Journal of critical care
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Journal of critical care · Aug 2013
Impact of bed availability on requesting and offering in-hospital intensive care unit transfers: a survey study of generalists and intensivists.
To evaluate whether bed availability affects a physician's decision to request or offer an intensive care unit (ICU) transfer. ⋯ There is high variability in the decision to request or offer ICU beds. There was not a significant association between bed availability and ICU transfer decisions.
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Journal of critical care · Aug 2013
Acinetobacter baumannii infection was decreased by the structural renovation of a medical intensive care unit.
The study aimed to determine whether improvements in intensive care unit (ICU) structural environment affect the incidence of ICU-acquired infections (IAIs), particularly those caused by multidrug-resistant pathogens. ⋯ These results suggest that structural ICU renovations only may not improve overall IAI incidence, except for transient decrease in IAI by A baumannii.
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Journal of critical care · Aug 2013
Low-tidal volume mechanical ventilation in patients with acute respiratory distress syndrome caused by pandemic influenza A/H1N1 infection.
Low-tidal volume (TV) mechanical ventilation is an important manipulation in managing patients with acute respiratory distress syndrome (ARDS). However, there is no definite evidence to support the use of this intervention in patients with viral etiologies. ⋯ Low-TV mechanical ventilation still benefits patients with ARDS caused by viral pneumonia.
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Journal of critical care · Aug 2013
Comparative StudyAccuracy of the chest radiograph to identify bilateral pulmonary infiltrates consistent with the diagnosis of acute respiratory distress syndrome using computed tomography as reference standard.
The purpose of the study is to evaluate the diagnostic accuracy of the anteroposterior chest radiograph to detect pulmonary abnormalities consistent with acute respiratory distress syndrome (ARDS). ⋯ The accuracy of the portable chest radiograph to detect pulmonary abnormalities consistent with ARDS is significantly limited. These findings suggest that the use of the chest radiograph results mainly in underrecognition of the syndrome, particularly when disease is not diffusely distributed, but also in overdiagnosis.
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Journal of critical care · Aug 2013
Urine output is associated with prognosis in patients with acute kidney injury requiring continuous renal replacement therapy.
Although some studies have found that early initiation of continuous renal replacement therapy (CRRT) is associated with better prognosis, no consensus exists on the best timing to start CRRT. We investigated whether the timing of CRRT initiation was relevant to overall mortality and explored which factors at the time of CRRT initiation were associated with better outcomes in critically ill patients with acute kidney injury (AKI). ⋯ Urine output but not BUN concentration was significantly associated with a better prognosis in critically ill patients with AKI requiring CRRT.