Journal of critical care
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Journal of critical care · Feb 2015
ReviewThe spectrum of psychocognitive morbidity in the critically ill: A review of the literature and call for improvement.
The objective of the study is to review the cognitive and psychiatric dysfunction experienced by critically ill patients during and after hospitalization. ⋯ We propose a paradigm change highlighting the need for interventions focused on early psychological support applied in parallel with stabilization of physiologic status in the ICU.
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Journal of critical care · Feb 2015
Adherence to guidelines for management of cerebral perfusion pressure and outcome in patients who have severe traumatic brain injury.
The aims of this study are to assess adherence to the Brain Trauma Foundation (BTF) cerebral perfusion pressure (CPP) guidelines and to determine if adherence is associated with mortality in patients who have a severe traumatic brain injury. ⋯ Cerebral perfusion pressure was greater than 70 mm Hg for most of the time. This level of CPP was associated with decreased hospital mortality.
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Journal of critical care · Feb 2015
Observational StudyThe impact of cardiac dysfunction on acute respiratory distress syndrome and mortality in mechanically ventilated patients with severe sepsis and septic shock: An observational study.
Acute respiratory distress syndrome (ARDS) is associated with significant mortality and morbidity in survivors. Treatment is only supportive, therefore elucidating modifiable factors that could prevent ARDS could have a profound impact on outcome. The impact that sepsis-associated cardiac dysfunction has on ARDS is not known. ⋯ Cardiac dysfunction in mechanically ventilated patients with sepsis did not impact ARDS incidence, clinical outcome in ARDS patients, or mortality. This contrasts against previous investigations demonstrating an influence of nonpulmonary organ dysfunction on outcome in ARDS. Given the frequency of ARDS as a sequela of sepsis, the impact of cardiac dysfunction on outcome should be further studied.
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Journal of critical care · Feb 2015
Observational StudyCharacteristics and outcomes of HIV-1-infected patients with acute respiratory distress syndrome.
We determined the prevalence of risk factors for the development of acute respiratory distress syndrome (ARDS), outcomes of critical illness, and the impact of highly active antiretroviral therapy in HIV-1-infected patients. We hypothesized that in an urban county hospital, HIV-1-infected patients with ARDS would have a higher mortality than their HIV-1-uninfected counterparts. ⋯ In patients with ARDS, HIV-1 infection was associated with greater illness severity but was not associated with higher mortality in ARDS. Future studies need to be done to evaluate the factors that contribute to high morbidity and mortality in medically vulnerable populations who develop ARDS.
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Journal of critical care · Feb 2015
A novel questionnaire to measure staff perception of end-of-life decision making in the intensive care unit-Development and psychometric testing.
The aim of this study was to create a questionnaire that measures barriers and facilitators of effective end-of-life (EOL) decision making and communication and associated stress as perceived by intensive care unit (ICU) staff. ⋯ The new questionnaire meets psychometric criteria of reliability and validity and promises to be a useful quality measure of EOL decision making in the ICU.