Journal of critical care
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Journal of critical care · Apr 2015
Observational StudyPredictive value of the complement system for sepsis-induced disseminated intravascular coagulation in septic patients in emergency department.
To investigate changes in circulating complement component C3, membrane attack complex (MAC), and mannose-binding lectin (MBL) in patients with sepsis-induced disseminated intravascular coagulation (DIC). ⋯ Complement 3, MAC, and MBL were significantly increased in septic patients with DIC. Membrane attack complex independently predicted sepsis-induced DIC and development of DIC after ED admission.
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Journal of critical care · Apr 2015
The effect of early quantitative resuscitation on organ function in survivors of septic shock.
The objective of this study is to determine if early quantitative resuscitation (QR) attenuates organ dysfunction in survivors of septic shock. ⋯ In survivors of septic shock, we found no difference in maximal organ dysfunction during hospitalization between patients who received QR vs NPC.
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Journal of critical care · Apr 2015
Effect of early mobilization on sedation practices in the neurosciences intensive care unit: A preimplementation and postimplementation evaluation.
The use of sedation and analgesia protocols, daily interruption of sedation, and early mobilization (EM) have been shown to decrease duration of mechanical ventilation and hospital length of stay (LOS). ⋯ After implementation of an EM program, an increase in opioid use and no significant change in other sedatives were observed. Despite an increase in the amount of physical therapy and occupational therapy provided to patients, there was no change in hospital and ICU LOS or duration of mechanical ventilation.
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Journal of critical care · Apr 2015
Reevaluation of the utilization of arterial blood gas analysis in the Intensive Care Unit: Effects on patient safety and patient outcome.
Arterial blood gas (ABG) analysis is a useful tool to evaluate hypercapnia in the context of conditions and diseases affecting the lungs. Oftentimes, indications for ABG analysis are broad and nonspecific and lead to frequent testing without test results influencing patient management. ⋯ A significant decrease of ABGs obtained in the ICU does not negatively impact patient outcome and safety. A decrease in the number of ABGs per patient allows cost-efficient patient care with a lower risk for complications.
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Journal of critical care · Apr 2015
The utility of remote supervision with feedback as a method to deliver high-volume critical care ultrasound training.
Despite international agreement that critical care ultrasound (CCUS) is an essential skill for intensive care providers, CCUS training and dissemination is complicated by a shortage of educators. Newer technology now permits remote, offline supervision as a method of overseeing trainees undergoing CCUS instruction. ⋯ This study suggests that the use of wireless archiving and offline oversight in a CCUS curriculum is a feasible and highly-efficient strategy permitting a small number of faculty to supervise a large number of trainees. This approach provides an efficient method to address unmet demand for CCUS education.