Journal of critical care
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Journal of critical care · Feb 2016
Comparative StudyUsing patient admission characteristics alone to predict mortality of critically ill patients: A comparison of 3 prognostic scores.
This study compared the performance of 3 admission prognostic scores in predicting hospital mortality. ⋯ All 3 intensive care unit admission prognostic scores had a good ability to predict hospital mortality of critically ill patients, with best discrimination in emergency admissions.
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Journal of critical care · Feb 2016
Superiority of transcutaneous CO2 over end-tidal CO2 measurement for monitoring respiratory failure in nonintubated patients: A pilot study.
Arterial blood gas measurement is frequently performed in critically ill patients to diagnose and monitor acute respiratory failure. At a given metabolic rate, carbon dioxide partial pressure (PaCO2) is entirely determined by CO2 elimination through ventilation. Transcutaneous partial pressure of carbon dioxide (PtcCO2) monitoring permits a noninvasive and continuous estimation of arterial CO2 tension (PaCO2). The accuracy of PtcCO2, however, has not been well studied. To assess the accuracy of different CO2 monitoring methods, we compared PtcCO2 and end-tidal CO2 concentration (EtCO2) to PaCO2 measurements in nonintubated intensive care unit (ICU) patients with acute respiratory failure. ⋯ We found large differences between EtCO2 and Paco2 in spontaneously breathing nonintubated ICU patients admitted for acute respiratory failure. Our study argues against the use of EtCO2 monitoring in such patients but raises the possibility that PtcCO2 measurement may provide reasonable estimates of PaCO2.
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Journal of critical care · Feb 2016
ReviewThoracic ultrasound: Potential new tool for physiotherapists in respiratory management. A narrative review.
The use of diagnostic ultrasound by physiotherapists is not a new concept; it is frequently performed in musculoskeletal physiotherapy. Physiotherapists currently lack accurate, reliable, sensitive, and valid measurements for the assessment of the indications and effectiveness of chest physiotherapy. Thoracic ultrasound may be a promising tool for the physiotherapist and could be routinely performed at patients' bedsides to provide real-time and accurate information on the status of pleura, lungs, and diaphragm; this would allow for assessment of lung aeration from interstitial syndrome to lung consolidation with much better accuracy than chest x-rays or auscultation. ⋯ This narrative review refers to lung and diaphragm ultrasound semiology and describes how physiotherapists could use this tool in their clinical decision-making processes in various cases of respiratory disorders. The use of thoracic ultrasound semiology alongside typical examinations may allow for the guiding, monitoring, and evaluating of chest physiotherapy treatments. Thoracic ultrasound is a potential new tool for physiotherapists.
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Journal of critical care · Feb 2016
Endothelial cell-specific molecule-1/endocan: Diagnostic and prognostic value in patients suffering from severe sepsis and septic shock.
This study aims to assess the diagnostic and prognostic value of endocan in patients with severe sepsis or septic shock on a medical intensive care unit (ICU). ⋯ Endocan showed diagnostic capacity to diagnose patients with severe sepsis and septic shock and revealed prognostic information for 30-days and 6-months all-cause mortality.
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Journal of critical care · Feb 2016
Do cost savings from reductions in nosocomial infections justify additional costs of single-bed rooms in intensive care units? A simulation case study.
Evidence shows that single-patient rooms can play an important role in preventing cross-transmission and reducing nosocomial infections in intensive care units (ICUs). This case study investigated whether cost savings from reductions in nosocomial infections justify the additional construction and operation costs of single-bed rooms in ICUs. ⋯ This case study shows that although single-patient rooms are more costly to build and operate, they can result in substantial savings compared with open-bay rooms by avoiding costs associated with nosocomial infections.