Journal of critical care
-
Journal of critical care · Apr 2011
Toward less sedation in the intensive care unit: a prospective observational study.
Excessive sedation is associated with prolonged mechanical ventilation and longer intensive care unit (ICU) and hospital stays. We evaluated the feasibility of using minimal sedation in the ICU. ⋯ In a mixed medical-surgical ICU, minimal use of continuous sedation seems feasible without apparent adverse effects.
-
Journal of critical care · Apr 2011
Diazepam as a component of goal-directed sedation in critically ill trauma patients.
Limited information addressing the safety and efficacy of diazepam in the intensive care unit, particularly in trauma patients, is available. The purpose of this study is to evaluate the safety and efficacy of diazepam when used in routine clinical practice as a component of a goal-directed sedation regimen in critically ill trauma patients. ⋯ Based on this limited sample, the use of diazepam as a component of goal-directed therapy appears safe and effective in providing adequate sedation in critically ill trauma patients using an average dosage of 40 mg/d.
-
Journal of critical care · Apr 2011
Intraoperative adherence to a low tidal volume ventilation strategy in critically ill patients with preexisting acute lung injury.
Low tidal volume (LTV) ventilation reduces mortality in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). This study investigates adherence of intraoperative LTV and whether patient outcomes were different with or without continued intraoperative LTV ventilation in patients with previously established ALI or ARDS. ⋯ Adherence to intraoperative LTV in surgical patients was low. Adherence of LTV intraoperatively was not associated with improved oxygenation, reductions in hospital length of stay, or in-hospital mortality. The importance of adhering to an intraoperative LTV strategy remains unclear.
-
Journal of critical care · Apr 2011
Validation of the Intensive Care Delirium Screening Checklist in nonintubated intensive care unit patients in a resource-poor medical intensive care setting in South India.
Delirium is a common, difficult-to-diagnose clinical condition in critical care units. The lack of recognition of delirium often results in increased morbidity and mortality. The study aimed to determine the validity and reliability of the Intensive Care Delirium Screening Checklist (ICDSC) in a resource-poor medical intensive care setting in South India. ⋯ Our findings indicate that in nonintubated intensive care unit patients, the ICDSC can be used to screen for delirium but should not be used as a diagnostic instrument in this patient population and that residents can be trained in the use of the instrument in resource-poor critical care settings. Using a different threshold for positivity of 3 rather than 4 appeared to offer improved screening characteristics in this resource-poor critical care setting.
-
Journal of critical care · Apr 2011
Multicenter StudyA prediction survival model for out-of-hospital cardiopulmonary resuscitations.
The aims of this study were to double check old (Resuscitation Predictor Scoring [RPS], Advanced Cardiac Life Support, and Early Prediction Score [EPS]) and form new (Serbian Quality of Life immediately [SR-QOLi], Serbian Quality of Life short-term [SR-QOLs], and Serbian Quality of Life long-term [SR-QOLl]) scores for survival prediction in out-of-hospital cardiopulmonary resuscitation (OHCPR) in Serbia. ⋯ In the course of the research, SR-QOL models were created for prediction of the immediate (SR-QOLi), short-term (SR-QOLs), and long-term (SR-QOLl) survival after the OHCPR, better predictions in our environment.