Journal of critical care
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Journal of critical care · Dec 2018
Observational StudyValidation of The Critical-care Pain Observation Tool (CPOT) for the detection of oral-pharyngeal pain in critically ill adults.
Mechanically ventilated patients experience pain at rest and during daily care procedures. Our objective was to test the reliability and validity of the Critical-Care Pain Observation Tool (CPOT) to detect oral-pharyngeal pain in intubated and tracheostomised adults during routine oral care procedures. ⋯ The CPOT is reliable and valid for the detection of oral-pharyngeal pain during oral care procedures indicated as painful by critically ill adults.
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Journal of critical care · Dec 2018
Meta AnalysisEffect of nonpharmacological interventions for the prevention of delirium in the intensive care unit: A systematic review and meta-analysis.
We aimed to classify nonpharmacological interventions used for preventing delirium in the intensive care unit (ICU), and estimate their effect size. ⋯ Nonpharmacological interventions were effective in reducing the duration and occurrence of delirium. Consistent application and development of nonpharmacological interventions for use in the ICU are important.
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Journal of critical care · Dec 2018
Randomized Controlled Trial Observational StudyA multi-center evaluation of a disposable catheter to aid in correct positioning of the endotracheal tube after intubation in critically ill patients.
To demonstrate that use of a minimally invasive catheter reduces endotracheal tube (ETT) malposition rate after intubation. ⋯ With use of an ETT positioning catheter after intubation, the ETT malposition rate was reduced by 82%. This catheter-based system was safe, and its use may perhaps decrease the need for the post-intubation chest radiograph.
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Journal of critical care · Dec 2018
ReviewPhysiotherapy in the neurotrauma intensive care unit: A scoping review.
This scoping review summarizes the literature on the safety and effectiveness of physiotherapy interventions in patients with neurological and/or traumatic injuries in the intensive care unit (ICU), identifies literature gaps and provides recommendations for future research. ⋯ Gaps in the literature suggest that future studies require assessment of long term functional outcomes and quality of life, examination of homogenous populations and more robust methodologies including clinical trials and larger samples.
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Journal of critical care · Dec 2018
Multicenter StudyAntibiotics has more impact on mortality than other early goal-directed therapy components in patients with sepsis: An instrumental variable analysis.
To estimate the effect of each of the EGDT components, as well as of the antibiotics, on length-of-stay and mortality. ⋯ Among patients entering ER with infection and shock or hypoperfusion criteria, the use of appropriate antibiotics in the first 3 h is the measure that has the greatest impact on survival. In addition, among patients with hyperlactatemia >4 mmol/L, the clearance of >10% of lactate during resuscitation is associated with better outcomes.