Journal of critical care
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Journal of critical care · Dec 2018
Acute skeletal muscle wasting and relation to physical function in patients requiring extracorporeal membrane oxygenation (ECMO).
Muscle weakness is common in patients requiring extracorporeal membrane oxygenation (ECMO), but early identification is challenging. This study aimed to 1) quantify the change in quadriceps size and quality (echogenicity) from baseline to day 10 using ultrasound in patients requiring ECMO, 2) determine the relationship between ultrasound measures, muscle strength and highest mobility level. ⋯ In patients requiring ECMO there was marked wasting of the quadriceps over the first 10 days. Ultrasound measures were related to muscle strength and highest mobility level.
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Journal of critical care · Dec 2018
qSOFA as predictor of mortality and prolonged ICU admission in Emergency Department patients with suspected infection.
We assessed the quick Sequential Organ Failure Assessment (qSOFA) score as a predictor of in-hospital mortality or prolonged ICU stay in Emergency Department (ED) patients with suspected infection. ⋯ Among ED patients with suspected infection, a positive qSOFA identified those at much greater risk of mortality and longer ICU stay.
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Journal of critical care · Dec 2018
Long-term recovery profile of patients with severe disability or in vegetative states following severe primary intracerebral hemorrhage.
We conducted a single-center retrospective review to investigate the long-term recovery of patients who were severely disabled or vegetative secondary to primary intracerebral hemorrhage upon discharge from hospital from January 2009 to November 2013. ⋯ Neurological status at discharge from hospital was not truly indicative of long-term prognosis for patients who were severely disabled or vegetative. Patients in both groups can potentially improve in the long term and may benefit from prolonged rehabilitation programmes to maximize their recovery potential.
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It is uncertain whether, in critical care medicine, non-blinded trials are associated with a bias toward a different effect size. The aim of our study was to assess if conducting non-blinded/open label studies leads to greater effect size than blinded studies, and to provide an estimate of the weight of this difference. ⋯ The NNT for blinded studies is 40% higher than for unblinded studies. This should be taken into account when planning and interpreting the findings of non-blinded studies performed in critically ill settings.
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Journal of critical care · Dec 2018
Transition to a newly constructed single patient room adult intensive care unit - Clinicians' preparation and work experience.
To describe how clinicians were prepared for the transition to a novel single patient room (SPR) intensive care unit (ICU) and their work experience during this transition. ⋯ The use of preparation strategies that are tailored to clinicians' roles helped build readiness for transition to a novel SPR ICU and facilitated the adaptation process. Challenges related to teamwork dynamics and practices in an isolating environment persisted beyond the adaptation period and must be addressed and overcome to better meet the needs and expectations of ICU clinicians.