Journal of critical care
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Journal of critical care · Apr 2013
Reasons underlying interhospital transfers to an academic medical intensive care unit.
Interhospital critical care transfers are common, yet few studies address the underlying reasons for transfers. We examined clinician and patient/surrogate perceptions about interhospital transfers and assessed their agreement on these transfers. ⋯ Stakeholders do not always agree on the reasons for critical care transfers. Efforts to improve communication are warranted to ensure informed patient choices.
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Journal of critical care · Apr 2013
Effects of intravenous low-dose recombinant human atrial natriuretic peptide on renal function in the perioperative management for gastrointestinal perforation or ileus: a retrospective single-center study.
We studied the effectiveness of human atrial natriuretic peptide (hANP) on management of acute kidney injury. ⋯ Intravenous low dose of hANP was useful as acute kidney injury management in gastrointestinal perforation and ileus patients undergoing non-elective surgery.
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Journal of critical care · Apr 2013
Classification of dermatological disorders in critical care patients: a prospective observational study.
The objective of this study was to identify dermatological disorders detected in the intensive care unit (ICU), to analyze their specific characteristics, and to define a useful classification for intensive care physicians. ⋯ Dermatological disorders are a frequent problem in the ICU, and their recognition is key to set up an appropriate care plan. We propose a classification and description of the different types of dermatological disorders that are most commonly found in ICUs.
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Journal of critical care · Apr 2013
Energy expenditure in patients with severe head injury: controlled normothermia with sedation and neuromuscular blockade.
Providing optimal caloric intake is important for patients with severe traumatic brain injury. Insufficient nutrition worsens prognosis, and excessive nutrition may lead to complications such as weaning delay from mechanical ventilation. However, using controlled normothermia with sedation and neuromuscular blockade for patients with anticipated severe brain edema, the optimal caloric intake is still unclear. ⋯ Energy expenditure in patients with severe traumatic brain injury who need mechanical ventilation and have received controlled normothermia with sedation and neuromuscular blockade was 13% less than predicted basal levels. Energy expenditure might be obtained from age, body height, body weight, heart rate, and minute ventilation.
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Journal of critical care · Apr 2013
Use of a protocolized approach to the management of sepsis can improve time to first dose of antibiotics.
The Surviving Sepsis Guidelines established recommendations for early recognition and rapid treatment of patients with sepsis. Recognizing systemic difficulties that delayed the application of early goal-directed therapy, the Emergency Department and Critical Care leadership instituted a sepsis protocol to identify patients with sepsis and expedite antibiotic delivery. We aimed to determine if the sepsis protocol improved the time to first dose of antibiotics in patients diagnosed with sepsis. ⋯ Initiation of a sepsis protocol, which emphasizes early goal-directed therapy, can improve time to administration of first dose of antibiotics.