Journal of critical care
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Journal of critical care · Oct 2015
Observational StudyPosttraumatic stress disorder symptoms in close relatives of intensive care unit patients: Prevalence data resemble that of earthquake survivors in Chile.
Posttraumatic stress disorder (PTSD) in relatives of intensive care unit (ICU) patients has not been fully described. We studied potential relationships between PTSD and specific patients' conditions and relatives' psychologic characteristics. ⋯ Close relatives of patients admitted to the ICU experience a high prevalence of PTSD during and after hospitalization. Individual patient factors such as severity, age, and being on MV increase the occurrence of PTSD, as well as sex and baseline anxiety levels of caregivers. Preventative measures could be devised for this particular high-risk population.
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Journal of critical care · Oct 2015
Comparative Study Observational StudyComparison of point-of-care hemostatic assays, routine coagulation tests, and outcome scores in critically ill patients.
The purposes of the study are to compare point-of-care (POC) hemostatic devices in critically ill patients with routine laboratory tests and intensive care unit (ICU) outcome scoring assessments and to describe the time course of these variables in relation to mortality rate. ⋯ All POC and routine laboratory tests showed a hypocoagulative response in nonsurvivors compared to survivors. ReoRox was better than ROTEM and Multiplate at detecting differences between surviving and nonsurviving ICU patients. However, Simplified Acute Physiology Score 3 showed the best association to mortality outcome.
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Journal of critical care · Oct 2015
Comparative StudyEvaluation of long-term outcomes of very old patients admitted to intensive care: Survival, functional status, quality of life, and quality-adjusted life-years.
To evaluate long-term outcomes among a population of very old patients (≥80years) after nonelective intensive care unit (ICU) admission. ⋯ For those who survive, return to previous functional activity was likely. Long-term survival and quality of life achieved afterward were translated in more than a year of perfect health status gained.
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Journal of critical care · Oct 2015
Predialysis hypernatremia is a prognostic marker in acute kidney injury in need of renal replacement therapy.
The present study aimed to evaluate the prognostic impact of predialysis dysnatremia in patients with acute kidney injury requiring renal replacement therapy (RRT). ⋯ Almost 50% of patients with acute kidney injury in need of RRT in the ICU had mild or severe dysnatremia before dialysis initiation. Hypernatremia was the main sodium disturbance and independently associated with poor outcome in the study population.
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Journal of critical care · Oct 2015
Observational StudyOne-year experience with an acute respiratory distress syndrome standard operating procedure on intensive care unit.
Mortality in acute respiratory distress syndrome (ARDS) patients remains unacceptable high, and there is substantial variation in the diagnostic and management strategies used. We recently established a standardized algorithm for the early identification and guideline conform therapy of ARDS on intensive care units (ICUs). We here present the results of a first-year observatory period after implementation of the ARDS bundle on our ICU. ⋯ A standardized ARDS bundle fundamentally increases awareness of this clinical picture on ICU and facilitates application of evidence-based therapies like prone positioning and use of neuromuscular blockers. These data encourage evaluating our ARDS SOP in a prospective trial to identify potential effects on mortality.