Journal of critical care
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Journal of critical care · Oct 2013
Acute respiratory distress syndrome: Underrecognition by clinicians.
Previous reports suggest that acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is underdiagnosed in both adult and pediatric clinical practice. Underrecognition of this condition may be a barrier to instituting a low tidal volume ventilation strategy. This study aimed to determine the accuracy of clinical diagnoses of ARDS in daily practice using the American European Consensus Conference (AECC) criteria as a criterion standard and to investigate whether clinical recognition of ARDS altered ventilator management. ⋯ Acute respiratory distress syndrome is underrecognized by clinicians in ICU, and recognition does not result in lower tidal volume ventilation. Significant barriers remain to the recognition of ALI/ARDS and application of an evidence-based ventilator strategy.
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Journal of critical care · Oct 2013
Ionized hypocalcemia is an early event and is associated with organ dysfunction in children admitted to the intensive care unit.
The purpose was to determine the frequency and risk factors of ionized hypocalcemia and to evaluate this disturbance as a predictor of mortality in a pediatric intensive care unit (ICU). ⋯ Ionized hypocalcemia is common during the ICU stay, particularly in the first 3 days of admission. This disturbance was not found to be a predictor of mortality, but it is independently associated with more severe organ dysfunction.
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Journal of critical care · Oct 2013
Is vitamin D deficiency associated with development of Acinetobacter baumannii infections in critically ill patients?
A growing number of evidence demonstrates deficiency of vitamin D in critically ill patients. We aimed to evaluate the vitamin D status of our critically ill patients and its relevance to infections in these patients. ⋯ Vitamin D deficiency is common in critically ill patients. Even though there was no statistical difference between vitamin D deficient and sufficient patients regarding development of infections in general, A baumannii infections were significantly more frequent in the deficient group. Vitamin D deficiency was found as one of the independent risk factors for A baumannii infections. Further multicenter studies with a larger sample size are required to validate our data.
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Journal of critical care · Oct 2013
Evaluation of hemostatic biomarker abnormalities that precede platelet count decline in critically ill patients with sepsis.
The hemostatic biomarkers for early diagnosis of sepsis-associated coagulopathy have not been identified. The purpose of this study was to evaluate hemostatic biomarker abnormalities preceding a decrease in platelet count, which is a surrogate indicator of overt coagulopathy in sepsis. ⋯ Decreased PC and α2-PI activity preceded a decrease in platelet count in intensive care unit patients with sepsis.
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Journal of critical care · Oct 2013
Measuring safety culture in Palestinian neonatal intensive care units using the Safety Attitudes Questionnaire.
This study aimed to measure safety culture, examine variations among neonatal intensive care units (NICUs), and assess the associations with caregiver characteristics. ⋯ We found large variations in safety culture within and between a comprehensive sample of Palestinian NICUs. The findings suggest the need for a customized approach that builds on existing strengths and targets areas of opportunities for improvement to optimize health care delivery to the most vulnerable of patients, sick newborns in the NICU setting.