Journal of critical care
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Journal of critical care · Feb 2018
Multicenter StudyEffects of polymyxin B hemoperfusion on hemodynamics and prognosis in septic shock patients.
We designed this study to examine the clinical effects of polymyxin B hemoperfusion (PMX-HP) in septic shock patients. ⋯ PMX-HP may have potential benefits for hemodynamic and prognostic outcomes in septic shock patients with intra-abdominal or gram-negative bacterial infection.
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Journal of critical care · Feb 2018
Multicenter Study Comparative StudyIs patient length of stay associated with intensive care unit characteristics?
We described the association between Intensive care units (ICU) characteristics and ICU Length of stay (LoS), after correcting for patient characteristics. We also compared the predictive performances of models including either patient and ICU characteristics or only patient characteristics. ⋯ After correcting for patient characteristics, we found statistically significant associations between ICU LoS and six ICU characteristics, mainly describing staff availability. Furthermore, we conclude that including ICU characteristics did not significantly improve ICU LoS prediction.
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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
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
Multicenter StudyEnd-of-life discussions: Who's doing the talking?
To determine, in a tertiary academic medical center, the reported frequency of end-of-life discussions among nurses and the influence of demographic factors on these discussions. ⋯ In a survey conducted in two tertiary care institutions, more than one-third of nurses from all disciplines responded that they never or almost never discuss end-of-life issues with their patients. Specialty influenced the likelihood of discussing end-of-life issues with patients.