Journal of critical care
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Journal of critical care · Dec 2018
Randomized Controlled Trial Multicenter StudyP(v-a)CO2/C(a-v)O2-directed resuscitation does not improve prognosis compared with SvO2 in severe sepsis and septic shock: A prospective multicenter randomized controlled clinical study.
The present study examined the value of P(v-a)CO2/C(a-v)O2 compared with ScvO2 as a target for clinical resuscitation of severe sepsis/septic shock. ⋯ P(v-a)CO2/C(a-v)O2-directed resuscitation did not improve prognosis compared with ScvO2 in severe sepsis and septic shock. ClinicalTrials.gov Identifier NCT01877798.
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Journal of critical care · Dec 2018
Multicenter Study Observational StudyCaregivers' perceptions towards communication with mechanically ventilated patients: The results of a multicenter survey.
The purpose of this study was to investigate ICU health care providers' perception towards communication and associated problems with mechanically ventilated (MV) patients. The primary aim was to quantify the extent of the problem and to determine its effect on patient care and job satisfaction. ⋯ In half of the interactions with MV patients, health care professionals experience significant communication difficulties. The respondents indicated that these difficulties frequently lead to negative effects on patient care and job satisfaction. These results emphasize the need for improvements such as the development of communication protocols, skills training and continued research into new communication methods.
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Journal of critical care · Dec 2018
Randomized Controlled TrialEffects of designated leadership and team-size on cardiopulmonary resuscitation: The Basel-Washington SIMulation (BaWaSim) trial.
During cardiopulmonary resuscitation (CPR), it remains unclear whether designating an individual person as team leader compared with emergent leadership results in better team performance. Also, the effect of CPR team size on team performance remains understudied. ⋯ Within this international US/Swiss trial, leadership designation and larger team size did not improve hands-on time, but emergent leadership teams initiated defibrillation earlier. Improvements in performance may be more likely to be achieved by optimization of emergent leadership than increasing the size of cardiac arrest teams.
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Journal of critical care · Dec 2018
Not all organ dysfunctions are created equal - Prevalence and mortality in sepsis.
While organ dysfunctions within sepsis have been widely studied, interaction between measures of organ dysfunction remains an understudied area. The objective of this study is to quantify the impact of organ dysfunction on in-hospital mortality in infected population. ⋯ There exist differences in measures of organ dysfunction occurrence and their association with mortality. These findings support increased clinical efforts to identify sepsis patients to inform diagnostic decisions.
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Journal of critical care · Dec 2018
Observational StudyPatients with small-vessel vasculitides have the highest mortality among systemic autoimmune diseases patients treated in intensive care unit: A retrospective study with 5-year follow-up.
Systemic autoimmune diseases are a heterogeneous group of disorders associated with dysfunction of multiple organs and unpredictable course. Complicated management and treatment become even more challenging when patients require critical care. This study aims to compare outcomes of small-vessel vasculitides (SVV) and other systemic autoimmune diseases (SAD) patients admitted to the intensive care unit (ICU). ⋯ Among systemic autoimmune diseases small vessel vasculitides appear to be associated with the highest ICU mortality, higher requirement for advanced procedures and aggressive immunosuppressive therapy.