Critical care medicine
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Critical care medicine · Oct 2017
Association Between Survival and Time of Day for Rapid Response Team Calls in a National Registry.
Decreased staffing at nighttime is associated with worse outcomes in hospitalized patients. Rapid response teams were developed to decrease preventable harm by providing additional critical care resources to patients with clinical deterioration. We sought to determine whether rapid response team call frequency suffers from decreased utilization at night and how this is associated with patient outcomes. ⋯ Rapid response team activation is less frequent during the early morning and is followed by a spike in mortality in the 7 AM hour. These findings suggest that failure to rescue deteriorating patients is more common overnight. Strategies aimed at improving rapid response team utilization during these vulnerable hours may improve patient outcomes.
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Critical care medicine · Oct 2017
Acute Respiratory Distress Syndrome Due To Tuberculosis in a Respiratory ICU Over a 16-Year Period.
Whether tuberculosis-related acute respiratory distress syndrome is associated with worse outcomes when compared with acute respiratory distress syndrome secondary to other causes remains unknown. Herein, we compare the outcomes between the two groups. ⋯ Tuberculosis is an uncommon cause of acute respiratory distress syndrome even in high tuberculosis prevalence countries. Acute respiratory distress syndrome due to tuberculosis behaves like acute respiratory distress syndrome due to other causes and does not affect the ICU survival.
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Critical care medicine · Oct 2017
Does Admission to the ICU Prevent African American Disparities in Withdrawal of Life-Sustaining Treatment?
We sought to determine whether black patients admitted to an ICU were less likely than white patients to withdraw life-sustaining treatments. ⋯ This study suggests that Black patients may be less likely to withdraw life-supportive measures than whites, but that this disparity may be absent in patients who spend time in the ICU during their hospitalization.
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Critical care medicine · Oct 2017
Effectiveness and Safety of an Extended ICU Visitation Model for Delirium Prevention: A Before and After Study.
To evaluate the effect of an extended visitation model compared with a restricted visitation model on the occurrence of delirium among ICU patients. ⋯ In this medical-surgical ICU, an extended visitation model was associated with reduced occurrence of delirium and shorter length of delirium/coma and ICU stay.
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Critical care medicine · Oct 2017
Observational StudySingle-Operator Ultrasound-Guided Central Venous Catheter Insertion Verifies Proper Tip Placement.
To evaluate whether a single-operator ultrasound-guided, right-sided, central venous catheter insertion verifies proper placement and shortens time to catheter utilization. ⋯ A single-operator ultrasound-guided central venous catheter insertion is effective in verifying proper tip placement and shortens time to catheter utilization.