Journal of critical care
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Journal of critical care · Feb 2021
Meta AnalysisAutomated weaning from mechanical ventilation: Results of a Bayesian network meta-analysis.
Mechanical ventilation (MV) weaning is a crucial step. Automated weaning modes reduce MV duration but the question of the best automated mode remains unanswered. Our objective was to compare the major automated modes for MV weaning in critically ill and post-operative adult patients. ⋯ Compared to standard weaning practice, all automated modes significantly reduced the duration of MV weaning in critically ill and post-operative adult patients. When cross-compared using a network meta-analysis, no specific mode was different in reducing the duration of MV weaning. The study was registered in PROSPERO (CRD42015024742).
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Journal of critical care · Feb 2021
The use and usefulness of ICU diaries to support family members of critically ill patients.
To analyze and describe the use and usefulness of the ICU diary to support family members of critically ill patients. ⋯ The ICU diary is useful to family members as a stress reduction, information management, and communication tool. The design of ICU diary implementations must address system factors to assure family members receive benefits from diary use. Further research is needed to expand our understanding of the optimal structure, process, and content of ICU diary implementations.
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Journal of critical care · Feb 2021
EditorialOn predictions in critical care: The individual prognostication fallacy in elderly patients.
Predicting the future course of critical conditions involves personal experience, heuristics and statistical models. Although these methods may perform well for some cases and population averages, they suffer from substantial shortcomings when applied to individual patients. ⋯ This notably applies to triage situations in response to a lack of healthcare resources. We will discuss these issues and argue that analysing longitudinal data obtained from time-limited trials in intensive care can provide a more robust approach to individual prognostication.
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Journal of critical care · Feb 2021
ReviewA mixed methods study to effectively utilize trigger tools in the ICU.
This study aimed to create a trigger tool for our intensive care units (ICUs) to support our departmental quality improvement efforts. ⋯ We used the modified Delphi process to derive consensus-selected triggers to identify ICU specific adverse events with opportunity for improvement in local care. This methodology can be adopted by other centers looking to introduce trigger tools in a manner selective to their practice needs.
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To document the equipment, resource and bed capacity of Intensive Care Units (ICUs) in the Republic of Ghana. ⋯ Ghana has a significant shortage of critical care beds that are inequitably distributed across the country and a shortfall of intensivists to staff ICUs. A holistic approach that focuses on the key bottlenecks to quality improvement would be required to improve the capacity and quality of critical care delivery.