Journal of critical care
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Journal of critical care · Feb 2017
Review Multicenter Study Observational StudyNutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients-A multicenter prospective cohort study.
Characterize the nutritional risk of critically ill patients with the modified NUTrition Risk in the Critically ill (NUTRIC) score. ⋯ Almost half of the patients in Portuguese ICUs are at high nutritional risk. NUTRIC score was strongly associated with main clinical outcomes.
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Journal of critical care · Feb 2017
Meta AnalysisThe effect of vasoactive drugs on mortality in patients with severe sepsis and septic shock. A network meta-analysis of randomized trials.
Inotropes and vasopressors are cornerstone of therapy in septic shock, but search for the best agent is ongoing. We aimed to determine which vasoactive drug is associated with the best survival. ⋯ Among several regimens for pharmacological cardiovascular support in septic patients, regimens based on inodilators have the highest probability of improve survival.
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Journal of critical care · Feb 2017
Meta AnalysisImproved rule-out diagnostic gain with a combined aortic dissection detection risk score and D-dimer Bayesian decision support scheme.
The objective of this study was to develop a Bayesian clinical decision support mathematical model that can assist in assessing a diagnostic utility integrating the aortic dissection detection risk score (ADD-RS) combined with the diagnostic quality of D-dimer testing.
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Journal of critical care · Feb 2017
Randomized Controlled TrialSleep in intensive care unit: The role of environment.
To determine if improving intensive care unit (ICU) environment would enhance sleep quality, assessed by polysomnography (PSG), in critically ill mechanically ventilated patients. ⋯ Characteristics of normal sleep were absent in many of the PSG recordings in these critically ill patients. We were not able to further reduce the already existing low noise levels in the ICU and did not find any association between the environmental intervention and the presence of normal sleep characteristics in the PSG.
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Journal of critical care · Feb 2017
ReviewWhat is an intensive care unit? A report of the task force of the World Federation of Societies of Intensive and Critical Care Medicine.
Since their widespread introduction more than half a century ago, intensive care units (ICUs) have become an integral part of the health care system. Although most ICUs are found in high-income countries, they are increasingly a feature of health care systems in low- and middle-income countries. The World Federation of Societies of Intensive and Critical Care Medicine convened a task force whose objective was to answer the question "What is an ICU?" in an internationally meaningful manner and to develop a system for stratifying ICUs on the basis of the intensity of the care they provide. ⋯ A level 1 ICU is capable of providing oxygen, noninvasive monitoring, and more intensive nursing care than on a ward, whereas a level 2 ICU can provide invasive monitoring and basic life support for a short period. A level 3 ICU provides a full spectrum of monitoring and life support technologies, serves as a regional resource for the care of critically ill patients, and may play an active role in developing the specialty of intensive care through research and education. A formal definition and descriptive framework for ICUs can inform health care decision-makers in planning and measuring capacity and provide clinicians and patients with a benchmark to evaluate the level of resources available for clinical care.