Journal of critical care
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Journal of critical care · Aug 2013
Prediction of fluid responsiveness in patients admitted to the medical intensive care unit.
Accurate prediction of fluid responsiveness is of importance in the treatment of patients admitted to the intensive care unit (ICU). We investigated whether physical examination, central venous pressure (CVP), central venous oxygen saturation (ScvO2), passive leg raising (PLR) test, and transpulmonary thermodilution (TPTD)-derived parameters can predict volume responsiveness in patients admitted to the ICU. ⋯ Prediction of fluid responsiveness is difficult using physical examination, CVP, ScvO2, PLR maneuver, or TPTD-derived variables in critically ill patients. A volume challenge test should be considered for the assessment of fluid responsiveness in critically ill patients admitted to the ICU.
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Journal of critical care · Aug 2013
The effect of electrical muscle stimulation on the prevention of disuse muscle atrophy in patients with consciousness disturbance in the intensive care unit.
Disuse atrophy of the lower limbs of patients with consciousness disturbance has often been recognized as "an unavoidable consequence," such that the mechanism was not investigated diligently. In this study, we examined the preventive effects of electrical muscle stimulation (EMS) against disuse atrophy of the lower limbs in patients in coma after stroke or traumatic brain injury in the intensive care unit. ⋯ Electrical muscle stimulation is effective in the prevention of disuse muscle atrophy in patients with consciousness disorder.
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Journal of critical care · Aug 2013
Coronary artery disease in patients clinically diagnosed with myocardial infarction in the medical intensive care unit.
The purpose of this study is to compare the clinical characteristics and outcomes of patients with and without coronary artery disease (CAD) confirmed by coronary angiography in critically ill patients clinically diagnosed with myocardial infarction. ⋯ Coronary angiography in critically ill patients should only be performed in highly selected patients with predicting factors for CAD.
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Journal of critical care · Aug 2013
Assessing the quality of interdisciplinary rounds in the intensive care unit.
Interdisciplinary rounds (IDRs) in the intensive care unit (ICU) are increasingly recommended to support quality improvement, but uncertainty exists about assessing the quality of IDRs. We developed, tested, and applied an instrument to assess the quality of IDRs in ICUs. ⋯ The quality of IDRs in the ICU can be reliably assessed for patient plan of care and process with the IDR Assessment Scale.
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Journal of critical care · Aug 2013
Antibiotic resistance patterns in medical and surgical patients in a combined medical-surgical intensive care unit.
Studies have found different rates of antimicrobial resistance among patients in medical and surgical intensive care units (ICUs). We studied whether these differences were a function of geography or differences in the patient populations, by comparing resistance rates among bacteria isolated from a combined medical/surgical ICU. ⋯ Reported differences in resistance patterns among bacteria cultured from medical and surgical patients may be due to geographic separation of the ICUs as opposed to differences in the patient characteristics. This study suggests that ICU-specific antibiograms remain a useful tool to guide the choice of antimicrobial therapy, even in medical/surgical ICUs.