Journal of critical care
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Journal of critical care · Oct 2016
Changes in peripheral perfusion relate to visceral organ perfusion in early septic shock: A pilot study.
To correlate clinical indicators of peripheral perfusion with visceral organ vascular tone in 30 septic shock patients. ⋯ Capillary refill time and skin mottling may be correlated with the pulsatility index, a sonographic surrogate of vascular tone, of visceral organs in early septic shock.
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Journal of critical care · Oct 2016
Observational StudyClinical and economic burden of bloodstream infections in critical care patients with central venous catheters.
Bloodstream infections (BSIs) complicate the management of intensive care unit (ICU) patients. We assessed the clinical and economic impact of BSI among patients of a managed care provider group who had a central venous catheter (CVC) placed in the ICU. ⋯ Bloodstream infections after CVC placement in ICU patients are associated with significant increases in costs of care and risk of death during the index hospitalization but no differences in readmissions or costs after discharge.
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Journal of critical care · Oct 2016
Observational StudyRoutine delirium monitoring is independently associated with a reduction of hospital mortality in critically ill surgical patients: A prospective, observational cohort study.
Although delirium monitoring is recommended in international guidelines, there is lacking evidence for improved outcome due to it. We hypothesized that adherence to routine delirium monitoring would improve clinical outcome in adult critically ill patients. ⋯ Our data suggest an improved outcome for mechanically ventilated patients being screened for delirium in clinical routine.
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Journal of critical care · Oct 2016
The association between prior statin use and long-term outcomes after critical care admission.
Statins may have immunomodulatory effects that benefit critically ill patients. Therefore, we retrospectively examined the association between survival and the prescription of statins prior to admission to an intensive care unit (ICU), or high dependency unit (HDU), as a result of major elective surgery or as an emergency with a presumed diagnosis of sepsis. ⋯ Prior statin use was not associated with improved outcomes in patients admitted to critical care after elective surgical cases or with a presumed diagnosis of sepsis.
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Journal of critical care · Oct 2016
Clinical outcomes of cardiac arrest patients according to opioid use history.
Opioid analgesics are potent respiratory depressants. The purpose of this study was to describe the effects of opioids administered within 24hours before cardiac arrest on clinical outcomes. ⋯ Opioid administration within 24hours before cardiac arrest per se was not associated with adverse outcomes. However, administration of opioid analgesics on an as-needed basis was associated with poorer survival outcomes than regular dosing. Greater attention should be paid to patients who receive as-needed opioid administration in the general ward.