Critical care medicine
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Critical care medicine · Sep 2016
Multicenter StudyCardiac Arrests Associated With Tracheal Intubations in PICUs: A Multicenter Cohort Study.
To determine the incidence and epidemiologic characteristics of cardiac arrests among tracheal intubations in PICUs. ⋯ Tracheal intubation-associated cardiac arrests occurred during 1.7% of PICU tracheal intubations. Tracheal intubation-associated cardiac arrests were much more common with tracheal intubations when the child had acute hemodynamic instability or oxygen failure and when the child had a history of difficult airway or cardiac disease.
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Critical care medicine · Sep 2016
Measuring Adaptive Coping of Hospitalized Patients With a Severe Medical Condition: The Sickness Insight in Coping Questionnaire.
Adaptive coping strategies are associated with less psychological distress. However, there is no brief, specific, and validated instrument for assessing adaptive coping among seriously ill patients. Our objective was to examine the validity and patient-proxy agreement of a novel instrument, the Sickness Insight in Coping Questionnaire. ⋯ Overall, the Sickness Insight in Coping Questionnaire has good psychometric properties. ICU clinicians can use the Sickness Insight in Coping Questionnaire to gain insight in adaptive coping style of patients through ratings of patients or their close family members.
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Critical care medicine · Sep 2016
Observational StudyGlycated Hemoglobin A1c Levels Are Not Affected by Critical Illness.
Glycated hemoglobin A1c is used to estimate glycemic control. However, its value upon ICU admission may be altered by critical illness and not reflect true glycemic status. We assessed the relationship between ICU admission glycated hemoglobin A1c and premorbid glycated hemoglobin A1c levels. ⋯ Glycated hemoglobin A1c levels are not altered by the onset of critical illness. Glycated hemoglobin A1c quantified at ICU admission can, therefore, be used to reliably estimate chronic glycemic control and guide acute glycemic therapy.
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Critical care medicine · Sep 2016
Observational StudyRelationship Between African-American Race and Delirium in the ICU.
Delirium is a highly prevalent syndrome of acute brain dysfunction among critically ill patients that has been linked to multiple risk factors, such as age, preexisting cognitive impairment, and use of sedatives; but to date, the relationship between race and delirium is unclear. We conducted this study to identify whether African-American race is a risk factor for developing ICU delirium. ⋯ African-American race does not confer any additional risk for developing incident or prevalent delirium in the ICU. Instead, younger African Americans tend to have lower rates of incident delirium compared with Caucasians of similar age.
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Critical care medicine · Sep 2016
From Pediatrics to Geriatrics: Toward a Unified Standardized Screening Tool for Delirium: A Thought Experiment.
We aim to provide evidence for our view that a single, standardized (and preferably observational) screening tool for delirium should be used in patients of all ages (children, adults, and the elderly). ⋯ The proposed screening tools (Cornell Assessment of Pediatric Delirium and Delirium Observation Screening) entail all main diagnostic criteria, and so they are conceptually valid translations of delirium into operational terms. Given the much greater overlap than difference in this neuropsychiatric context of critical illness between children on the one hand and adults and elderly on the other, we propose that these tools would be ideal as the unified standardized screening tool.