Journal of critical care
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Journal of critical care · Feb 2025
Multicenter Study Comparative Study Observational StudyVasopressor utilization in septic shock patients receiving propofol versus midazolam.
The purpose of this study was to evaluate the effect of propofol versus midazolam on vasopressor requirements in patients with septic shock to better guide sedative selection. ⋯ In patients with septic shock, vasopressor requirement increases with propofol were non-inferior to midazolam within the first 12 h.
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Journal of critical care · Feb 2025
Multicenter StudyThe interplay between organizational culture and burnout among ICU professionals: A cross-sectional multicenter study.
Organizational culture is considered a protective factor against burnout among ICU professionals. The aim of this study is to study the association between organizational culture as a potential antecedent to previously found mediating risk factors for burnout, namely, work-life balance and moral distress. ⋯ Multiple aspects of organizational culture reduce burnout among ICU professionals in a largely indirect manner, via moral distress and work-life balance. Improving organizational culture can mitigate burnout symptoms among ICU clinicians.
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Journal of critical care · Feb 2025
Multicenter StudyIntensivists' ethical perceptions about decisions to withhold or withdraw treatment: A clinical ethics empirical investigation.
Intensive care professional societies have issued policy recommendations regarding decisions to withhold and/or withdraw treatment (Wh&Wd) that consistently classify them as ethically equivalent and ethically neutral. However, on the ground they are often perceived as "active" and morally problematic. Moreover, recent studies have highlighted personal "variability" in the way such decisions are made. Therefore, it seemed necessary to explore intensivists' different ethical perceptions about Wh&Wd decisions. ⋯ The study results allow for recognition of intensivists' moral distress about Wh&Wd decisions and open new perspectives to deal with their deep-rooted variability, most notably by working on the rationale and format of the collegial decision-making procedure.
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Journal of critical care · Feb 2025
Advance directives in the intensive care unit: An eight-year vanguard cohort study.
To investigate the frequency, content, and clinical translation of advance directives in intensive care units (ICUs). ⋯ Advance directives are available in a minority of ICU patients and often contain subjective/contradictory wording. Physicians respected directives in 90 % of patients, with treatment adapted following their wishes. However, violation of directives may have serious consequences with unfavorable in-hospital outcomes and decreased long-term survival with treatment adaption following directives.
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Journal of critical care · Feb 2025
Malnutrition in survivors of critical illness and long-term survival outcomes: A cohort study.
This study aimed to determine the prevalence of malnutrition and associated risk factors among intensive care unit (ICU) survivors and to investigate whether malnutrition after ICU admission is associated with long-term survival outcomes. ⋯ Malnutrition within 1 year of ICU admission was reported in 8.1 % of survivors. Notably, malnutrition after ICU admission was associated with an increased risk of mortality between 1 and 5 years after ICU admission among ICU survivors.