Journal of critical care
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Journal of critical care · Jun 2017
Comparative Study Observational StudyOutcomes of nighttime refusal of admission to the intensive care unit: The role of the intensivist in triage.
To compare outcomes of patients refused medical intensive care unit (MICU) admission overnight to those refused during the day and to examine the impact of the intensivist in triage. ⋯ Patients refused MICU admission overnight are more likely to be later admitted to an ICU than patients refused during the day. However, the mechanism for this observation does not appear to depend on the intensivist's direct evaluation of the patient. Further investigation into the clinician-specific effects of ICU triage and identification of potentially modifiable hospital triage practices will help to improve both ICU utilization and patient safety.
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Journal of critical care · Jun 2017
Correlation between transition percentage of minute volume (TMV%) and outcome of patients with acute respiratory failure.
We have previously shown in patients receiving adaptive support ventilation (ASV) that there existed a Transition %MinVol (TMV%) where the patient's work of breathing began to reduce. In this study, we tested the hypothesis that higher TMV% would be associated with poorer outcome in patients with acute respiratory failure. ⋯ An increase, or lack of decrease, of TMV% from Day 1 to Day 2 was associated with higher risk of in-hospital death.
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Journal of critical care · Jun 2017
Observational StudyCorrelation study on chromogranin A genetic polymorphism and prognosis of critically ill patients.
The objective was to investigate the correlation between single nucleotide polymorphism (SNP) of chromogranin A (CHGA) and prognosis of critically ill patients. ⋯ Critically ill patients with CHGA-415 T/C mutant genotype display higher 30-day mortality than those with the wild-type group. CHGA-415 T/C polymorphism is an independent risk factor of poor prognosis in critically ill Chinese Han patients.
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Journal of critical care · Jun 2017
Multicenter StudyRelatives' perception of stressors and psychological outcomes - Results from a survey study.
To identify relevant stressors or resources of relatives of critically ill patients and explore their relationship with psychological outcomes. ⋯ Our study confirmed a high prevalence of PICS-F among relatives of critically ill patients. Feeling overburdened and experiencing acute stressors may be related to negative psychological outcomes. In future, vulnerable relatives might be identified by a single-item screening tool on feeling overburdened.
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Journal of critical care · Jun 2017
ReviewReconsidering the role of decompressive craniectomy for neurological emergencies.
There is little doubt that decompressive craniectomy can reduce mortality. However, there is concern that any reduction in mortality comes at an increase in the number of survivors with severe neurological disability. ⋯ It would appear unlikely that further randomised controlled trials will be possible given the significant reduction in mortality achieved by surgical decompression. It may be that observational cohort studies and outcome prediction models may provide data to determine those patients most likely to benefit from surgical decompression.