Crit Care Resusc
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To develop methods for distinguishing patients with in-hospital cardiac arrest (IHCA) from patients with out-of-hospital cardiac arrest (OHCA) in routinely collected intensive care unit registry data, and to explore the utility of the methods for describing trends in adult ICU cardiac arrest (CA) admissions and outcomes. ⋯ Use of routinely collected registry data uncovered important trends in adult ICU admission and survival rates for patients with IHCA and OHCA. The improved survival rates and increased number of admissions to tertiary centres requires further study to understand mechanisms and related factors.
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To compare the admission characteristics, discharge destination and mortality of patients reviewed by the rapid response team (RRT) for deterioration with those of other hospital patients; and to determine the association between RRT review for deterioration and mortality. ⋯ Patients reviewed for deterioration were older and had greater comorbidity than patients the RRT was not called to review. RRT review for deterioration was an independent risk factor for mortality.
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Review
Informed consent for procedures in the intensive care unit: ethical and practical considerations.
There is increasing interest in procedural consent (informed consent for invasive procedures) in the intensive care unit. We reviewed studies of procedural consent and show that it is not yet routine practice to obtain consent before performing invasive procedures on ICU patients. We considered logistical barriers to procedural consent in the critical care environment and the ethical implications of introducing routine procedural consent to the ICU.
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To determine the accuracy of multidetector computed tomography (MDCT) in the diagnosis of nonocclusive mesenteric ischaemia (NOMI) among patients after cardiovascular surgery. ⋯ MDCT has high sensitivity but lacks specificity in the diagnosis of NOMI. Its main value is in selection of patients for non-operative management, at least in the short-to-medium term.