Journal of critical care
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Journal of critical care · Oct 2019
Technology-mediated macrocognition: Investigating how physicians, nurses, and respiratory therapists make critical decisions.
Although intensive care clinicians are expected to make data-driven critical decisions using the technologies available to them, the effect of those technologies on decision-making are not well understood. Using the macrocognitive framework, we studied critical decision-making and technology use to understand how different specialists within teams make decisions and guide the development of decision-making support technologies. ⋯ This exploratory study provides much needed details about the different ways in which specialists use technologies to support decision-making tasks, particularly those involving sensemaking, which are essential to the design and development of decision-support technologies.
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Journal of critical care · Oct 2019
Adhering to the procalcitonin algorithm allows antibiotic therapy to be shortened in patients with ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) increases exposure to antibiotics. Physicians are however reluctant to shorten treatment, arguing this could lead to failures and worse outcome. Monitoring procalcitonin (PCT) has proven effective for decreasing exposure to antibiotics in randomized controlled trials, but additional "real-life" studies are needed. ⋯ PCT-guided ABT adherence appears safe for patients with VAP and is likely to reduce exposure to antibiotics.
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Journal of critical care · Oct 2019
Case ReportsAcute hyperammonemic encephalopathy due to a portosystemic shunt in a non-cirrhotic adult patient.
To report a successfully treated hyperammonemia due to a portosystemic shunt in adult patient. ⋯ Hyperammonemia is not always related to liver failure in critically ill patients, but should be considered in all unknown origins of an altered mental status. A portosystemic shunt can be the responsible for this phenomenon, and it has a newly treatment technique named plug-assisted retrograde transvenous obliteration (PARTO), which can be quickly performed with high technical success rate and clinical efficacy for the treatment of the splenorenal and/or gastrorenal shunt.
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Journal of critical care · Oct 2019
Sleep quality and daytime sleepiness among Polish anaesthesiologists and intensivists.
We aimed to investigate sleep quality (SQ), daytime sleepiness (DS), and their relation with subject- and work-related factors among Polish anaesthesiologists. ⋯ Poor SQ and excessive DS are frequently occurring phenomena. Since sleep disturbances are also related to the nature of their profession, the problem could be reduced by introducing organisational changes at work.
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Journal of critical care · Oct 2019
Observational StudyEffects of short-term hyperoxia on sytemic hemodynamics, oxygen transport, and microcirculation: An observational study in patients with septic shock and healthy volunteers.
To characterize the microvascular effects of a brief period of hyperoxia, in patients with septic shock and in healthy volunteers. ⋯ Short-term hyperoxia induced systemic cardiovascular changes but was not associated with noticeable derangement in sublingual microcirculation and skin perfusion. Nevertheless, longer exposures to hyperoxia might have produced different results.