Journal of critical care
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Journal of critical care · Mar 2004
Comparative StudyComparison of a commercially available clinical information system with other methods of measuring critical care outcomes data.
To compare the quality of data recorded by a commercially available clinical information system (CIS) to other commonly used methods for obtaining large amounts of patient data. ⋯ Compared to other commonly used data sources for clinical research, a commercially available CIS is an acceptable source of ICU patient data.
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Journal of critical care · Mar 2004
ReviewInfluencing advance directive completion rates in non-terminally ill patients: a systematic review.
To conduct a systematic review of educational advance care planning interventions directed at patients without terminal illness to determine their influence on the completion rate of advance directives (AD). ⋯ Advance directive completion rates documenting patient preferences for end-of-life care may be increased by simple patient-directed educational interventions.
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Journal of critical care · Mar 2004
Randomized Controlled Trial Comparative Study Clinical TrialApplication of a cuirass and institution of biphasic extra-thoracic ventilation by gear-protected physicians.
To evaluate the speed by which cuirass application, followed by biphasic extra-thoracic ventilation, can be instituted by full anti-chemical protective gear-wearing physicians. ⋯ Physicians wearing full anti-chemical protective gear applied the cuirass and instituted biphasic extra-thoracic ventilation faster than ET intubation and manual positive pressure ventilation. Extra-thoracic ventilation should be further evaluated as an option for emergent respiratory support during toxic mass casualty events.
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Journal of critical care · Mar 2004
Comparative StudySerum levels of calcium and albumin in survivors versus nonsurvivors after critical injury.
Injured patients who require aggressive resuscitation with intravenous (IV) fluids and blood products will frequently acquire low levels of serum calcium (CA) and albumin (ALB) in the intensive care unit (ICU) as result of this therapy. The purpose of this longitudinal study was to determine the time course of CA and ALB during ICU admission in survivors (S) compared to nonsurvivors (N) after major trauma. The study design is to verify if CA, ALB, or albumin-corrected CA can be used as indicators of patient survivability after critical injury. ⋯ CA changes during ICU care demonstrate distinct response patterns (P <.00005) for survivors versus nonsurvivors. The magnitude of upward response in CA after the fluid resuscitation phase is a marker that correlates with a patient's ability to withstand the physiologic stresses encountered during ICU treatment after major trauma. Our findings indicate that uncorrected CA values are a better guide for calcium replacement therapy in trauma patients than albumin-adjusted CA. This study suggests that response patterns of CA can be a useful reference to aid in monitoring the progress of critically injured patients.