Journal of critical care
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Knowledge of families' perspective of quality of intensive care unit (ICU) care is important, especially with regard to end-of-life (EOL) care. Adaptation of the US-developed "Quality of dying and death questionnaire" (QODD) to a European setting is lacking. The primary aim of this study is to examine the euroQODD's usability and its assessments of EOL care in a cohort of Danish and Dutch family members. ⋯ The majority of family members were satisfied with the quality of EOL care and quality of dying and death. They agreed with decisions made to limit treatment and most felt they had participated to some extent in decision-making, although some would have preferred greater participation. Addition of items that can be accurately treated as effect indicators will improve the instrument's usefulness in measuring the overall quality of dying and death.
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Journal of critical care · Apr 2018
The predictive performances of equations used to estimate unbound phenytoin concentrations in a medical ICU population and the impact of exogenous albumin administration.
This study evaluated the predictive performances of four equations (Sheiner-Tozer [ST], Kane-modified ST, Anderson-modified ST, and Cheng-modified ST) used to estimate free phenytoin concentrations in a medical intensive care unit (MICU) and assessed the impact of exogenously administered albumin. ⋯ Estimating unbound concentrations with equations in the MICU population is discouraged.
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Journal of critical care · Apr 2018
Pre-hospital frailty and hospital outcomes in adults with acute respiratory failure requiring mechanical ventilation.
We aimed to estimate the independent effect of pre-hospital frailty (PHF) on hospital mortality and prolonged hospital length of stay (pLOS) while adjusting for other patient level factors. ⋯ PHF, identified by frailty diagnoses from before index hospitalization, may be a useful approach for identifying adults with ARF at increased risk of hospital mortality and pLOS.
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Journal of critical care · Apr 2018
Rate of low tidal volume ventilation use remains low in patients with acute respiratory distress syndrome despite improvement efforts at a single center.
Low tidal volume ventilation (LTVV) reduces mortality in acute respiratory distress syndrome (ARDS) patients. Understanding local barriers to LTVV use at a former ARDS Network hospital may provide new insight to improve LTVV implementation. ⋯ Most ARDS patients did not receive LTVV despite implementation of a protocol. ARDS was also recognized in a minority of patients, suggesting an opportunity for improvement of care.
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Journal of critical care · Apr 2018
Quantitative relationships among plasma lactate, inorganic phosphorus, albumin, unmeasured anions and the anion gap in lactic acidosis.
Quantitative relationships among plasma [Lactate], [Pi], [Albumin], unmeasured anions ([UA]) and the anion gap (AGK) in lactic acidosis (LA) are not well defined. ⋯ In LA, cAGK is more sensitive than AGK in predicting [Lactate]>4.0mEq/L.