Journal of critical care
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Journal of critical care · Aug 2011
Colorimetric capnography, a new procedure to ensure correct feeding tube placement in the intensive care unit: an evaluation of a local protocol.
Radiography is the criterion standard method to ensure correct placement of a feeding tube. Recently, excellent results were reported using a combination of colorimetric capnography and epigastric auscultation, but the impact of this technique has not been studied to date. Objectives were to assess whether our local procedure, using colorimetric capnography to ensure proper feeding tube placement, improves the patient's care, satisfies nurses, and decreases costs compared with the standard procedure requiring systematic radiography. ⋯ The use of colorimetric capnography and epigastric auscultation to confirm feeding tube placement improves nurse's organization of care, saves time, and decreases costs.
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Journal of critical care · Aug 2011
Comparative StudyDynamic response of liquid-filled catheter systems for measurement of blood pressure: precision of measurements and reliability of the Pressure Recording Analytical Method with different disposable systems.
We aimed to compare the effects of a blood pressure transducer system specifically manufactured to limit underdamping artifacts with those of a standard system on hemodynamic parameter estimation and accuracy. ⋯ Underdamping/resonance artifacts frequently affect blood pressure measurement in operating rooms and intensive care units and cause severe overestimation of systolic blood pressure and incorrect estimation of hemodynamic parameters when the pulse contour method is used.
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Journal of critical care · Aug 2011
Increasing patient safety event reporting in 2 intensive care units: a prospective interventional study.
The aims of this study were to increase the reporting of patient safety events and to enhance report analysis and responsive action. ⋯ After the introduction of this new approach, reporting rates have increased significantly throughout the first year. Differences in reporting rates among workers and units may reveal priorities and barriers to reporting. The integrated approach facilitated prompt response to selected reports.
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Journal of critical care · Aug 2011
Patient factors associated with transfusion practices in Veterans Affairs intensive care units: implications for further research.
We sought to describe how patient characteristics influence the frequency of red blood cell (RBC) transfusions among critically ill patients after taking into account hemoglobin (Hgb) level. ⋯ Intensive care unit patients admitted for AMI, unstable angina, and congestive heart-failure had higher likelihood of receiving RBC transfusions below specific Hgb levels varying from 6 to 11 g/dL. Further research is needed to determine how these transfusion practices influence outcomes.
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Journal of critical care · Aug 2011
Herpes simplex virus: a marker of severity in bacterial ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units and has a high morbidity and mortality rate. It is mainly a bacterial disease, although the potential role of viruses as pathogens or copathogens in VAP is under discussion. Our study aims were to determine the incidence of herpes simplex virus (HSV) in the lower respiratory tract (LRT) secretions in patients with bacterial VAP and to assess its potential clinical relevance. ⋯ Herpes simplex virus excretion in LRT secretions is not infrequent in VAP, and it is associated with greater severity and worse prognosis.