Critical care medicine
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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.
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Critical care medicine · Oct 2017
Quality Improvement Initiatives in Sepsis in an Emerging Country: Does the Institution's Main Source of Income Influence the Results? An Analysis of 21,103 Patients.
We aimed to assess the results of a quality improvement initiative in sepsis in an emerging setting and to analyze it according to the institutions' main source of income (public or private). ⋯ This quality improvement initiative in sepsis in an emerging country was associated with a reduction in mortality and with improved compliance with quality indicators. However, this reduction was sustained only in private institutions.
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Critical care medicine · Oct 2017
No Impact of Preadmission Anti-Inflammatory Drug Use on Risk of Depression and Anxiety After Critical Illness.
Risk of depression and anxiety is elevated after intensive care. Drugs with anti-inflammatory properties may have antidepressant and anxiolytic effects. The aim of this study was to investigate the association between preadmission use of drugs with anti-inflammatory effects and risk of new-onset depression and anxiety among adult patients admitted to an ICU. ⋯ Preadmission use of statins, nonsteroidal anti-inflammatory drugs, glucocorticoids, or combinations did not alter the risk of depression and anxiety after critical illness.
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Critical care medicine · Oct 2017
Observational StudyPatterns and Outcomes Associated With Timeliness of Initial Crystalloid Resuscitation in a Prospective Sepsis and Septic Shock Cohort.
The objectives of this study were to 1) assess patterns of early crystalloid resuscitation provided to sepsis and septic shock patients at initial presentation and 2) determine the association between time to initial crystalloid resuscitation with hospital mortality, mechanical ventilation, ICU utilization, and length of stay. ⋯ Crystalloid was initiated significantly later with comorbid heart failure and renal failure, with absence of fever or hypotension, and in inpatient-presenting sepsis. Earlier crystalloid initiation was associated with decreased mortality. Comorbidities and severity did not modify this effect.