Journal of critical care
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Journal of critical care · Apr 2015
Editorial Comment LetterThe unplanned intensive care unit admission.
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Journal of critical care · Apr 2015
Randomized Controlled Trial Multicenter StudyInsulin infusion therapy in critical care patients: Regular insulin vs short-acting insulin. A prospective, crossover, randomized, multicenter blind study.
The aim of this multicenter, prospective, randomized, crossover trial is to compare, in critical care patients receiving insulin infusion therapy (IIT), the pharmacodynamic of Humulin insulin (Hlin), currently used as "standard of care," and Humalog insulin (Hlog), a shorter acting insulin formulation. This was measured as extent and duration of the carryover effect of insulin treatment, with the latter calculated as ratio between blood glucose concentration (BGC) reduction during and after IIT. ⋯ The use of constant Hlog infusion for IIT, when compared with Hlin at the same dose, is associated with a less profound carryover effect on BGC after discontinuation of IIT, a briefer duration of carryover, a faster BGC drop during infusion, and a quicker BGC rise after discontinuation. These characteristics suggest that Hlog IIT may be preferable for use in critically ill patients.
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Journal of critical care · Apr 2015
The Critical Care Communication project: Improving fellows' communication skills.
The aim of this study was to develop an evidence-based communication skills training workshop to improve the communication skills of critical care fellows. ⋯ This 3-day communication skills training program increased critical care fellows' self-reported family meeting communication skills.
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Journal of critical care · Apr 2015
Developing a percutaneous dilatational tracheostomy service by medical intensivists: Experience at one academic Institution.
Percutaneous dilatational tracheostomy (PDT) is increasingly becoming the preferred method, compared with open surgical tracheostomy, for patients requiring chronic ventilatory assistance. Little is known regarding the process involved to incorporate PDT as a standard service in the medical intensive care unit. In this report, we describe our experience developing a "PDT service" led by medical intensivists. ⋯ We successfully developed a medical intensivist-driven PDT service, sharing our unique successes and challenges, to facilitate the care of our patients requiring prolonged ventilator support.