Journal of critical care
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Journal of critical care · Aug 2013
The effect of electrical muscle stimulation on the prevention of disuse muscle atrophy in patients with consciousness disturbance in the intensive care unit.
Disuse atrophy of the lower limbs of patients with consciousness disturbance has often been recognized as "an unavoidable consequence," such that the mechanism was not investigated diligently. In this study, we examined the preventive effects of electrical muscle stimulation (EMS) against disuse atrophy of the lower limbs in patients in coma after stroke or traumatic brain injury in the intensive care unit. ⋯ Electrical muscle stimulation is effective in the prevention of disuse muscle atrophy in patients with consciousness disorder.
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Journal of critical care · Aug 2013
A 5-year observational study of lung-protective ventilation in the operating room: a single-center experience.
We assessed the evolution of lung-protective ventilation strategies during anesthesia and identified factors associated with the selection of a nonprotective ventilation strategy. ⋯ Although use of nonprotective ventilation decreased over time, an important percentage of patients continue to receive nonprotective ventilation.
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Journal of critical care · Aug 2013
Assessing the quality of interdisciplinary rounds in the intensive care unit.
Interdisciplinary rounds (IDRs) in the intensive care unit (ICU) are increasingly recommended to support quality improvement, but uncertainty exists about assessing the quality of IDRs. We developed, tested, and applied an instrument to assess the quality of IDRs in ICUs. ⋯ The quality of IDRs in the ICU can be reliably assessed for patient plan of care and process with the IDR Assessment Scale.
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Journal of critical care · Aug 2013
Urine output is associated with prognosis in patients with acute kidney injury requiring continuous renal replacement therapy.
Although some studies have found that early initiation of continuous renal replacement therapy (CRRT) is associated with better prognosis, no consensus exists on the best timing to start CRRT. We investigated whether the timing of CRRT initiation was relevant to overall mortality and explored which factors at the time of CRRT initiation were associated with better outcomes in critically ill patients with acute kidney injury (AKI). ⋯ Urine output but not BUN concentration was significantly associated with a better prognosis in critically ill patients with AKI requiring CRRT.
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Journal of critical care · Aug 2013
Antibiotic resistance patterns in medical and surgical patients in a combined medical-surgical intensive care unit.
Studies have found different rates of antimicrobial resistance among patients in medical and surgical intensive care units (ICUs). We studied whether these differences were a function of geography or differences in the patient populations, by comparing resistance rates among bacteria isolated from a combined medical/surgical ICU. ⋯ Reported differences in resistance patterns among bacteria cultured from medical and surgical patients may be due to geographic separation of the ICUs as opposed to differences in the patient characteristics. This study suggests that ICU-specific antibiograms remain a useful tool to guide the choice of antimicrobial therapy, even in medical/surgical ICUs.