Journal of critical care
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Journal of critical care · Dec 2006
Multicenter StudyContradictions and communication strategies during end-of-life decision making in the intensive care unit.
The aim of this study was to identify inherent tensions that arose during family conferences in the intensive care unit, and the communication strategies clinicians used in response. ⋯ This study offered insights into end-of-life decision making, prompting clinicians to be conscious of the contradictions that arise and to use specific strategies to address these contradictions in their communication with families.
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Journal of critical care · Dec 2006
Multicenter StudyToward learning from patient safety reporting systems.
To evaluate the frequency and type of factors involved in incidents reported to a patient safety reporting system and answer specific questions to enhance the value of PSRS data to improve patient safety. ⋯ The Intensive Care Unit Safety Reporting System provides a mechanism for multiple ICUs to identify hazards. Data trends show a correlation between multiple contributing factors and higher rates of harm. Further research is needed to help determine how to use PSRS data to improve patient safety.
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Journal of critical care · Dec 2006
Isolation of Aspergillus in critically ill patients: a potential marker of poor outcome.
Recent reports have suggested a rising incidence of pulmonary aspergillosis in intensive care unit (ICU) patients. The aim of this study was to determine the clinical significance of isolating Aspergillus from respiratory samples of critically ill patients. ⋯ Isolation of Aspergillus in critically ill patients is a poor prognostic marker and is associated with high mortality irrespective of invasion or colonization. Those who are neutropenic, on immunosuppressive therapy, on broad-spectrum antibiotics, or had bone marrow transplantation are more likely to have invasive pulmonary aspergillosis.
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Journal of critical care · Dec 2006
Impact of chloride balance in acidosis control: the Stewart approach in hemodialysis critically ill patients.
Metabolic acidosis is highly prevalent in critically ill patients with acute renal failure. Little is known about the mechanisms by which renal replacement therapy intervenes in such cases. The objective of this study is to analyze the role of hemodialysis in acidosis correction in intensive care unit patients, with an emphasis on chloride levels in plasma and dialysate. ⋯ The serum chloride/dialysate chloride relationship during hemodialysis has an important impact on acidosis control.