Journal of critical care
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Journal of critical care · Dec 2013
Observational StudyPlasma mitochondrial DNA levels in patients with trauma and severe sepsis: Time course and the association with clinical status.
This study aimed to investigate the serial changes in plasma levels of mitochondrial DNA (mtDNA) in patients with trauma and severe sepsis and the mechanism of increase in mtDNA levels and the association between the levels and severity. ⋯ The levels of mtDNA were elevated during traumatic injury and severe sepsis, although time course and prognostic significance differed between the groups, suggesting that the mechanisms of mtDNA release into plasma differ.
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Journal of critical care · Dec 2013
Staff acceptance of a telemedicine intensive care unit program: A qualitative study.
We conducted an evaluation to identify factors related to intensive care unit (ICU) staff acceptance of a telemedicine ICU (Tele-ICU) program in preimplementation and postimplementation phases. ⋯ Telemedicine ICU implementation is complex. Time and resources should be allocated for local coordination, continuous needs assessment for Tele-ICU support, staff training, developing interpersonal relationships, and systems design and evaluation. Such efforts are likely to be rewarded with more rapid staff acceptance of this new technology.
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Journal of critical care · Dec 2013
Six-day postoperative impact of a standardized nurse observation and escalation protocol: A preintervention and postintervention study.
The purpose of the study is to determine the impact of a standardized nurse observation and escalation protocol on observation frequency, the measurement of vital signs, and the incidence of in-hospital mortality and resurgery. ⋯ The mean patient observation frequency per nursing shift increased from 0.9076 (95% confidence interval [CI], 0.8921-0.9231) preintervention to 0.9940 (95% CI, 0.9708-1.0172; P < .001) postintervention and was lower in case of 6-day postoperative mortality (0.6686 [95% CI, 0.4984-0.8388] vs other patients 0.9475 [95% CI, 0.9340-0.9610]; P = .003) or resurgery (0.8402 [95% CI, 0.7894-0.8909] vs other patients 0.9564 [95% CI, 0.9378-0.9657]; P = .003). The mean number of vital signs measured per observation episode increased from a mean of 1.81 (95% CI, 1.79-1.83) preintervention to 2.45 (95% CI, 2.39-2.51; P < .001) postintervention. The relative risk reduction was 73.7% (95% CI, 22.8-91.0; P = .015) for 6-day postoperative in-hospital mortality and 30.9% (95% CI, 9.5-47.2; P = .007) for 6-day postoperative resurgery.
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Journal of critical care · Dec 2013
A novel method of post-pyloric feeding tube placement at bedside.
Post-pyloric feeding tube placement is often difficult, and special equipment or peristalsis agents are used to aid insertion. Although several reports have described blind techniques for post-pyloric feeding-tube placement, no general consensus about method preference has been achieved. ⋯ With a novel technique, from the bedside, without special tools or drugs, we successfully placed post-pyloric feeding tubes. Essential points when inserting the tube are confirmation of the location of the tube tip by palpation of injected air, and to avoid deflection and looping.
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Journal of critical care · Dec 2013
Real-time sample entropy predicts life-saving interventions after the Boston Marathon bombing.
Identifying patients in need of a life-saving intervention (LSI) during a mass casualty event is a priority. We hypothesized that real-time, instantaneous sample entropy (SampEn) could predict the need for LSI in the Boston Marathon bombing victims. ⋯ Sample entropy strongly correlates with injury severity and predicts LSI after blast injuries sustained in the Boston Marathon bombings. Sample entropy may be a useful triage tool after blast injury.