Journal of critical care
-
Journal of critical care · Aug 2018
Multicenter Study Observational StudyFactors associated with delayed rapid response team activation.
Delayed activation of the rapid response team (RRT) is common and has been associated with adverse outcomes. However, little is known about the factors associated with delayed activation. This was an observational study from two hospitals in Ottawa, Canada, including adult inpatients with experiencing an activation of the RRT. ⋯ The reasons for RRT call were significantly different (P < 0.001) with respiratory distress (29.3% versus 24.8%), and hypotension (17.4% versus 13.2%) being more common in the delayed group, and dysrhythmias (15.9% versus 18.5%) and altered level of consciousness (13.5% versus 18.7%) being less common. RRT activation was more delayed on non-surgical services (P < 0.001). Delayed activation was associated with increased mortality (Adjusted odds ratio [OR] 1.23, 95% CI 1.07-1.41), ICU admission (Adjusted OR 1.72, 95% CI 1.51-1.96), and hospital length of stay (13 versus 15 days, P < 0.001).
-
Journal of critical care · Jun 2018
Multicenter Study Observational StudyCurrent practices and safety of medication use during rapid sequence intubation.
Characterize medication practices during and immediately after rapid sequence intubation (RSI) by provider/location and evaluate adverse drug events. ⋯ Medication practices during RSI vary amongst provider and medications are often used inappropriately. There is opportunity for optimization of medication use during RSI.
-
Journal of critical care · Jun 2018
Multicenter StudyImpact of physician-less pediatric critical care transport: Making a decision on team composition.
To explore the impact of a physician non-accompanying pediatric critical care transport program, and to identify factors associated with the selection of specific transport team compositions. ⋯ No significant differences were observed with increasing use of a physician non-accompanying team. Selection of transport team compositions was influenced by clinical and system factors, but appreciable variation still remained among triage physicians.
-
Journal of critical care · Jun 2018
Multicenter StudyAssessing frailty in the intensive care unit: A reliability and validity study.
To describe pre-ICU frailty in critically ill patients using the Clinical Frailty Scale (CFS). ⋯ CFS scores can be generated using medical chart review and can be reliably completed by ICU clinicians and research staff.
-
Journal of critical care · Jun 2018
Multicenter Study Observational StudyThe impact of organ dysfunctions on mortality in patients with severe sepsis: A multicenter prospective observational study.
Disseminated intravascular coagulations (DIC), acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI) are major organ dysfunctions that occur in patients with sepsis. This study aimed to elucidate the impact of these organ dysfunctions on mortality in patients with severe sepsis. ⋯ DIC and AKI are frequent complications in patients with severe sepsis. In this study, DIC, and AKI stage 3 were independent risk factors of in-hospital mortality.