Journal of critical care
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Journal of critical care · Oct 2012
ReviewFever in non-neurological critically ill patients: a systematic review of observational studies.
There is no recommendation on how increased body temperature should be treated in non-neurological critically ill patients. To understand the epidemiology of fever and its association with mortality, we conducted a systematic review of the literature to search for data related to the association between fever and mortality. ⋯ The limited evidence available suggests that the recommended definition of fever (38.3°C) might be too low to predict increased mortality. Because fever is common in the intensive care unit, there is an urgent need for more studies in this field.
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Journal of critical care · Oct 2012
ReviewNoise in hospital intensive care units--a critical review of a critical topic.
The aims of the study were to examine the studies related to hospital noise in intensive care units (ICUs) to understand the sources and effects of noise and to describe best practices and common problems in the varying methods commonly applied to reduce the noise level. ⋯ Significant opportunities exist to improve methodologies to study noise levels to reduce noise in hospital ICUs. Many previous studies have used inconsistent methodologies with poorly defined parameters that make it difficult to compare results. Our work points out common pitfalls in the recording and sharing of hospital acoustic parameters and also points to the paucity of important economic considerations in extant studies. These results can be helpful for future research in this area. Many past salutary interventions--including educational noise reduction programs, behavioral modification using sound detection equipment, and low- as well as high-cost environmental alterations--do not generally appear to be adequate to minimize noise to levels for hospital rooms specified by international agencies. But a potentially important clue for future work involves the finding that as the number of patients and staff of the ICU increases, noise levels appear to also increase.
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Journal of critical care · Aug 2012
Review Meta AnalysisPrognostic value of extravascular lung water index in critically ill patients: a systematic review of the literature.
The prognostic value of extravascular lung water (EVLW) has been widely investigated; however, a wide range of its predictive accuracy has been reported. ⋯ The EVLWI appears to be a good predictor of mortality in critically ill patients.
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Journal of critical care · Aug 2012
ReviewLiberation of neurosurgical patients from mechanical ventilation and tracheostomy in neurocritical care.
Neurosurgical patients commonly require mechanical ventilation and monitoring in a neurocritical care unit. There are only few studies that specifically address the process of liberation from mechanical ventilation in this population. Patients who remain ventilator or artificial airway dependent receive a tracheostomy. ⋯ In this article, we review the general principles of liberation and the current literature as it pertains to neurosurgical patients with primary brain injury. The criteria for "readiness of extubation" include a combination of neurologic assessment, hemodynamic, and respiratory parameters. Future studies are required to better assess indicators for extubation readiness, evaluate the predictors of extubation failure in brain-injured patients, and define the most appropriate timing for a tracheostomy.
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Journal of critical care · Aug 2012
Review Meta AnalysisEfficacy of information interventions in reducing transfer anxiety from a critical care setting to a general ward: a systematic review and meta-analysis.
Our aim was to undertake a comprehensive systematic review on the efficacy of information interventions on reducing anxiety in patients and family members on transfer from a critical care setting to a general ward. ⋯ Providing information to understand a future ward environment can significantly reduce patients' and family members' transfer anxiety from the critical care setting when compared with standard care.