Journal of critical care
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Journal of critical care · Apr 2019
Improving the adoption of optimal venous thromboembolism prophylaxis in critically ill patients: A process evaluation of a complex quality improvement initiative.
This study evaluated a complex initiative to increase evidence-based use of low molecular weight heparin for venous thromboembolism prophylaxis among adult medical-surgical ICU patients. ⋯ The findings of this process evaluation identified implementation strategies that can improve the use of evidence-informed practices, help interpret outcomes in the context of interventions and guide future quality improvement initiatives.
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Journal of critical care · Apr 2019
Bedside chest compression skills: Performance and skills retention in in-hospital trained pediatric providers. A simulation study.
To assess the effects of a real-time feedback device and refresher sessions in acquiring and retaining chest compression skills. ⋯ A real-time visual feedback device improved CC skills with better results in infants. Skills decayed over time despite two refresher sessions with feedback.
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Journal of critical care · Apr 2019
Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality.
While most influenza patients have a self-limited respiratory illness, 5-10% of hospitalized patients develop severe disease requiring ICU admission. The aim of this study was to identify influenza-specific factors associated with ICU admission and mortality. Furthermore, influenza-specific pulmonary bacterial, fungal and viral co-infections were investigated. ⋯ The current study indicates that a history of OSAS/CSAS, myocardial infarction and BMI > 30 might be related to ICU admission in influenza patients. Second, ICU patients develop more pulmonary co-infections. Last, (pre-existent) renal failure and diabetes mellitus are more often observed in non-survivors.
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Journal of critical care · Apr 2019
μImpact of a nursing-driven sedation protocol with criteria for infusion initiation in the surgical intensive care unit.
Analgesia and sedation protocols (ASPs) reduce duration of mechanical ventilation (MV) in the medical intensive care unit (ICU), but data in the surgical ICU (SICU) are limited. The objective of this study was to determine the impact of a nursing-driven ASP with criteria for infusion initiation in the SICU. ⋯ A nursing-driven ASP with criteria for infusion initiation in mechanically-ventilated SICU patients may increase ventilator-free time, maintain patients at the target sedation goal, and reduce opioid and benzodiazepine utilization.
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Journal of critical care · Apr 2019
How to facilitate the placement of a transesophageal probe in a ventilated patient?
Transesophageal probe insertion in the ventilated patients often is difficult. Different complex techniques were suggested for easier placement of the transesophageal probe. In this work, we describe a simple technique of TEE probe insertion in ventilated patients. ⋯ In the anesthetized intubated and ventilated patients, the TEE probe can be easily inserted when the patient is in the left decubital position. We suggest this algorithm in all such patients, when appropriate.