Journal of critical care
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Journal of critical care · Feb 2012
Time spent in the emergency department and mortality rates in severely injured patients admitted to the intensive care unit: An observational study.
The aim of this study was to identify the determinants of a shorter emergency department time (EDt) in patients with severe trauma (STPs) admitted to the intensive care unit and determine whether EDt influences mortality. ⋯ Patients in the ED with indicators of high trauma severity have a reduced EDt but a higher mortality rate. Advanced age increases both mortality and EDt. With the factors included in the model, EDt was not an independent factor for mortality in STPs.
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Journal of critical care · Feb 2012
Outcomes for critically ill patients with HIV and severe sepsis in the era of highly active antiretroviral therapy.
With the advent of highly active antiretroviral therapy (HAART), sepsis has become a more frequent ICU diagnosis for patients with HIV infections. Yet, little is known about the etiologies of acute infections in critically ill patients with HIV and the factors that affect in-hospital mortality. ⋯ In this large cohort study, nosocomial/health care-associated infections were common in ICU patients with HIV and severe sepsis. Hospital mortality was associated with acute illness severity, but not clearly associated with variables related to HIV infection. Interventions that aim to prevent or more effectively treat nosocomial infections in critically ill patients with HIV may favorably impact clinical outcomes.
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Journal of critical care · Feb 2012
Device-associated infection rates and extra length of stay in an intensive care unit of a university hospital in Wroclaw, Poland: International Nosocomial Infection Control Consortium's (INICC) findings.
The aim of this study was to determine device-associated health care-associated infections (DA-HAI) rates, microbiologic profile, bacterial resistance, and length of stay in one intensive care unit (ICU) of a hospital member of the International Nosocomial Infection Control Consortium (INICC) in Poland. ⋯ Most DA-HAI rates are lower in Poland than in INICC, but higher than in the National Healthcare Safety Network, expressing the feasibility of lowering infection rates and increasing patient safety.
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Our laboratory receives many routine requests for plasma zinc analysis from intensive care units (ICUs) throughout Scotland. However, such requests are inappropriate because plasma zinc concentrations fall independently of nutritional deficiency during the systemic inflammatory response and, therefore, in critically ill patients. This survey was performed to investigate how widespread this practice was and if low plasma zinc concentrations were interpreted as zinc deficiency so triggering inappropriate initiation of zinc supplementation. ⋯ The finding of a low plasma zinc concentration in Intensive Therapy Unit patients is often misinterpreted as indicating zinc deficiency and inappropriately prompts zinc supplementation. There is no evidence base to support high-dose zinc supplementation in ICU patients. This practice is justifiable only if future randomized trials demonstrate a benefit.
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Journal of critical care · Feb 2012
Intensive care admissions and outcome at the University of Calabar Teaching Hospital, Nigeria.
An intensive care unit (ICU) is for critically ill patients who are likely to benefit from the expertise care provided. The outcome is dependent on the available human and material resources. The University of Calabar Teaching Hospital is a 410-bed hospital. ⋯ Ventilator malfunction, power failure, and oxygen exhaustion led to the unfavorable outcome in patients who were ventilated. In pediatric patients, the mortality rate was 45.5%. Early identification and referral of critically ill patients from the wards, availability of ventilator with battery backup, and maintenance of functioning equipment would reduce the high mortality rate recorded in the study.