Journal of critical care
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Journal of critical care · Dec 2017
A modified Delphi process to identify clinical and research priorities in patient and family centred critical care.
To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. ⋯ Stakeholders identified clear and distinct priorities for PFCC in clinical care and research, though there was greater consensus for clinical care.
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Journal of critical care · Dec 2017
Comparative StudyDifference in inspiratory flow between volume and pressure control ventilation in patients with flow dyssynchrony.
Flow dyssynchrony is common during volume control ventilation but minimized during pressure control. Characterizing inspiratory flow during pressure control breaths can inform adjustments of the fixed flow of volume control to address flow dyssynchrony. This study compared inspiratory flow peak and pattern between volume control and adaptive pressure control breaths. ⋯ In patients with flow dyssynchrony during volume control ventilation, adjustment of inspiratory flow pattern should be considered to minimize this dyssynchrony.
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Newly diagnosed swallowing dysfunction is rare, with an incidence <1% in hospitalized patients. The purpose of this study was to evaluate the incidence and clinical characteristics of dysphagia in elderly trauma patients specifically. ⋯ Elderly trauma patients with a high comorbidity burden or with prolonged ICU lengths of stay should be screened for dysphagia.
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Journal of critical care · Dec 2017
Glycemic control in patients undergoing coronary artery bypass graft surgery: Clinical features, predictors, and outcomes.
Critically ill patients with hyperglycemia have worse prognosis. The degree to which glycemic control is achieved following CABG surgery and the association with clinical outcomes is not well understood. ⋯ Achieving glycemic control following high risk CABG was associated with lower operative mortality and morbidity, yet achieved in only 15% of patients. Hospitals varied considerably in their ability to achieve good glycemic control.
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Journal of critical care · Dec 2017
A "Code ICU" expedited review of critically ill patients is associated with reduced emergency department length of stay and duration of mechanical ventilation.
To examine the effect of a system of expedited review of critically ill patients in the Emergency Department (ED) on ED length of stay (LOS) and Intensive Care Unit (ICU) outcomes. ⋯ A system of rapid review of critically ill patients in the ED was associated with reduced ED LOS and improved ICU outcomes.