Journal of critical care
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Journal of critical care · Dec 2006
Impact of chloride balance in acidosis control: the Stewart approach in hemodialysis critically ill patients.
Metabolic acidosis is highly prevalent in critically ill patients with acute renal failure. Little is known about the mechanisms by which renal replacement therapy intervenes in such cases. The objective of this study is to analyze the role of hemodialysis in acidosis correction in intensive care unit patients, with an emphasis on chloride levels in plasma and dialysate. ⋯ The serum chloride/dialysate chloride relationship during hemodialysis has an important impact on acidosis control.
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Journal of critical care · Sep 2006
ReviewThe checklist--a tool for error management and performance improvement.
Levels of cognitive function are often compromised with increasing levels of stress and fatigue, as is often the norm in certain complex, high-intensity fields of work. Aviation, aeronautics, and product manufacturing have come to rely heavily on checklists to aid in reducing human error. ⋯ Despite demonstrated benefits of checklists in medicine and critical care, the integration of checklists into practice has not been as rapid and widespread as with other fields. This narrative is a guide to the evolution of medical and critical care checklists, and a discussion of the barriers and risks to the implementation of checklists.
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Journal of critical care · Sep 2006
C-reactive protein concentration as a predictor of intensive care unit readmission: a nested case-control study.
The purpose of this study is to assess the ability of potential clinical predictors and inflammatory markers to predict intensive care unit (ICU) readmission during the same hospitalization. ⋯ A high CRP concentration within 24 hours before ICU discharge is associated with a higher risk of readmission to the ICU.
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Journal of critical care · Sep 2006
The Pediatric Early Warning System score: a severity of illness score to predict urgent medical need in hospitalized children.
We developed and performed the initial retrospective validation of a pediatric severity of illness score. The score is to preemptively identify hospitalized children who are likely to require resuscitation to treat cardiopulmonary arrest. ⋯ Application of the score may have identified more than 3 quarters of code blue calls in our hospital with at least an hour's warning. After further refinement and validation, the PEWS score has great potential to increase the efficiency of care delivery and to improve the outcomes of care provided to hospitalized children.