Journal of critical care
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Journal of critical care · Feb 2016
Randomized Controlled TrialPrevalence, risk factors, and outcomes associated with physical restraint use in mechanically ventilated adults.
The purpose was to describe characteristics and outcomes of restrained and nonrestrained patients enrolled in a randomized trial of protocolized sedation compared with protocolized sedation plus daily sedation interruption and to identify patient and treatment factors associated with physical restraint. ⋯ Physical restraint was common in mechanically ventilated adults managed with a sedation protocol. Restrained patients received more opioids and benzodiazepines. Except for alcohol use, patient characteristics and treatment factors did not predict restraint use.
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Journal of critical care · Feb 2016
Kinetic estimated glomerular filtration rate and acute kidney injury in cardiac surgery patients.
To determine how a formula to estimate kinetically changing glomerular filtration rate (keGFR) relates to serum creatinine changes and to compare the discriminatory ability of keGFR to that of perioperative change in serum creatinine to predict acute kidney injury (AKI) and mortality. ⋯ Despite no change in immediate perioperative serum creatinine levels, keGFR fell and this predicted subsequent AKI. Using keGFR enables identification of patients who, despite unchanged postoperative creatinine, incur clinically significant kidney injury based on reduction in GFR and increased mortality.
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Journal of critical care · Feb 2016
Impact of bronchoalveolar lavage multiplex polymerase chain reaction on microbiological yield and therapeutic decisions in severe pneumonia in intensive care unit.
The purpose of the study is to evaluate the impact of adding bronchoalveolar lavage multiplex polymerase chain reaction (M-PCR) to conventional cultures (CC) on microbiological yield and therapeutic decisions in adult intensive care unit patients with pneumonia and severe sepsis or septic shock. ⋯ Bronchoalveolar lavage M-PCR with culture leads to higher microbiological yield and earlier modification of antibiotics compared to conventional culture.