Journal of critical care
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Journal of critical care · Feb 2018
Multicenter StudyInitial fluid resuscitation following adjusted body weight dosing is associated with improved mortality in obese patients with suspected septic shock.
The optimal initial fluid resuscitation strategy for obese patients with septic shock is unknown. We evaluated fluid resuscitation strategies across BMI groups. ⋯ Using AdjBW to calculate initial fluid resuscitation volume for obese patients with suspected shock may improve outcomes compared to other weight-based dosing strategies. The optimal fluid dosing strategy for obese patients should be a focus of future prospective research.
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Journal of critical care · Feb 2018
Effects of staff training and electronic event monitoring on long-term adherence to lung-protective ventilation recommendations.
To investigate long-term effects of staff training and electronic clinical decision support (CDS) on adherence to lung-protective ventilation recommendations. ⋯ Staff training effectively improves adherence to lung-protective ventilation strategies. The observed CDS effect seemed less pronounced, although it can easily be adapted to new recommendations. Both interventions, which futures studies could deploy in combination, promise to improve the precision of mechanical ventilation.
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Journal of critical care · Feb 2018
Randomized Controlled Trial Multicenter Study Comparative StudyEnteral nutrition as stress ulcer prophylaxis in critically ill patients: A randomized controlled exploratory study.
We investigated whether early enteral nutrition alone may be sufficient prophylaxis against stress-related gastrointestinal (GI) bleeding in mechanically ventilated patients. ⋯ We found no benefit when pantoprazole is added to early enteral nutrition in mechanically ventilated critically ill patients. The routine prescription of acid-suppressive therapy in critically ill patients who tolerate early enteral nutrition warrants further evaluation.
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Journal of critical care · Feb 2018
ReviewMajor publications in the critical care pharmacotherapy literature: January-December 2016.
To summarize select critical care pharmacotherapy guidelines and studies published in 2016. ⋯ The review provides a synopsis of select pharmacotherapy publications in 2016 applicable to clinical practice.