Journal of critical care
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Journal of critical care · Feb 2015
ReviewThe spectrum of psychocognitive morbidity in the critically ill: A review of the literature and call for improvement.
The objective of the study is to review the cognitive and psychiatric dysfunction experienced by critically ill patients during and after hospitalization. ⋯ We propose a paradigm change highlighting the need for interventions focused on early psychological support applied in parallel with stabilization of physiologic status in the ICU.
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Journal of critical care · Feb 2015
Adherence to guidelines for management of cerebral perfusion pressure and outcome in patients who have severe traumatic brain injury.
The aims of this study are to assess adherence to the Brain Trauma Foundation (BTF) cerebral perfusion pressure (CPP) guidelines and to determine if adherence is associated with mortality in patients who have a severe traumatic brain injury. ⋯ Cerebral perfusion pressure was greater than 70 mm Hg for most of the time. This level of CPP was associated with decreased hospital mortality.
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Journal of critical care · Feb 2015
Comparative StudyComparison between ultrasound- and bronchoscopy-guided percutaneous dilational tracheostomy in critically ill patients: A retrospective cohort study.
Percutaneous dilational tracheostomy (PDT) is routinely performed in the intensive care unit with bronchoscopic guidance. Recently, ultrasound (US) has emerged as a new safety adjunct tool to increase the efficacy of PDT. However, the available data are limited to case series without any control group. Hence, a retrospective cohort study was designed to evaluate the efficacy of US-guided PDT compared with bronchoscopy-guided PDT. ⋯ Ultrasound-guided PDT is effective, safe, and associated with similar complication rates and clinical outcomes compared with bronchoscopy-guided PDT.
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Journal of critical care · Feb 2015
Observational StudyEpidemiology and outcomes in patients with severe sepsis admitted to the hospital wards.
The purpose of this study was to detail the trajectory and outcomes of patients with severe sepsis admitted from the emergency department to a non-intensive care unit (ICU) setting and identify risk factors associated with adverse outcomes. ⋯ Patients presenting to the emergency department with severe sepsis were frequently admitted to a non-ICU setting, and the rate increased over time. Of 8 patients admitted to the hospital ward, one was transferred to the ICU within 48 hours and/or died within 28 days of admission. Factors present at admission were identified that were associated with adverse outcomes.
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Journal of critical care · Feb 2015
A novel questionnaire to measure staff perception of end-of-life decision making in the intensive care unit-Development and psychometric testing.
The aim of this study was to create a questionnaire that measures barriers and facilitators of effective end-of-life (EOL) decision making and communication and associated stress as perceived by intensive care unit (ICU) staff. ⋯ The new questionnaire meets psychometric criteria of reliability and validity and promises to be a useful quality measure of EOL decision making in the ICU.