Critical care medicine
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Critical care medicine · Jul 2019
Untangling Infusion Confusion: A Comparative Evaluation of Interventions in a Simulated Intensive Care Setting.
Assess interventions' impact on preventing IV infusion identification and disconnection mix-ups. ⋯ The results suggest that line labels/organizers may increase infusion identification accuracy and efficiency.
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Critical care medicine · Jul 2019
Meta AnalysisEffect of Neurally Adjusted Ventilatory Assist on Patient-Ventilator Interaction in Mechanically Ventilated Adults: A Systematic Review and Meta-Analysis.
Neurally-adjusted ventilatory assist improves patient-ventilator synchrony although with uncertain effect on clinical outcome..
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Critical care medicine · Jul 2019
Randomized Controlled Trial Multicenter StudyLow-Dose Versus Therapeutic Anticoagulation in Patients on Extracorporeal Membrane Oxygenation: A Pilot Randomized Trial.
To determine whether randomization of patients undergoing extracorporeal membrane oxygenation to either therapeutic or a low-dose anticoagulation protocol results in a difference in activated partial thromboplastin time and anti-Xa. ⋯ Allocating patients on extracorporeal membrane oxygenation to two different anticoagulation protocols led to a significant difference in mean daily activated partial thromboplastin time and anti-Xa levels between groups. When considering subgroups analyses, these results were consistent in patients on venovenous extracorporeal membrane oxygenation. Our results support the feasibility of a larger trial in patients undergoing venovenous extracorporeal membrane oxygenation to compare different anticoagulation protocols; however, this study does not provide evidence on the optimal anticoagulation protocol for patients undergoing extracorporeal membrane oxygenation.
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Critical care medicine · Jul 2019
Staged Implementation of Awakening and Breathing, Coordination, Delirium Monitoring and Management, and Early Mobilization Bundle Improves Patient Outcomes and Reduces Hospital Costs.
To measure the impact of staged implementation of full versus partial ABCDE bundle on mechanical ventilation duration, ICU and hospital lengths of stay, and cost. ⋯ In a clinical practice setting, the addition of (E)arly mobilization and structured (C)oordination of ABCDE bundle components to a spontaneous (B)reathing, (A)wakening, and (D) elirium management background led to substantial reductions in the duration of mechanical ventilation, length of stay, and cost.
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Critical care medicine · Jul 2019
Observational StudyThe Effectiveness of α2Agonists As Sedatives in Pediatric Critical Care: A Propensity Score-Matched Cohort Study.
There is limited evidence supporting the widespread use of α2 agonists (clonidine and dexmedetomidine) in pediatric critical care sedation. This study sought to test the association between the use of α2 agonists and enhanced sedation. ⋯ Use of α2 agonists was associated with similar time adequately sedated as a matched unexposed group although no reduction in morphine or benzodiazepine coadministration was observed. There was a shift toward lighter sedation with α2 agonist use.