Journal of critical care
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Journal of critical care · Oct 2014
Serum lipid profile, cytokine production, and clinical outcome in patients with severe sepsis.
The purpose of the study is to evaluate the prevalence and clinical significance of hypolipidemia and the relationship to cytokine concentrations and outcomes in septic patients. ⋯ Low cholesterol and lipoprotein concentrations are detected in septic patients, especially in individuals with poor outcome. High-density lipoprotein cholesterol concentration seems to be an early independent predictive marker of survival in severe sepsis.
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Journal of critical care · Oct 2014
Management of severe community-acquired pneumonia: A survey on the attitudes of 468 physicians in Iberia and South America.
The purpose of this study is to characterize the practices of pulmonary, internal medicine, and critical care physicians toward the management of patients with severe community-acquired pneumonia (CAP). ⋯ Despite the recent advances of knowledge reflected in the present study in the management of severe CAP, several of them are still incompletely translated into clinical practice. Significant variation in practice is observed among physicians and represents a potential target for future research and educational interventions.
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Journal of critical care · Oct 2014
Observational StudyInterruptions experienced by cardiovascular intensive care unit nurses: An observational study.
Intensive care unit (ICU) nurses get interrupted frequently. Although interruptions take cognitive resources from a primary task and may hinder performance, they may also convey critical information. Effective management of interruptions in ICUs requires the understanding of interruption characteristics, the context in which interruption happens, and interruption content. ⋯ Mitigation strategies other than blocking should also be explored. In addition, interrupters might have evaluated primary task severity before interrupting. Therefore, making task severity more transparent may help others modulate when and how they interrupt a nurse.
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Journal of critical care · Oct 2014
Surveillance cultures in intensive care units: A nationwide survey on current practice providing future perspectives.
To explore the extent of surveillance culture (SC) implementation underlying motives for obtaining SC and decision making based on the results. ⋯ Surveillance culture implementation is common in Dutch ICUs to optimize individual patients' treatment. Consensus is lacking on how to deal with SC results when the focus of infection is not at the sampled site.
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Journal of critical care · Oct 2014
Low tissue oxygen saturation at emergency center triage is predictive of intensive care unit admission.
Timely recognition of critical patients by emergency center triage is an ongoing challenge. Peripheral tissue oxygen saturation (StO2) measurement has been used to monitor shock patients' responses to resuscitation. Interest has developed in evaluating StO2 as a triage tool, but limited studies have addressed critically ill patients. ⋯ In this patient population, an StO2 less than 70% significantly increased the risk of ICU admission. Tissue oxygen saturation at triage identifies critical patients who may not be recognized by vital signs alone. Tissue oxygen saturation measurement could help providers make earlier decisions regarding hospital resource allocation.