Journal of critical care
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Journal of critical care · Aug 2019
Multicenter Study Comparative StudyNighttime and non-business days are not associated with increased risk of in-hospital mortality in patients with severe sepsis in intensive care units in Japan: The JAAM FORECAST study.
Hospital services are reduced during off-hour such as nighttime or weekend. Investigations of the off-hour effect on initial management and outcomes in sepsis are very limited. Thus, we tested the hypothesis that patients who were diagnosed with severe sepsis during the nighttime or on non-business days had altered initial management and clinical outcomes. ⋯ Nighttime and weekends were not associated with increased in-hospital mortality of severe sepsis.
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Journal of critical care · Aug 2019
Multicenter Study Comparative Study Observational StudyDifferences in prevalence of ICU protocols between neurologic and non-neurologic patient populations.
To compare the differences in the presence of protocols aimed at addressing complications for neurologically injured patients vs. non-neurologic injured patients in a large sample of ICUs across the United States. ⋯ In this cohort, we found differences in the prevalence of respiratory illness prevention protocols between critically ill patients with neurologic illness and the general critically ill population.
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Journal of critical care · Aug 2019
Randomized Controlled Trial Comparative StudyBolus therapy with 3% hypertonic saline or 0.9% saline in emergency department patients with suspected sepsis: A pilot randomised controlled trial.
Hypertonic saline administered during fluid resuscitation may mitigate endothelial glycocalyx (EG) shedding and inflammation. The objective of this pilot randomised controlled trial was to measure the effect of hypertonic saline, compared to isotonic saline, on biomarkers of EG shedding and inflammation in emergency department patients with suspected sepsis. ⋯ Although a single bolus of hypertonic saline increased serum osmolality, it did not reduce biomarkers of EG shedding or inflammation, compared to patients that received isotonic saline.
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Journal of critical care · Aug 2019
Multicenter Study Observational StudyApplication of dynamic pulse pressure and vasopressor tools for predicting outcomes in patients with sepsis in intensive care units.
We aimed to determine whether the combination of dynamic pulse pressure and vasopressor (DPV) use is applicable for mortality risk stratification in patients with severe sepsis. We proposed the use of the DPV tool and compared it with traditional sepsis severity indices. ⋯ The DPV tool can be applied for 7-day and 28-day mortality risk prediction in patients with sepsis.
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Journal of critical care · Aug 2019
Multicenter StudyDevelopment and daily use of a numeric rating score to assess sleep quality in ICU patients.
Insufficient sleep burdens critically ill patients, optimizing sleep may enhance patient's outcomes. Current assessment methods may unnecessary burden patients. Therefore, a single numeric rating score was validated for sleep assessment. ⋯ A single numeric rating score for sleep is interchangeable for the RCSQ score for assessment of sleep quality. Optimal cut-off is >5. Use of a numeric rating score for sleep is a practical way to evaluate and monitor sleep as perceived by patients in daily ICU practice.