Journal of critical care
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Journal of critical care · Dec 2014
Correlation of patient-reported outcomes of sedation and sedation assessment scores in critically ill patients.
Patient-reported outcomes (PROs) are recommended as indicators of quality in the intensive care unit. We studied the correlation between PROs of sedation quality and a universal sedation assessment scale in critically ill patients. ⋯ Patient-reported outcomes of sedation correlate with the percentage of time spent in the goal range of scores for a universal sedation assessment scale. These findings represent initial attempts to appreciate the patient's perspective in the management and monitoring of agitation.
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Journal of critical care · Dec 2014
EditorialAnalysis of the reports of high-level commissions that have comprehensively reviewed US public policy on brain death.
The notion of brain death from its inception has not been uniformly understood with many grisly conceptions of it as it pertains to reliability and to organ donation. Accordingly, the aforementioned recitation of statutes and commission reports has served a useful societal role in addressing controversies and misconceptions while promulgating unifying foundational concepts and guidance in practical translation to clinical practice. ⋯ The second is through established procedures to reliably determine the presence of total brain death with the presence of a comatose state which is irreversible. Another common thread through the ethically focused reports has been recognition that organ donation and death are temporally and geographically associated but there is emphasis that the processes of determination of death(by somatic or cerebral criteria) must be logically, ethically, and procedurally separate from the procedures for performing organ harvesting and transplantation.
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Journal of critical care · Dec 2014
Review Meta AnalysisProlonged vs intermittent infusion of piperacillin/tazobactam in critically ill patients: A narrative and systematic review.
The purpose of this study is to review the rationale of prolonged (ie, extended or continuous) infusion of piperacillin/tazobactam (PIP/TAZ) in critically ill patients and to perform a systematic review that compare the effectiveness of prolonged infusion with intermittent bolus of PIP/TAZ. ⋯ Pharmacokinetic/pharmacodynamic studies provide a robust rationale to prefer prolonged above intermittent infusion of PIP/TAZ. However, although some studies suggest a better outcome in critically ill patients receiving prolonged infusion, the level of evidence is moderate.