Journal of critical care
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Journal of critical care · Feb 2019
Multicenter Study Observational StudyAdherence to guidelines for the management of donors after brain death.
Guideline adherence for the management of a donor after brain death (DBD) is largely unknown. This study aimed to perform an importance-performance analysis of prioritized key interventions (KIs) by linking guideline adherence rates to expert consensus ratings for the management of a DBD. ⋯ Guideline adherence to an expert panel predefined care set in DBD donor management proved moderate leaving substantial room for improvement. An importance-performance analysis can be used to improve implementation and documentation of guidelines.
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Journal of critical care · Feb 2019
Strong correlation between doppler snuffbox resistive index and systemic vascular resistance in septic patients.
To compare systemic vascular resistance index (SVRI) as measured by invasive transpulmonary indicator dilution (TPID) and non-invasive Doppler-derived resistive index in septic patients. ⋯ Using ultrasound to measure RI is a noninvasive, inexpensive, reliable method to evaluate peripheral vascular resistance in septic patients, and it is highly correlated with SVRI. In addition, SBRI can be used to evaluate peripheral circulatory disturbances in septic patients.
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Journal of critical care · Feb 2019
Outcomes comparison in patients admitted to low complexity rural and urban intensive care units in the Veterans Health Administration.
To evaluate mortality, length of stay, and inter-hospital transfer in the Veteran Health Administration (VHA) among low complexity Intensive Care Unit (ICU) patients. ⋯ Despite challenges, low complexity ICUs in rural VA facilities fare similarly to urban counterparts. Being part of a national healthcare system may have benefits to explore in sustaining critical care access in rural areas outside the VA healthcare system.
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Journal of critical care · Feb 2019
Observational StudyUse of biomarkers in the prediction of culture-proven infection in the surgical intensive care unit.
The purpose of this study was to prospectively analyze the predictive role of classic predictors for suspected infection (temperature, WBC and derivatives) with two biomarkers, procalcitonin and lactate, on the incidence of culture-proven infection in the surgical intensive care unit (SICU). ⋯ The ability to utilize procalcitonin values in the diagnosis of culture-proven infection was not realized in this study. However, the association of admission peak procalcitonin values with admission peak lactate values identified a group of patients who were culture-negative for suspected infection. No other admission predictor was associated with culture-proven infection.
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Journal of critical care · Feb 2019
Multicenter StudyMeasuring quality indicators to improve pain management in critically ill patients.
To evaluate the quality of pain assessment in Dutch ICUs and its room for improvement. ⋯ There is substantial variation in pain assessment across Dutch ICUs, and ample room for improvement. With this study we took a first step towards quality assurance of pain assessment in Dutch ICUs.