Journal of critical care
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Journal of critical care · Oct 2016
The Intensive care unit specialist: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine.
The role of the critical care specialist has been unequivocally established in the management of severely ill patients throughout the world. Data show that the presence of a critical care specialist in the intensive care unit (ICU) environment has reduced morbidity and mortality, improved patient safety, and reduced length of stay and costs. ⋯ The curriculum to ensure appropriate training around the world is diverse but should ideally meet some minimum standards. The World Federation of Societies of Intensive and Critical Care Medicine has set up a task force to address issues concerning the training, functions, roles, and responsibilities of an ICU specialist.
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Journal of critical care · Oct 2016
Heart-type fatty acid-binding protein and myocardial creatine kinase enable rapid risk stratification in normotensive patients with pulmonary embolism.
Risk assessments of hemodynamically stable patients with pulmonary embolisms (PE) remain challenging. In this context heart-type fatty acid-binding protein (H-FABP), creatine kinase isoenzyme MB (CK-MB), and troponin I (TnI) may hold prognostic utility for patients with pulmonary embolism. ⋯ Both H-FABP and CK-MB are associated with short term mortality in normotensive PE patients and could be advantageous for risk stratification in this intermediate risk group.
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Journal of critical care · Oct 2016
The association between prior statin use and long-term outcomes after critical care admission.
Statins may have immunomodulatory effects that benefit critically ill patients. Therefore, we retrospectively examined the association between survival and the prescription of statins prior to admission to an intensive care unit (ICU), or high dependency unit (HDU), as a result of major elective surgery or as an emergency with a presumed diagnosis of sepsis. ⋯ Prior statin use was not associated with improved outcomes in patients admitted to critical care after elective surgical cases or with a presumed diagnosis of sepsis.
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Journal of critical care · Oct 2016
Caregiver strain following critical care discharge: An exploratory evaluation.
The objective of this exploratory evaluation was to understand the impact of critical care survivorship on caregivers. ⋯ This evaluation has demonstrated that there is a significant burden for caregivers of critical care survivors. Furthermore, they reported high levels of posttraumatic stress disorder, anxiety, depression, and insomnia. Future work on rehabilitation from critical care should focus on the inclusion of caregivers.
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Journal of critical care · Oct 2016
Clinical outcomes of cardiac arrest patients according to opioid use history.
Opioid analgesics are potent respiratory depressants. The purpose of this study was to describe the effects of opioids administered within 24hours before cardiac arrest on clinical outcomes. ⋯ Opioid administration within 24hours before cardiac arrest per se was not associated with adverse outcomes. However, administration of opioid analgesics on an as-needed basis was associated with poorer survival outcomes than regular dosing. Greater attention should be paid to patients who receive as-needed opioid administration in the general ward.