Journal of critical care
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Journal of critical care · Feb 2018
Effects of staff training and electronic event monitoring on long-term adherence to lung-protective ventilation recommendations.
To investigate long-term effects of staff training and electronic clinical decision support (CDS) on adherence to lung-protective ventilation recommendations. ⋯ Staff training effectively improves adherence to lung-protective ventilation strategies. The observed CDS effect seemed less pronounced, although it can easily be adapted to new recommendations. Both interventions, which futures studies could deploy in combination, promise to improve the precision of mechanical ventilation.
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Journal of critical care · Feb 2018
Elevated modified shock index in early sepsis is associated with myocardial dysfunction and mortality.
The aim of this study was to explore the association of an elevated modified shock index (MSI) in sepsis and myocardial dysfunction. ⋯ Elevated modified shock index during early sepsis is associated with the development of myocardial dysfunction and depression, SOFA score and mortality.
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Journal of critical care · Feb 2018
The impact of a daily "medication time out" in the Intensive Care Unit.
Medical errors play a large role in preventable harms within our health care system. Medications administered in the ICU can be numerous, complex and subject to daily changes. We describe a method to identify medication errors with the potential to improve patient safety. ⋯ A daily medication time out should be considered as an additional mechanism for patient safety in the ICU.
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Journal of critical care · Feb 2018
Risk factors for potential drug-drug interactions in intensive care unit patients.
To determine risk factors for each severity-based category of potential drug-drug interactions (DDIs) encountered at intensive care unit (ICU) patients. ⋯ The rate of the DDIs in ICU patients at a tertiary care hospital is high, and adversely influenced by number of drugs or drug groups prescribed per patient, antiarrhythmic or anticonvulsant drug prescription, comorbidities, length of hospitalization and surgery. On the other hand, presence of cognitive deficit and transfer from emergency department to ICU protect ICU patients from the DDIs.
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Journal of critical care · Feb 2018
The role of neutrophil gelatinase-associated lipocalin (NGAL) in the detection of blast lung injury in a military population.
To study the relationship between serum neutrophil gelatinase-associated lipocalin (NGAL) and military blast and gunshot wound (GSW) to establish whether potential exists for NGAL as a biomarker for blast lung injury (BLI). ⋯ Raised NGAL correlated with increased severity of injury (worse survival probability i.e. TRISS and low pH) in both patient groups. There was an inverse correlation between admission NGAL and a marker of blast lung injury (low P/F ratio) at 24h in blast injured group but not GSW group that warrants further investigation.