Journal of critical care
-
Journal of critical care · Sep 2010
Factors associated with persistent delirium after intensive care unit admission in an older medical patient population.
This study was designed to identify factors associated with persistent delirium in an older medical intensive care unit (ICU) population. ⋯ Age, use of opioids, and haloperidol were associated with persistent delirium. Further research is needed regarding the use of haloperidol and opioids on persistent delirium.
-
Journal of critical care · Sep 2010
Limiting life-sustaining treatment in German intensive care units: a multiprofessional survey.
Deciding about the limitation of life-sustaining treatment (LST) is a major challenge for intensive care medicine. The aim of the study was to investigate the practices and perspectives of German intensive care nurses and physicians on limiting LST. ⋯ Limiting LST is common in German intensive care units. The major shortcomings are team communication, communication with the patient's family, and documentation of the decision-making process.
-
Journal of critical care · Sep 2010
The association between deprivation and hospital mortality for admissions to critical care units in England.
Few studies have investigated the association between level of social deprivation and acute hospital outcome for admissions to adult general critical care units. It is important to be aware if an association exists because risk prediction models do not adjust for deprivation. ⋯ There is an association between increasing deprivation and increasing risk of mortality for admissions to adult general critical care unit units in England. Further research is required to identify other unmeasured potential confounders (eg, smoking, alcohol consumption) as possible explanations for this association.
-
Journal of critical care · Sep 2010
Unplanned discharges from a surgical intensive care unit: readmissions and mortality.
There is great patient turnover every day on surgical intensive care units (SICUs). Surgical intensive care unit beds are provided for major elective surgery. Emergency admissions trigger unplanned discharges. Those patients are at risk for a worse outcome. ⋯ Earlier-than-planned discharge from a SICU leads to a substantially higher readmission rate. Readmission correlates with an elevated risk of death. Most readmissions in a surgical clinic are due to surgical complications. Readmission for respiratory failure accounts for most of the mortality.
-
Journal of critical care · Sep 2010
The "fever workup" and respiratory culture practice in critically ill trauma patients.
Fever and leukocytosis (FAL) in critically ill patients often triggers a "workup" that includes a respiratory secretion culture (RCx). We evaluated our respiratory culture practice associated with FAL. We hypothesized that FAL would be associated with a RCx, but would not be associated with a positive culture or treating a respiratory infection in critically injured patients during their first 14 intensive care unit (ICU) days. ⋯ Fever and leukocytosis were associated with the decision to obtain RCxs but were not associated with positive RCxs in our ICU practice. Respiratory secretion culture results had a low specificity and did not consistently impact treatment decisions. Factors other than fever and leukocytosis alone should influence the decision to obtain RCxs during the first 14 days in the ICU after trauma.