Journal of critical care
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Journal of critical care · Mar 2010
Factors associated with anemia in patients with cancer admitted to an intensive care unit.
The study aimed to evaluate the relative impact of clinical and demographic factors associated with the prevalence and incidence of anemia (hemoglobin [Hb] <12 g/dL) in critically ill patients with cancer. ⋯ Clinical factors are more influential than demographic factors in the observed rates of prevalence and incidence of anemia in the ICU; thus, protocols are needed to identify subgroups of patients with cancer who could benefit from novel management strategies.
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Journal of critical care · Mar 2010
Study of device use adjusted rates in health care-associated infections after implementation of "bundles" in a closed-model medical intensive care unit.
"Bundles" strategies improve health care-associated infection (HCAI) rates in medical intensive care units (MICUs). However, few studies have analyzed HCAI rates adjusted for the device removal component of the bundles. An observational study of adult MICU patients while using bundles to prevent HCAIs associated with endovascular catheters, mechanical ventilation, and urinary tract catheters was conducted. ⋯ Ventilator-associated pneumonia (VAP) per 1000 ventilator days diminished from 2.17 to 0.62 (uIRR, 0.29; 95% CI, 0.21-0.38; P < .0001). After adjustment for device use, aIRRs of CRBSI (0.14; 95% CI, 0.11-0.18), UTI (0.09; 95% CI, 0.06-0.12), and VAP (0.33; 95% CI, 0.22-0.47) declined significantly (P < .00001). Implementing comprehensive bundle strategies reduces HCAI beyond the impact of device removal.
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The study aimed to examine query strategies that would provide an exhaustive search method to retrieve the most referenced articles within specific categories of critical care. ⋯ Retrieving frequently cited, influential articles in critical care requires using multiple search terms and manuscript sources. Periodic compilations of most cited articles may be useful for critical care practitioners and researches to keep abreast of important information.
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Journal of critical care · Mar 2010
Usefulness of intra-abdominal pressure in a predominantly medical intensive care unit.
The deleterious effects of elevated intra-abdominal pressure (IAP) have been known for more than a century. The proposed objectives were to measure changes in IAP and analyze increase-related factors and complications and whether high IAP and its persistence are related to complications and mortality in a predominantly medical intensive care unit. ⋯ In this study, a threshold IAP of 20 mm Hg and its permanence over time were the best predictive factors of complications and mortality. Among other relationships, we also observed that older patients had higher IAP. High IAP was a cause of intolerance to enteral nutrition.
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Journal of critical care · Mar 2010
Insight in microcirculation and histomorphology during burn shock treatment using in vivo confocal-laser-scanning microscopy.
Microcirculatory disturbances are well known during shock; however, the accompanied histomorphological alterations are widely unknown. We used high resolution confocal-laser-scanning microscopy for the evaluation of microcirculation and histomorphology during Burn Shock treatment. ⋯ Confocal-laser-scanning microscopy provides a noninvasive tool for simultaneous evaluation of microcirculation and tissue histomorphology. It may help to assess the adequacy of and response to resuscitation of burn patients early after trauma.