Journal of critical care
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Journal of critical care · Sep 2007
Multicenter StudyA multicenter survey of Ontario intensive care unit nurses regarding the use of sedatives and analgesics for adults receiving mechanical ventilation.
Nursing-directed sedation protocols have been shown to reduce the duration of mechanical ventilation and shorten the length of intensive care unit (ICU) stay among critically ill adult patients. ⋯ In this survey of ICU nurses, we identified a perceived need for improvement in sedation and analgesia practices. Most respondents believed that the use of a nursing-directed sedation protocol in combination with a sedation scoring system would provide greater practice consistency among nurses and physicians and thus improve the care of critically ill patients.
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Journal of critical care · Sep 2007
Comparative StudyInvasive candidiasis treated in the intensive care unit: observations from a randomized clinical trial.
The objectives of this study were to contrast risk factors, microbiology, and outcomes in patients with invasive candidiasis treated in an intensive care unit (ICU) with those in patients with invasive candidiasis treated outside an ICU and to describe therapeutic results with caspofungin in ICU patients. ⋯ In ICU patients treated with antifungal therapy, invasive candidiasis is associated with substantial mortality, but most deaths cannot be directly attributed to this infection.
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Journal of critical care · Sep 2007
Sedation and weaning from mechanical ventilation: effects of process optimization outside a clinical trial.
We studied the effects of reorganization and changes in the care process, including use of protocols for sedation and weaning from mechanical ventilation, on the use of sedative and analgesic drugs and on length of respiratory support and stay in the intensive care unit (ICU). ⋯ Changes in organizational and care processes were associated with an altered pattern of sedative and analgesic drug prescription, a decrease in length of (noninvasive) respiratory support and length of stay in survivors, and decreases in resource use as measured by TISS-28 and mortality.
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Journal of critical care · Sep 2007
Multicenter Study Comparative StudyIntensive care unit safety incidents for medical versus surgical patients: a prospective multicenter study.
The aim of this study is to determine if patient safety incidents and the system-related factors contributing to them systematically differ for medical versus surgical patients in intensive care units. ⋯ Medical and surgical patients in the intensive care unit experience very similar types of safety incidents with similar associated patient harm and system factors. Common initiatives to improve patient safety for medical and surgical patients should be undertaken with a specific focus on improving training and teamwork among the intensive care team.
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Journal of critical care · Sep 2007
Multicenter Study Comparative StudyThe COASST study: cost-effectiveness of albumin in severe sepsis and septic shock.
The cost-effectiveness of albumin-based fluid support in patients with severe sepsis is not known. ⋯ The application of the SAFE Study results to CUB-Réa data shows that albumin infusion is cost-effective in severe sepsis.