might allow accurate estimation of the total energy expenditure and proper management of nutritional therapy in Asian sepsis patients.
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Journal of critical care · Apr 2020
Automated screening of natural language in electronic health records for the diagnosis septic shock is feasible and outperforms an approach based on explicit administrative codes.
Identification of patients for epidemiologic research through administrative coding has important limitations. We investigated the feasibility of a search based on natural language processing (NLP) on the text sections of electronic health records for identification of patients with septic shock. ⋯ An automated search strategy based on a combination of explicit and implicit concept retrieval is feasible to screen electronic health records for septic shock and outperforms an administrative coding based explicit approach.
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Journal of critical care · Apr 2020
Corrigendum to "What do patients rate as most important when cared for in the ICU and how is this met? - An empowerment questionnaire survey" in Journal of Critical Care 40 (2017) 83-89.
This study aimed to explore what patients rate as being of the greatest importance and less important, when being cared for in the intensive care unit (ICU). The aim was also to examine the extent to which these topics are met. ⋯ The items Staff being positive to visitors, Receiving pain relief and Receive visits from next of kin, were the items most frequently c onsidered as "always met", while the items Have influence and Receive help to look forward were less often met. It was found that there is a potential for improvement in helping the ICU patients to maintain contact with reality, remind them about their importance to someone or something, and what they could look forward to when becoming healthier and returning to ordinary life.