Critical care medicine
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Critical care medicine · Mar 2014
Cornell Assessment of Pediatric Delirium: A Valid, Rapid, Observational Tool for Screening Delirium in the PICU.
To determine validity and reliability of the Cornell Assessment of Pediatric Delirium, a rapid observational screening tool. ⋯ With an overall prevalence rate of 20.6% in our study population, delirium is a common problem in pediatric critical care. The Cornell Assessment of Pediatric Delirium is a valid, rapid, observational nursing screen that is urgently needed for the detection of delirium in PICU settings.
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Critical care medicine · Mar 2014
Monitoring of Spinal Cord Perfusion Pressure in Acute Spinal Cord Injury: Initial Findings of the Injured Spinal Cord Pressure Evaluation Study.
To develop a technique for continuously monitoring intraspinal pressure at the injury site (intraspinal pressure) after traumatic spinal cord injury. ⋯ Our findings provide proof-of-principle that subdural intraspinal pressure at the injury site can be measured safely after traumatic spinal cord injury.
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Critical care medicine · Mar 2014
Comparative StudyLung Injury and Its Prognostic Significance in Acute Liver Failure.
Hypoxemia is a feared complication of acute liver failure, and high oxygen requirements will frequently lead to removal of patients from the transplant list. As data regarding the prevalence and outcome of acute respiratory distress syndrome in acute liver failure are scant and hypoxemia being a commonly encountered systemic complication, we analyzed radiological, gas exchange, and ventilator data in consecutive patients admitted with acute liver failure. ⋯ The prevalence of lung injury is relatively low in acute liver failure, where 21% fulfilled acute respiratory distress syndrome criteria. Overall presence of acute respiratory distress syndrome appeared to have a limited impact on outcome.
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Critical care medicine · Mar 2014
Comparative StudyComparison of the Mortality Probability Admission Model III, National Quality Forum, and Acute Physiology and Chronic Health Evaluation IV Hospital Mortality Models: Implications for National Benchmarking.
To examine the accuracy of the original Mortality Probability Admission Model III, ICU Outcomes Model/National Quality Forum modification of Mortality Probability Admission Model III, and Acute Physiology and Chronic Health Evaluation IVa models for comparing observed and risk-adjusted hospital mortality predictions. ⋯ Acute Physiology and Chronic Health Evaluation IVa offered the best discrimination and calibration on a large common dataset and excluded fewer patients than Mortality Probability Admission Model III or ICU Outcomes Model/National Quality Forum. The choice of ICU performance benchmarks should be based on a comparison of model accuracy using data for identical patients.
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Critical care medicine · Mar 2014
Observational StudyCentral Venous Catheter Placement by Advanced Practice Nurses Demonstrates Low Procedural Complication and Infection Rates-A Report From 13 Years of Service.
To report procedural characteristics and outcomes from a central venous catheter placement service operated by advanced practice nurses. ⋯ This report has demonstrated low complication rates for a hospital-wide service delivered by advance practice nurses. The results suggest that a centrally based service with specifically trained operators can be beneficial by potentially improving patient safety and promoting organizational efficiencies.