Journal of critical care
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Journal of critical care · Jun 2019
ReviewSelecting and evaluating decision-making strategies in the intensive care unit: A systematic review.
Many patients in the Intensive Care Unit (ICU) die after a decision to withhold or withdraw treatment. To ensure that for each patient the appropriate decision is taken, a careful decision-making process is required. This review identifies strategies that can be used to optimize the decision-making process for continuing versus limiting life sustaining treatment of ICU patients. ⋯ The decision-making process in the ICU can be enhanced by frequent family-meetings with predefined topics. Ethical and palliative support is useful in specific situations. These interventions can reduce non-beneficial ICU treatment days.
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Journal of critical care · Jun 2019
ReviewSelecting and evaluating decision-making strategies in the intensive care unit: A systematic review.
Many patients in the Intensive Care Unit (ICU) die after a decision to withhold or withdraw treatment. To ensure that for each patient the appropriate decision is taken, a careful decision-making process is required. This review identifies strategies that can be used to optimize the decision-making process for continuing versus limiting life sustaining treatment of ICU patients. ⋯ The decision-making process in the ICU can be enhanced by frequent family-meetings with predefined topics. Ethical and palliative support is useful in specific situations. These interventions can reduce non-beneficial ICU treatment days.
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Journal of critical care · Jun 2019
Sodium bicarbonate therapy for critically ill patients with metabolic acidosis: A scoping and a systematic review.
We aimed to assess the biochemical and physiological effects, clinical efficacy, and safety, of intravenous NaHCO3 therapy in critically ill patients with acute metabolic acidosis. ⋯ Given the lack of data on the effects of intravenous NaHCO3 therapy to support its clinical use and the frequency of bicarbonate therapy, a program of investigation appears justified.
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Journal of critical care · Apr 2019
Review Meta Analysis Comparative StudyCrystalloids vs. colloids for fluid resuscitation in the Intensive Care Unit: A systematic review and meta-analysis.
Guidelines recommend crystalloids for fluid resuscitation in sepsis/shock and switching to albumin in cases where crystalloids are insufficient. We evaluated hemodynamic response to crystalloids/colloids in critically ill adults. ⋯ Crystalloids were less efficient than colloids at stabilizing resuscitation endpoints; guidance on when to switch is urgently required.
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Journal of critical care · Apr 2019
Review Meta Analysis Comparative StudyCrystalloids vs. colloids for fluid resuscitation in the Intensive Care Unit: A systematic review and meta-analysis.
Guidelines recommend crystalloids for fluid resuscitation in sepsis/shock and switching to albumin in cases where crystalloids are insufficient. We evaluated hemodynamic response to crystalloids/colloids in critically ill adults. ⋯ Crystalloids were less efficient than colloids at stabilizing resuscitation endpoints; guidance on when to switch is urgently required.