Articles: critical-illness.
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Anesthesia and analgesia · Dec 2024
Observational StudyPoor Concordance Between Intensive Care Unit Patients' and Family Members' Patient Dignity Inventory Scores Despite Communication of Dignity-Related Distress.
Promptly assessing and treating the distress of intensive care unit (ICU) patients may improve long-term psychological outcomes. One holistic approach to reduce patient distress is through dignity-centered care, traditionally used in palliative care. The 25-item Patient Dignity Inventory has construct validity and reliability for measuring dignity-related distress among ICU patients. Because family members often serve as ICU patients' surrogates and play an integral role in patients' dignity, we examined whether family members reliably recognized ICU patients' sources of distress. ⋯ Although ICU patients often report sharing sources of distress with their loved ones, family members cannot accurately or reliably assess the extent to which patients experience psychosocial, existential, and symptom-related distress during critical illness. Treatments of distress should not be delayed by the absence of family members.
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Detailed reports are scarce on minimally-invasive tracheostomy (MIT) techniques for critically ill patients with challenging anatomy or complex coagulopathies. In such high-risk patients, conventional percutaneous dilatational tracheostomy (PDT) may lead to severe complications. ⋯ The use of our refined care bundle enabled swift minimally-invasive tracheostomy in high-risk patients without the occurrence of serious complications.
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Journal of critical care · Dec 2024
One-year outcomes in COVID-19 and non-COVID-19 intensive care unit survivors.
To determine differences in one-year multi-domain health outcomes in COVID-19 and non-COVID-19 intensive care unit (ICU) survivors. ⋯ COVID-19 ICU survivors experience equal or less health problems but a greater decline in QoL one year after ICU admission compared to non-COVID-19 ARDS or pneumonia survivors.
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Management of neuraxial catheters mandates consideration of comorbid conditions requiring anticoagulation, which may complicate their management. Cangrelor is an intravenous P2Y12 inhibitor with a plasma half-life of 3 to 6 minutes. ⋯ We present a case of a patient with an epidural catheter in situ who became critically ill, requiring antiplatelet therapy with cangrelor. We discuss pertinent considerations of neuraxial techniques in patients requiring cangrelor therapy and review existing guidelines for the management of these patients as well as current evidence of the use of platelet function tests in this setting.