Journal of critical care
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Journal of critical care · Oct 2020
Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey.
To survey healthcare workers (HCW) on availability and use of personal protective equipment (PPE) caring for COVID-19 patients in the intensive care unit (ICU). ⋯ HCWs reported widespread shortages, frequent reuse of, and adverse effects related to PPE. Urgent action by healthcare administrators, policymakers, governments and industry is warranted.
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Journal of critical care · Oct 2020
ReviewConflicts of interest in the context of end of life care for potential organ donors in Australia.
End-of-life (EOL) care has become an integral part of intensive care medicine and includes the exploration of possibilities for deceased organ and tissue donation. Donation physicians are specialist doctors with expertise in EOL processes encompassing organ and tissue donation, who contribute significantly to improvements in organ and tissue donation services in many countries around the world. ⋯ These obligations are complementary and provide a unique skillset to care for dying patients and their families in the ICU. In this paper we review current controversies around EOL care in the ICU, including the use of palliative analgesia and sedation specifically with regards to withdrawal of cardiorespiratory support, the usefulness of the so-called doctrine of double effect to guide ethical decision-making, and the management of potential or perceived conflicts of interest in the context of dual professional roles.
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Journal of critical care · Oct 2020
Clinical TrialEffects of pleural effusion drainage in the mechanically ventilated patient as monitored by electrical impedance tomography and end-expiratory lung volume: A pilot study.
In patients with pleural effusion (PLE) monitored by Electrical Impedance Tomography (EIT) an increase in end-expiratory lung impedance (EELI) is observed following evacuation of the PLE. We aimed at differentiating the effect of fluid removal from lung reaeration and describe the change in ventilation distribution. ⋯ The increase in EELI in the EIT image after PLE removal was primarily due to the removal of the conductive effusion fluid.
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Journal of critical care · Oct 2020
Diagnostic accuracy of arterial and venous renal Doppler assessment for acute kidney injury in critically ill patients: A prospective study.
Renal Resistive Index (RRI) and Venous Impedance Index (VII) might be of additional value for diagnosing Acute Kidney Injury (AKI). The purpose of this study was to assess the diagnostic accuracy of RRI and VII for AKI. ⋯ In acutely admitted critically ill patients, measures of renal perfusion by renal ultrasound were not different between patients with and without AKI, and show limited diagnostic accuracy for AKI. Registered:NCT03577405.
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Journal of critical care · Oct 2020
Randomized Controlled TrialEffect of in-bed cycling on acute muscle wasting in critically ill adults: A randomised clinical trial.
To examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a period of critical illness. ⋯ In-bed cycling did not reduce muscle wasting in critically ill adults, but this study provides useful effect estimates for large-scale clinical trials.