Journal of critical care
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Journal of critical care · Jun 2009
Construction of a parent satisfaction instrument: perceptions of pediatric intensive care nurses and physicians.
The aims of the study were (1) to identify parental satisfaction items through the opinions of pediatric intensive care unit (PICU) nurses and physicians, (2) to reach consensus on the identified items, and (3) to apply factor analysis to evaluate the items and domains toward a PICU parental satisfaction instrument. ⋯ Priorities in parental satisfaction measures are identified. The findings are fundamental in the development of a PICU parental satisfaction instrument.
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Journal of critical care · Jun 2009
Age differences in survival outcomes and resource use for chronically critically ill patients.
Chronically critically ill (CCI) patients use a disproportionate amount of resources, yet little research has examined outcomes for older CCI patients. The purpose of this study was to compare outcomes (mortality, disposition, posthospital resource use) between older (> or =65 years) and middle-aged (45-64 years) patients who require more than 96 hours of mechanical ventilation while in the intensive care unit. ⋯ Older subjects were at higher risk of overall mortality and used, on average, more postdischarge services per patient when compared with middle-aged subjects.
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Journal of critical care · Jun 2009
Positive end-expiratory pressure alters the severity and spatial heterogeneity of ventilator-induced lung injury: an argument for cyclical airway collapse.
Ventilator-induced lung injury (VILI) is a recognized complication of mechanical ventilation. Although the specific mechanism by which mechanical ventilation causes lung injury remains an active area of study, both alveolar overdistension and cyclical airway collapse and recruitment have been suggested as contributing causes. We hypothesized that mechanical ventilation in the absence of positive end-expiratory pressure (PEEP) causes VILI to be more severe and regionally variable as compared with PEEP = 8 cm H(2)O. ⋯ These results suggest that VILI is regionally heterogeneous and spatially correlates with regions in which cyclical airway collapse and recruitment is most likely to occur.
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Journal of critical care · Jun 2009
Passive decision-making preference is associated with anxiety and depression in relatives of patients in the intensive care unit.
The objectives were to describe the decision-making preferences of relatives (family members) of patients in intensive care units (ICUs), to determine whether the relatives had symptoms of anxiety and depression while the patients were in the ICU, and to determine whether there was a relationship between the relatives' preferences and symptoms. ⋯ The relatives who preferred a passive decision-making role were the most likely to be anxious and depressed.
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Journal of critical care · Jun 2009
Vascular endothelial growth factor receptor and coreceptor expression in human acute respiratory distress syndrome.
Acute respiratory distress syndrome (ARDS) is characterized by the development of noncardiogenic pulmonary edema, which has been related to the bioactivity of vascular endothelial growth factor (VEGF). Vascular endothelial growth factor receptors and coreceptors regulate this bioactivity. We hypothesized VEGF receptors 1 and 2 (VEGFR1, VEGFR2) and coreceptor neuropilin-1 (NRP-1) would be expressed in human lung tissue with a significant change in expression in ARDS lung. ⋯ Differential temporal VEGFR1, VEGFR2, and NRP-1 up-regulation occurs in human ARDS, providing evidence of further functional regulation of VEGF bioactivity via VEGFR2 consistent with a protective role for VEGF in lung injury recovery. The mechanisms behind these observations remain to be clarified.