Journal of critical care
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Journal of critical care · Dec 2016
ICU-RESPECT: An index to assess patient and family experiences of respect in the intensive care unit.
The purpose of the study is to develop a brief index of patient and family experiences of respect in the intensive care unit (ICU). ⋯ The "ICU-RESPECT" index demonstrates high reliability and concurrent validity in ICU patients and families. Future research should validate this index in other ICU settings, assess its predictive validity, and evaluate different methods for maximizing response rate. As hospitals address patient experience more broadly in response to national metrics, the index could identify particular behaviors or ICUs that would benefit from interventions to enhance respectful treatment.
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Journal of critical care · Dec 2016
Four-factor prothrombin complex concentrate for life-threatening bleeds or emergent surgery: A retrospective evaluation.
Previous trials investigating usage of four-factor prothrombin complex concentrate (4F-PCC) excluded patients with various thrombotic risk factors. The objective of this study was to evaluate the safety and effectiveness of 4F-PCC in a real-world setting based on an institutional protocol that does not have strict exclusion criteria. ⋯ 4F-PCC was associated with a notable thromboembolic risk. All patient-specific risk factors should be considered prior to administration. 4F-PCC remains a useful agent for warfarin reversal. Lack of concomitant vitamin K may contribute to INR rebound.
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Journal of critical care · Dec 2016
Admission plasma levels of the neuronal injury marker neuron-specific enolase are associated with mortality and delirium in sepsis.
Neuron-specific enolase (NSE) concentrations are prognostic following traumatic and anoxic brain injury and may provide a method to quantify neuronal injury in other populations. We determined the association of admission plasma NSE concentrations with mortality and delirium in critically ill septic patients. ⋯ Higher plasma NSE concentrations were associated with mortality and delirium in critically ill septic patients, suggesting that NSE may have utility as a marker of neuronal injury in sepsis.