Journal of critical care
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Journal of critical care · Apr 2016
Balancing hope and despair at the end of life: The contribution of organ and tissue donation.
Concern for the grieving family can moderate the intentions of critical care staff to advocate deceased organ and tissue donation. Conversely, benevolent actions may provoke distress through missed opportunities to save or transform lives. This article provides insight into the perceived benefits of organ and tissue donation for grieving families who experienced end-of-life care in the intensive care unit. ⋯ Our study findings underlined the significance of donation decision making for grieving families. Organ and tissue donation has the potential to balance hope and despair at the end of life when the wishes of the dying, deceased, and bereaved are fulfilled.
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Journal of critical care · Apr 2016
Extent of pleural effusion on chest radiograph is associated with failure of high-flow nasal cannula oxygen therapy.
The purpose of the study was to determine whether pleural effusion (PE) is associated with a failure of high-flow nasal cannula (HFNC) therapy. ⋯ The extent of PE on chest radiograph and SOFA score were associated with HFNC failure.
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Journal of critical care · Apr 2016
Use of fentanyl and midazolam in mechanically ventilated children-Does the method of infusion matter?
Benzodiazepines and opioids are commonly used in pediatric intensive care unit. However, there is no previous study assessing the use of administering these drugs combined (single solution) or separately. We sought to evaluate the impact of these 2 different methods of providing sedation/analgesia in pediatric intensive care unit. ⋯ Patients who received a single solution of midazolam and fentanyl had a higher cumulated dose of compared with those patients who did not. The potential risk for long-term neurologic effects on developing brains associated with this finding should be considered.
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Journal of critical care · Apr 2016
Adoption and de-adoption of drotrecogin alfa for severe sepsis in the United States.
Drotrecogin alfa was a landmark drug for treatment of severe sepsis, yet little is known about how it was adopted and de-adopted during its 10-year period of availability. ⋯ Drotrecogin alfa use declined over time, with marked changes in use associated with drug-specific financial incentives but not the publication of clinical practice guidelines or clinical trials.
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Journal of critical care · Apr 2016
Delayed anticoagulation is associated with poor outcomes in high-risk acute pulmonary embolism.
Early diagnosis and timely treatment are essential to improve the outcomes of pulmonary embolism (PE), but no study has investigated the impact of anticoagulation timing on clinical outcomes in high-risk acute PE patients. We analyzed the relationship between early anticoagulation initiation and in-hospital mortality in high-risk acute PE patients at the intensive care unit (ICU) of a teaching hospital. ⋯ Delayed anticoagulation is an important prognostic factor of poor outcomes in high-risk acute PE patients.