Journal of critical care
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Journal of critical care · Dec 2020
Case ReportsReflux events detected by multichannel bioimpedance smart feeding tube during high flow nasal cannula oxygen therapy and enteral feeding: First case report.
The use of high flow nasal cannula (HFNC) oxygen therapy is common in patients with respiratory distress to prevent intubation or ensure successful extubation. However, these critical patients also need medical nutritional support and practitioners are often reluctant to prescribe oral or enteral feeding, leading to a decrease in energy and protein intake. ⋯ A new technology detecting the presence and duration of gastro-esophageal reflux and preventing aspiration in real-time has been developed and our case shows how HFNC oxygen therapy exposes patients to significantly more reflux events as compared to mechanical ventilation. This is the first description of this technique observed in critical care.
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Journal of critical care · Dec 2020
ReviewNational registries: Lessons learnt from quality improvement initiatives in intensive care.
National clinical quality registries (CQRs) are effective tools for improving the outcomes of patients admitted to the intensive care unit (ICU), and are increasingly important as healthcare needs evolve. A high-quality ICU CQR is built from a foundation of common requirements and challenges. First, performance indicators of the structure, process, or outcomes of patient care should measure what is important. ⋯ Sixth, ICU CQRs must be dynamic to meet the needs of an evolving healthcare system and stakeholders. Finally, these lessons are far from comprehensive. Sharing perspectives on the development of ICU CQRs can help maximise their value as a powerful platform for informing policy development and improving the outcomes of patients admitted to the ICU.
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Journal of critical care · Dec 2020
Initial inflammatory response is an independent predictor of unfavorable outcome in patients with good-grade aneurysmal subarachnoid hemorrhage.
Purpose of the present study was to determine if routine biochemical markers of acute phase response are associated with unfavorable outcome in patients with good-grade aneurysmal SAH. ⋯ An initial inflammatory response could be a possible explanation for poor outcome in good-grade SAH patients. These findings might help to identify a subgroup of good grade SAH patients who are at greater risk for unfavorable outcome early during treatment course/at baseline, and who could benefit most from potential anti-inflammatory therapy.
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Journal of critical care · Dec 2020
Association of triage hypothermia with in-hospital mortality among patients in the emergency department with suspected sepsis.
To identify if triage hypothermia (<36.0 °C) among emergency department (ED) encounters with sepsis are independently associated with mortality. ⋯ Up to one in three patients with sepsis have triage hypothermia, which is independently associated with mortality. 10-20% of patients with hypothermic sepsis do not have other vital sign abnormalities.