Journal of critical care
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Journal of critical care · Oct 2017
Review Meta AnalysisSystematic review and meta-analysis of renal replacement therapy modalities for acute kidney injury in the intensive care unit.
To compare clinical outcomes among critically ill adults with acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT), intermittent hemodialysis (IHD) or sustained low efficiency dialysis (SLED). ⋯ We did not find a definitive advantage for any RRT modality on short-term patient or kidney survival. Well-designed, adequately-powered trials are needed to better define the role of RRT modalities for treatment of critically ill patients with AKI.
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Journal of critical care · Oct 2017
Review Meta AnalysisIntubation using apnoeic oxygenation to prevent desaturation: A systematic review and meta-analysis.
To determine whether or not apnoeic oxygenation reduces the incidence of hypoxaemia during endotracheal intubation. ⋯ In patients whom are being intubated for any indication other than respiratory failure, apnoeic oxygenation at any flow rate 15L or greater is likely to reduce their incidence of desaturation (<90%) and critical desaturation (<80%). However, further high quality RCTs are required given the high degree of heterogeneity in many of the outcomes and subgroup analyses.
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Journal of critical care · Oct 2017
Multicenter StudyPediatric intermediate care and pediatric intensive care units: PICU metrics and an analysis of patients that use both.
To examine how intermediate care units (IMCUs) are used in relation to pediatric intensive care units (PICUs), characterize PICU patients that utilize IMCUs, and estimate the impact of IMCUs on PICU metrics. ⋯ There was no association between having an IMCU and most measures of PICU efficiency. At hospitals with an IMCU, patients spent more time in the PICU once they were cleared for discharge. Other ways that IMCUs might affect PICU efficiency or particular patient populations should be investigated.
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Journal of critical care · Oct 2017
Is 'gut feeling' by medical staff better than validated scores in estimation of mortality in a medical intensive care unit? - The prospective FEELING-ON-ICU study.
The aim of the FEELING-ON-ICU study was to compare mortality estimations of critically ill patients based on 'gut feeling' of medical staff and by Acute Physiology And Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA). ⋯ The concept of physicians' 'gut feeling' was comparable to classical objective scores in mortality estimations of critically ill patients. Concerning practicability physicians' evaluations were advantageous to complex score calculation.
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Journal of critical care · Oct 2017
Association between advanced practice nursing and 30-day mortality in mechanically ventilated critically ill patients: A retrospective cohort study.
Little is known about the association between advanced practice nursing and mortality. The aim of this study was to evaluate whether the presence of advanced practice nurses (APN), that is, certified nurse (CN) and certified nurse specialist (CNS) in intensive care, is associated with 30-day mortality for mechanically ventilated critically ill patients. ⋯ Our findings show that APNs may play an important role in improving patient outcome in the adult ICU.