Journal of critical care
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Journal of critical care · Apr 2018
Exploring the scope of communication content of mechanically ventilated patients.
Ineffective communication during mechanical ventilation (MV) and critical illness is distressing to many patients. This study aimed to describe the scope of communication content of ventilated critically ill patients. ⋯ The scope of communication content of ventilated ICU patients was broad, extending far beyond task-focused subject matter. Content ranged from conveying symptom-related messages to active participation in medical discussions, to conversing with family about a range of complex multi-dimensional issues, to sharing their own psychoemotional experiences. These patient-centered needs should be recognized and addressed in communication strategies.
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Journal of critical care · Apr 2018
Observational StudyNeuromuscular electrophysiological disorders and muscle atrophy in mechanically-ventilated traumatic brain injury patients: New insights from a prospective observational study.
It is unclear whether the muscular changes in mechanically-ventilated traumatic brain injury patients (TBI) are only associated with disuse or additionally to neuromuscular electrophysiological disorders (NED). The correlation between muscle atrophy and NED may affect functional outcomes and rehabilitation programs significantly. ⋯ Mechanically-ventilated patients with TBI developed NED in addition to changes in muscle structure during their stay in the ICU.
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Journal of critical care · Apr 2018
Pragmatic studies for acute kidney injury: Consensus report of the Acute Disease Quality Initiative (ADQI) 19 Workgroup.
Acute kidney injury (AKI) has become a major medical and financial burden in China along with the rest of the world. There have been considerable advances in the understanding of the epidemiology and pathogenesis of AKI. However, there is no consensus regarding the optimal care for patients. The Acute Disease Quality Initiative (ADQI) 19 meeting focused on identifying and designing relevant and achievable AKI-related studies in China. ⋯ Consensus was reached on a research agenda for AKI with a specific focus on pragmatic trials in China.
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Journal of critical care · Apr 2018
Patient characteristics, incidence, technique, outcomes and early prediction of tracheostomy in the state of Victoria, Australia.
Tracheostomy is a relatively common procedure in Intensive Care Unit (ICU) patients. ⋯ The incidence of tracheostomy and the adjusted mortality rate of patients who received a tracheostomy have significantly decreased over a decade. Day of admission information could not be used to predict subsequent tracheostomy.
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Journal of critical care · Apr 2018
Serum anion gap predicts lactate poorly, but may be used to identify sepsis patients at risk for death: A cohort study.
(1) To test whether serum bicarbonate or anion gap can be used to predict elevated lactate or mortality in emergency department (ED) patients with sepsis, and (2) to define thresholds that may predict elevated lactate and mortality. ⋯ Anion gap and serum bicarbonate poorly predict changes in lactate and mortality. In resource-limited settings where lactate is unavailable, anion gap ≥20mEq/L may be used to further risk-stratify patients for ongoing sepsis care, but lactate remains a preferred biomarker.