Journal of critical care
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Journal of critical care · Apr 2020
Multicenter StudyAssociation between organizational characteristics and adequate pain management at the intensive care unit.
Half of the patients experience pain during their ICU stay which is known to influence their outcomes. Nurses and physicians encounter organizational barriers towards pain assessment and treatment. We aimed to evaluate the association between adequate pain management and nurse to patient ratio, bed occupancy rate, and fulltime presence of an intensivist. ⋯ Higher nurse to patient ratios increase the percentage of patients with adequate pain management especially in medical and mechanically ventilated patients.
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Journal of critical care · Apr 2020
Heterogeneous effect of increasing spinal cord perfusion pressure on sensory evoked potentials recorded from acutely injured human spinal cord.
To investigate the effect of increasing spinal cord perfusion pressure (SCPP) on sensory evoked potentials (SEPs) and injury site metabolism in patients with severe traumatic spinal cord injury TSCI. ⋯ Increasing SCPP after acute, severe TSCI may be beneficial (if associated with increase in SEP amplitude) or detrimental (if associated with decrease in SEP amplitude). Our findings support individualized management of patients with acute, severe TSCI guided by monitoring from the injury site rather than applying universal blood pressure targets as is current clinical practice.
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Journal of critical care · Apr 2020
Bedside dynamic calculation of mechanical power: A validation study.
To develop an equation to calculate the bedside dynamic mechanical power (MPdyn) for modern ventilators using the Work of Breathing ventilator (WOBv) parameter. ⋯ Physicians can easily calculate mechanical power by using MPdyn at the bedside of patients on volume control mode.