Journal of critical care
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Journal of critical care · Apr 2016
Randomized Controlled TrialMarkers of endothelial damage and coagulation impairment in patients with severe sepsis resuscitated with hydroxyethyl starch 130/0.42 vs Ringer acetate.
The Scandinavian Starch for Severe Sepsis/Septic Shock (6S) trial showed increased mortality in patients resuscitated with hydroxyethyl starch 130/0.42 (HES) vs Ringer acetate. Different effects of the fluids on the endothelium may have contributed to the observed outcome. We aimed to investigate associations between HES vs Ringer and changes in plasma biomarkers reflecting endothelial damage and coagulation impairment. ⋯ Resuscitation with HES vs Ringer decreased early endothelial damage. Although this finding should be interpreted with caution, it indicates that the increased mortality observed with HES in the 6S trial may not be explained by endothelial damage and it emphasizes the challenge of using surrogate markers as outcome.
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Journal of critical care · Apr 2016
Randomized Controlled TrialThe effect of a checklist on the quality of patient handover from the operating room to the intensive care unit: A randomized controlled trial.
Handover of patient care is a potential safety risk for the patient due to loss of information which may result in adverse outcome. We hypothesized that a checklist for handover from the operating room (OR) to the intensive care unit (ICU) will lead to an increase of quality regarding information transfer compared with a nonstandardized handover procedure. ⋯ This study gives first evidence that the use of a standardized checklist for patient handover from OR to ICU increases the quantity and quality of transmitted medical information.
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Journal of critical care · Apr 2016
Randomized Controlled TrialMicrobial cell preparation in enteral feeding in critically ill patients: A randomized, double-blind, placebo-controlled clinical trial.
Gut failure is a common condition in critically ill patients in the intensive care unit (ICU). Enteral feeding is usually the first line of choice for nutrition support in critically ill patients. However, enteral feeding has its own set of complications such as alterations in gut transit time and composition of gut eco-culture. ⋯ Patients receiving enteral feeding supplemented with a course of treatment achieved a faster return of gut function and required shorter duration of mechanical ventilation and shorter length of stay in the ICU. However, inflammatory markers did not show any significant change in the pretreatment and posttreatment groups. Overall, it can be concluded that microbial cell preparation enhances gut function and the overall clinical outcome of critically ill patients receiving enteral feeding in the ICU.
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Journal of critical care · Apr 2016
Randomized Controlled TrialThe effect of framing on surrogate optimism bias: A simulation study.
To explore the effect of emotion priming and physician communication behaviors on optimism bias. ⋯ Framing of CPR choice during code status conversations may influence surrogates' optimism bias.