Journal of critical care
-
Journal of critical care · Oct 2019
Observational StudyMoral distress in intensive care unit personnel is not consistently associated with adverse medication events and other adverse events.
To examine the association between moral distress in ICU personnel, and medication errors and adverse events, and other adverse events. ⋯ Moral distress in ICU personnel is generally not associated with medication errors or adverse events, or other adverse events, but it may be associated with both hyper-vigilance and distraction.
-
Journal of critical care · Oct 2019
Randomized Controlled Trial Multicenter Study Comparative StudyAnalgesia-first sedation in critically ill adults: A U.S. pilot, randomized controlled trial.
To determine the feasibility of conducting a multicenter ICU RCT of AFS compared to either protocol-directed sedation (PDS) or both PDS and daily sedation interruption (DSI) in North America. ⋯ A multicenter RCT evaluating AFS is feasible to conduct in North America.
-
Journal of critical care · Oct 2019
Randomized Controlled TrialIncreasing support by nasal high flow acutely modifies the ROX index in hypoxemic patients: A physiologic study.
The ROX (Respiratory rate-OXygenation) index is an early predictor of failure of nasal high flow (NHF), with lower values indicating higher risk of intubation. We measured the ROX index at set flow rate of 30 and 60 l/min in 57 hypoxemic patients on NHF. ⋯ The ROX index variation between flows was correlated with the change in end expiratory lung volume. Set flow rate during NHF might impact the ROX index value.
-
Journal of critical care · Oct 2019
Multicenter StudyCurrent practice and perceptions regarding pain, agitation and delirium management in patients receiving venovenous extracorporeal membrane oxygenation.
To characterize monitoring of pain, agitation, and delirium; investigate opioid and sedative choices; and describe prevention and treatment of delirium in adults receiving venovenous extracorporeal membrane oxygenation (vv-ECMO) for respiratory failure. ⋯ Most respondents use validated scales and protocols to assess and manage pain, agitation/sedation, and delirium. The majority of respondents reported targeting a deep level of sedation with propofol being used for both deep and light levels of sedation.
-
Journal of critical care · Oct 2019
Multicenter Study Observational StudyImpact of timing to source control in patients with septic shock: A prospective multi-center observational study.
Current guidelines recommend that rapid source control should be adopted in patients not >6-12 h after sepsis is diagnosed. However, evidence level of this guideline is not specified, and there is no previous study on patients with septic shock visiting the emergency department (ED). Therefore, we aimed to assess the impact of rapid source control in patients with septic shock visiting the ED. ⋯ Patients with septic shock visiting the ED who underwent source control showed better outcomes than those who did not. We failed to demonstrate the performance of rapid source control reduced the 28-day mortality in septic shock patients. Further studies are required to determine the impact of rapid source control in sepsis and septic shock.