Critical care medicine
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Critical care medicine · Jul 2006
Therapeutic hypothermia utilization among physicians after resuscitation from cardiac arrest.
We sought to evaluate current physician use of therapeutic hypothermia after cardiac arrest, to ascertain reasons for nonadoption of this treatment, and to determine current cooling techniques employed. ⋯ Physician utilization of cooling after cardiac arrest remains low. For improved adoption of therapeutic hypothermia, our data suggest that development of better cooling methodology and recent incorporation into resuscitation guidelines may improve use.
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Critical care medicine · Jul 2006
Impact of patient volume on the mortality rate of adult intensive care unit patients.
Expert task forces have proposed that adult critical care medicine services should be regionalized in order to improve outcomes. However, it is currently unknown if high intensive care unit (ICU) patient volumes are associated with reduced mortality rate. The objective was to investigate whether high-volume ICUs have better mortality outcomes than low-volume ICUs. ⋯ There is evidence that high ICU patient volumes are associated with lower mortality rates in high-risk critically ill adults.
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Critical care medicine · Jul 2006
Multicenter Study Clinical TrialFrom evidence to clinical practice: effective implementation of therapeutic hypothermia to improve patient outcome after cardiac arrest.
Therapeutic hypothermia has been recommended for postcardiac arrest coma due to ventricular fibrillation. However, no studies have evaluated whether therapeutic hypothermia could be effectively implemented in intensive care practice and whether it would improve the outcome of all comatose patients with cardiac arrest, including those with shock or with cardiac arrest due to nonventricular fibrillation rhythms. ⋯ Therapeutic hypothermia for the treatment of postcardiac arrest coma can be successfully implemented in intensive care practice with a major benefit on patient outcome, which appeared to be related to the type and the duration of initial cardiac arrest and seemed maintained in patients with shock.
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Critical care medicine · Jul 2006
Organizational climate and intensive care unit nurses' intention to leave.
The purposes of this study were to a) estimate the incidence of intensive care units nurses' intention to leave due to working conditions; and b) identify factors predicting this phenomenon. ⋯ Improving professional practice in the work environment and clinical competence of the nurses as well as supporting new hires may reduce turnover and help ensure a stable and qualified workforce.
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Critical care medicine · Jul 2006
A curriculum in critical care medicine for maternal-fetal medicine fellows.
Critical care education in maternal-fetal medicine has typically been limited or has been driven entirely by clinical cases. A pilot program was created to systematize critical care training within the context of an existing maternal-fetal medicine fellowship. ⋯ More structured critical care medicine training is feasible within a maternal-fetal medicine fellowship. A multimodal curriculum to teach critical care within a maternal-fetal medicine fellowship appears promising and could be implemented elsewhere. Interest in this area should be cultivated.