Journal of critical care
-
Journal of critical care · Dec 2017
Total and ionized magnesium testing in the surgical intensive care unit - Opportunities for improved laboratory and pharmacy utilization.
Ionized fraction (iMg) is the physiologically active form of magnesium (Mg); total Mg may not accurately reflect iMg status. Erroneously "low" Mg levels may result in unnecessary repetitive testing. ⋯ In the surgical ICU, categorical agreement (low, normal, high) was poor between Mg and iMg. Over 80% of "low" total Mg values are erroneous and may result in unnecessary additional measurements and repletion.
-
Journal of critical care · Dec 2017
ReviewVascular air embolism: A silent hazard to patient safety.
To narratively review published information on prevention, detection, pathophysiology, and appropriate treatment of vascular air embolism (VAE). ⋯ VAE is an important and underappreciated complication of surgery, anesthesia and medical procedures.
-
Journal of critical care · Dec 2017
Observational StudyPatterns of C-reactive protein ratio predicts outcomes in healthcare-associated pneumonia in critically ill patients with cancer.
Describe the patterns of C-reactive protein relative changes in response to antibiotic therapy in critically ill cancer patients with healthcare-associated pneumonia (HCAP) and its ability to predict outcome. ⋯ CRP-ratio was useful in the early prediction of poor outcomes in cancer patients with HCAP.
-
Journal of critical care · Dec 2017
Intermediate care to intensive care triage: A quality improvement project to reduce mortality.
Medical patients whose care needs exceed what is feasible on a general ward, but who do not clearly require critical care, may be admitted to an intermediate care unit (IMCU). Some IMCU patients deteriorate and require medical intensive care unit (MICU) admission. In 2012, staff in the Johns Hopkins IMCU expressed concern that patient acuity and the threshold for MICU admission were too high. Further, shared triage decision-making between residents and supervising physicians did not consistently occur. ⋯ Using a structured quality improvement process targeting triage education and increased resident/supervisor communication, we demonstrated reduced mortality among patients transferred from the IMCU to the MICU.
-
Journal of critical care · Dec 2017
Predictors of mortality in adults with Sickle cell disease admitted to intensive care unit in Bahrain.
Sickle cell disease (SCD) is one of the most common genetic blood disorders in Bahrain. However, there is a paucity of data regarding the clinical presentation of SCD patients who require ICU admission. This study aimed to describe the epidemiological data of SCD patients admitted to the ICU and to identify predictors of mortality in order to help intensivists identify patients at most risk. ⋯ Acute chest syndrome was the main reason for SCD patients to be admitted to the ICU. Older age, less frequent hospitalization, shorter stays in the ICU, and the need for renal replacement therapy were found to be indicators of high mortality rate SCD patients.