Journal of critical care
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Journal of critical care · Apr 2014
Multicenter StudyRisk factors for prolonged duration of mechanical ventilation in acute traumatic tetraplegic patients-a retrospective cohort study.
Respiratory complications constitute an important determinant of length of stay in tetraplegic patients. In a population of tetraplegic patients, we investigated the factors involved in the duration of mechanical ventilation (MV) and whether the duration of MV was associated with the long-term neurologic status. ⋯ Prevention of pneumonia and atelectasis is critical for the reduction of MV in tetraplegic patients. Prolonged MV was independently associated with poor neurologic status.
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Journal of critical care · Apr 2014
Comparative StudyComparison of circuit patency and exchange rates between 2 different continuous renal replacement therapy machines.
Continuous renal replacement therapy (CRRT) is an important tool in the care of critically ill patients. However, the impact of a specific CRRT machine type on the successful delivery of CRRT is unclear. The purpose of this study was to evaluate the effectiveness of CRRT delivery with an intensive care unit (ICU) bedside nurse delivery model for CRRT while comparing circuit patency and circuit exchange rates in 2 Food and Drug Administration-approved CRRT devices. This article presents the data comparing circuit exchange rates for 2 different CRRT machines. ⋯ There was no demonstrable difference in circuit patency as defined by the rate of filter exchanges per day of CRRT therapy.
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Journal of critical care · Apr 2014
Comparative StudyComputerized physician order entry in the cardiac intensive care unit: Effects on prescription errors and workflow conditions.
To evaluate the effects of a computerized physician order entry (CPOE) system in the cardiac intensive care unit by detecting prescription errors (PEs) and also to assess the impact on working conditions. ⋯ Computerized physician order entry in the cardiac intensive care unit proved to be a safe and effective strategy in reducing PEs and was globally well received by professionals.
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Journal of critical care · Apr 2014
Influence of dexmedetomidine therapy on the management of severe alcohol withdrawal syndrome in critically ill patients.
Although benzodiazepines are first-line drugs for alcohol withdrawal syndrome (AWS), rapidly escalating doses may offer little additional benefit and increase complications. The purpose of this study was to evaluate dexmedetomidine's impact on benzodiazepine requirements and hemodynamics in AWS. ⋯ Dexmedetomidine decreased benzodiazepine requirements and improved the overall hemodynamic profile of patients with severe AWS. These results provide promising evidence about the potential benefit of dexmedetomidine for AWS.
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Journal of critical care · Apr 2014
Prediction equation to estimate dead space to tidal volume fraction correlates with mortality in critically ill patients.
The measurement of dead space to tidal volume fraction (Vd/Vt) using various methodologies has been shown to be a reliable predictor of mortality in critically ill patients. In this study, we evaluated the correlation of a validated equation using clinically available information to predict calculation of Vd/Vt with clinically relevant outcome parameters in patients requiring mechanical ventilation. ⋯ In this study-specific population of critically ill patients, the prediction equation of Vd/Vt using clinically available parameters correlates with mortality. In addition, we provide a simple method to estimate Vd/Vt that can be potentially applicable to all critically ill intensive care unit patients.