Journal of critical care
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Journal of critical care · Feb 2016
Observational StudyNear-infrared spectroscopy to assess microvascular dysfunction: A prospective pilot study in cardiac surgery patients.
The diagnosis of microvascular dysfunction remains challenging after cardiac surgery. We hypothesized that peripheral near-infrared spectroscopy (NIRS) monitoring in combination with a vascular occlusion test could reliably assess postoperative microvascular dysfunction in that setting. ⋯ Peripheral NIRS monitoring in combination with a vascular occlusion test failed to assess cardiopulmonary bypass-induced microvascular dysfunction.
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Journal of critical care · Feb 2016
Observational StudyPrognosis of patients presenting extreme acidosis (pH <7) on admission to intensive care unit.
The purpose was to determine prognosis of patients presenting extreme acidosis (pH <7) on admission to the intensive care unit (ICU) and to identify mortality risk factors. ⋯ Patients with extreme acidosis on admission to ICU have a less severe than expected prognosis. Whereas mortality is almost 100% in cases of cardiac arrest before admission, mortality is much lower in the absence of cardiac arrest before admission, which justifies aggressive ICU therapies.
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Journal of critical care · Feb 2016
Observational StudyRisk factors for mortality despite early protocolized resuscitation for severe sepsis and septic shock in the emergency department.
The purpose was to identify risk factors associated with in-hospital mortality among emergency department (ED) patients with severe sepsis and septic shock managed with early protocolized resuscitation. ⋯ We identified a number of factors that were associated with in-hospital mortality among ED patients with severe sepsis or septic shock despite treatment with early protocolized resuscitation. These findings provide insights into aspects of early sepsis care that can be targets for future intervention.
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To explore the hypothesis that early ventilation strategies influence clinical outcomes in lung transplantation, we have examined our routine ventilation practices in terms of tidal volumes (Vt) and inflation pressures. ⋯ Low Vt ventilation has not been fully adopted in our practice. Ventilation with higher inflation pressures, but not Vt, was significantly associated with poorer outcomes after lung transplantation.
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Journal of critical care · Feb 2016
Moral distress in intensive care unit professionals is associated with profession, age, and years of experience.
To determine which demographic characteristics are associated with moral distress in intensive care unit (ICU) professionals. ⋯ Moral distress is higher in ICU nurses and other non-physician professionals than in physicians, is lower with older age for other non-physician professionals but greater with more years of experience in nurses, and is associated with tendency to leave the job.