Journal of critical care
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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
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
Early levels in blood of immunoglobulin M and natural killer cells predict outcome in nonseptic critically ill patients.
Critical illness results in derangements of all components of the immune response. Nonetheless, most of the efforts evaluating immune status in critically ill patients have been done in the field of sepsis. Here we have evaluated the immunity status at intensive care unit (ICU) admission in a cohort of nonseptic critically ill patients and its influence on their outcome. ⋯ In conclusion, our results demonstrate that IgM plays a protective role in critically ill patients with no sepsis, whereas NK cell counts seem to play a deleterious one. Aging and severity at admission affect levels of key factors of the immune system in the blood of these patients.
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Journal of critical care · Dec 2013
Observational StudyEchocardiography to predict tolerance to negative fluid balance in acute respiratory distress syndrome/acute lung injury.
In acute respiratory distress syndrome (ARDS) and acute lung injury (ALI), a conservative fluid management strategy improves lung function but could jeopardize extrapulmonary organ perfusion. The objective was to evaluate the diagnostic accuracy of echocardiography to predict tolerance of negative fluid balance (NFB) in patients with ARDS/ALI. ⋯ The ratio of E/Ea accurately predicted tolerance of NFB in patients with ARDS/ALI.
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Journal of critical care · Dec 2013
Sagittal abdominal diameter may effectively predict future complications and increased mortality in intensive care unit patients with severe sepsis.
To investigate whether increased visceral adipose tissue is a risk factor for increased morbidity and mortality in intensive care patients with severe sepsis. ⋯ An increased SAD may effectively predict future complications and increased mortality in intensive care unit patients with severe sepsis.