Journal of critical care
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Journal of critical care · Aug 2013
Comparative StudyAccuracy of the chest radiograph to identify bilateral pulmonary infiltrates consistent with the diagnosis of acute respiratory distress syndrome using computed tomography as reference standard.
The purpose of the study is to evaluate the diagnostic accuracy of the anteroposterior chest radiograph to detect pulmonary abnormalities consistent with acute respiratory distress syndrome (ARDS). ⋯ The accuracy of the portable chest radiograph to detect pulmonary abnormalities consistent with ARDS is significantly limited. These findings suggest that the use of the chest radiograph results mainly in underrecognition of the syndrome, particularly when disease is not diffusely distributed, but also in overdiagnosis.
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Journal of critical care · Aug 2013
Characterization of the spectrum of hemodynamic profiles in trauma patients with acute neurogenic shock.
Neurogenic shock considered a distributive type of shock secondary to loss of sympathetic outflow to the peripheral vasculature. In this study, we examine the hemodynamic profiles of a series of trauma patients with a diagnosis of neurogenic shock. ⋯ Results from this study suggest that hypotension of neurogenic shock can have multiple mechanistic etiologies and represents a spectrum of hemodynamic profiles. This understanding is important for the treatment decisions in managing these patients.
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Journal of critical care · Aug 2013
Acinetobacter baumannii infection was decreased by the structural renovation of a medical intensive care unit.
The study aimed to determine whether improvements in intensive care unit (ICU) structural environment affect the incidence of ICU-acquired infections (IAIs), particularly those caused by multidrug-resistant pathogens. ⋯ These results suggest that structural ICU renovations only may not improve overall IAI incidence, except for transient decrease in IAI by A baumannii.
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Journal of critical care · Aug 2013
Effects of the implementation of a preventive interventions program on the reduction of medication errors in critically ill adult patients.
Medication errors (MEs) are a major factor limiting the effectiveness and safety of pharmacological therapies in critically ill patients. The purpose was to determine if a preventive interventions program (PIP) is associated with a significant reduction on prevalence of patients with MEs in intensive care unit (ICU). ⋯ The implementation of PIP by a multidisciplinary team resulted in a significant reduction on the prevalence of patients with ME at an adult ICU.
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Journal of critical care · Aug 2013
Prescribing nonopioids in mechanically ventilated critically ill patients.
We searched for factors independently associated with the prescription of multimodal (balanced) analgesia in mechanically ventilated critically ill patients. ⋯ In mechanically ventilated patients, the addition of nonopioids to opioids is mostly prescribed for patients with lower illness severity scores and who are able to self-rate their pain intensity. These findings suggest that the concept of multimodal analgesia must be promoted in the intensive care unit.