Journal of critical care
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Journal of critical care · Dec 2011
Does intensive care unit severity of illness influence recall of baseline physical function?
The aim of this study is to evaluate if severity of illness in the intensive care unit influences patients' retrospective recall of their baseline physical function from before hospital admission. ⋯ Intensive care unit severity of illness was not associated with patients' retrospectively recalled baseline physical function. Patients with a lower level of education may be more influenced by ICU severity of illness, but the magnitude of this effect may not be clinically meaningful.
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Journal of critical care · Dec 2011
Clinical TrialA change in humidification system can eliminate endotracheal tube occlusion.
Inadequate airway humidification can result in endotracheal tube occlusion. There is evidence that heat and moisture exchangers (HMEs) are more prone to endotracheal tube occlusion than heated humidifiers (HHs) that contain a heated wire circuit. We aimed to compare the incidence of endotracheal tube occlusion while introducing a new dual-heated wire circuit HH in place of an established hydrophobic HME. ⋯ Our study demonstrates that there is a significant increase in the incidence of endotracheal tube occlusion when using a hydrophobic HME compared with an HH and that using a dual-heated wire circuit HH can eliminate endotracheal tube occlusion.
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Journal of critical care · Dec 2011
A multifaceted strategy to reduce inappropriate use of frozen plasma transfusions in the intensive care unit.
The purpose of this study is to determine the effect of a multifaceted behavior-change strategy on inappropriate use of frozen plasma (FP) transfusions in the intensive care unit (ICU). ⋯ The behavior-change strategy modestly improved appropriate use of FP transfusions in the ICU. Improving FP request form accuracy, completeness, and compliance may be required to achieve maximum effect and ensure sustainability.
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Journal of critical care · Dec 2011
Discrepancies in the RIFLE classification are due to the method used to assess the level of derangement of kidney function.
We hypothesized that RIFLE based on creatinine clearance (CrCl) is superior to that based on serum creatinine (sCr) or Cockroft-Gault (C-G) because it is an earlier marker of kidney dysfunction. ⋯ RIFLE classification using sCr or C-G at the third day of admission predicts outcome less accurately than with the use of CrCl. Because of the delay in the rise of sCr after a sudden glomerular filtration rate decrease, RIFLE based in CrCl may represent an advantage in terms of precocity.
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Journal of critical care · Dec 2011
Association between out-of-hospital emergency department transfer and poor hospital outcome in critically ill stroke patients.
Transfer of critically ill patients from outside emergency department has the potential for delaying the admission to the intensive care unit. We sought to determine the effect of outside emergency department transfer on hospital outcomes in critically ill patients with stroke. ⋯ These data suggest that in critically ill patients with stroke, transfer from outside emergency department is independently associated with poor outcome at hospital discharge. Further research is needed as to identify the potential causes for this effect.