American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial Multicenter Study
Serum Albumin Level at Intensive Care Unit Admission and Delirium Duration and Severity in Critically Ill Adults.
Hypoalbuminemia has been associated with an increased risk of in-hospital delirium. However, the relationship between serum albumin levels and the duration and severity of delirium is not well defined. ⋯ In patients with delirium, higher albumin levels were associated with shorter hospital stays but not with delirium duration or severity.
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Multicenter Study
Transitioning to Palliative Care in an Italian Cardiac Intensive Care Unit Network.
Recent data indicate that end-of-life management for patients affected by acute decompensated heart failure in cardiac intensive care units is aggressive, with late or no engagement of palliative care teams. ⋯ Therapy-limiting practices, including ICD deactivation, are not routine in the Italian centers participating in this study. The results emphasize the importance of integrating palliative care as a simultaneous process with intensive care to address the unmet needs of these patients and their families.
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Multicenter Study
Association of Lack of Fear of Dying With New Organ Failure: Results of a Multicenter Prospective Cohort Study.
Patients' anxiety on intensive care unit (ICU) admission is associated with subsequent deterioration. ⋯ Absence of fear of dying is associated with new organ failure within the first 7 days after ICU admission. Fear of dying may protect against subsequent deterioration by mobilizing patients' homeostatic resources. ClinicalTrials.gov Identifier: NCT02355626.
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Multicenter Study
Decreased Incidence of Rib Fractures in Pregnant Patients After Motor Vehicle Collisions.
Rib fractures are common after motor vehicle collisions. The hormonal changes associated with pregnancy decrease the stiffness and increase the laxity of cartilage and tendons. The effect of these changes on injury mechanics is not completely understood. ⋯ Pregnant patients have a lower rate of rib fracture after a motor vehicle collision than nonpregnant patients. The difference in injury mechanics may be due to hormonal changes that increase elasticity and resistance to bony injury of the ribs. In pregnant trauma patients, intrathoracic injury without rib fracture should raise concerns about injury severity. A multicenter evaluation of these findings is needed.
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Randomized Controlled Trial Multicenter Study
Patients' Adaptations After Acute Respiratory Distress Syndrome: A Qualitative Study.
Many patients confront physical, cognitive, and emotional problems after acute respiratory distress syndrome (ARDS). No proven therapies for these problems exist, and many patients manage new disability and recovery with little formal support. Eliciting patients' adaptations to these problems after hospitalization may identify opportunities to improve recovery. ⋯ Patients employed various strategies to manage problems after ARDS. More work is needed to identify and disseminate effective strategies to patients and their families.