Intensive care medicine
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Intensive care medicine · Jun 2007
Oral care practices in intensive care units: a survey of 59 European ICUs.
To explore the type and frequency of oral care practices in European ICUs and the attitudes, beliefs, and knowledge of health care workers. ⋯ In European ICUs oral care is considered very important. It is experienced as a task that is difficult to perform, and that does not necessarily succeed in ensuring oral health in patients with prolonged intubation. Oral care consists primarily of mouth washes. The use of toothbrushes should be given more attention.
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To compare available instruments for assessing delirium in critically ill adults that have undergone validity testing and provide clinicians with strategies to incorporate these instruments into clinical practice. ⋯ Incorporation of delirium assessment into clinical practice in the intensive care unit using a validated tool may improve patient care. Clinicians can adopt a number of different strategies to overcome the many barriers associated with routine delirium assessment in the ICU.
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Sepsis-associated delirium is a common and poorly understood neurological complication of sepsis. This review provides an update of the diagnostic criteria and treatment strategies and the current knowledge about the mechanisms involved in sepsis associated brain dysfunction. ⋯ The diagnosis of sepsis-associated delirium relies mainly on clinical and electrophysiological criteria, and its treatment is entirely based on general management of sepsis.
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Intensive care medicine · Jun 2007
Multicenter StudyPrecipitants of post-traumatic stress disorder following intensive care: a hypothesis generating study of diversity in care.
This prospective observational study was designed to explore the relationships between post-traumatic stress disorder (PTSD), patients' memories of the intensive care unit (ICU) and sedation practices. ⋯ The development of PTSD following critical illness is associated with a number of different precipitating factors that are in part related to how patients are cared for within intensive care. This study raises the hypothesis that the impact of care within the ICU has an impact on subsequent psychological morbidity and therefore must be assessed in future studies looking at the way patients are sedated in the ICU and how physical restraint is used.
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Intensive care medicine · Jun 2007
Serum lactate as a predictor of mortality in patients with infection.
To determine the utility of an initial serum lactate measurement for identifying high risk of death in patients with infection. ⋯ When broadly implemented in routine practice, measurement of lactate in patients with infection and possible sepsis can affect assessment of mortality risk. Specifically, an initial lactate >or=4.0 mmol/l substantially increases the probability of acute-phase death.