Journal of critical care
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Journal of critical care · Aug 2018
Multicenter Study Observational StudyFactors associated with delayed rapid response team activation.
Delayed activation of the rapid response team (RRT) is common and has been associated with adverse outcomes. However, little is known about the factors associated with delayed activation. This was an observational study from two hospitals in Ottawa, Canada, including adult inpatients with experiencing an activation of the RRT. ⋯ The reasons for RRT call were significantly different (P < 0.001) with respiratory distress (29.3% versus 24.8%), and hypotension (17.4% versus 13.2%) being more common in the delayed group, and dysrhythmias (15.9% versus 18.5%) and altered level of consciousness (13.5% versus 18.7%) being less common. RRT activation was more delayed on non-surgical services (P < 0.001). Delayed activation was associated with increased mortality (Adjusted odds ratio [OR] 1.23, 95% CI 1.07-1.41), ICU admission (Adjusted OR 1.72, 95% CI 1.51-1.96), and hospital length of stay (13 versus 15 days, P < 0.001).
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Journal of critical care · Aug 2018
Multicenter StudyLate organ failures in patients with prolonged intensive care unit stays.
The purpose of this study was to characterize the organ failures that develop among patients with prolonged ICU stays, defined as those who spent a minimum of 14 days in an ICU. ⋯ Strategies aiming to reduce the development of new late organ failures may be a novel target for preventing persistent critical illness.
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Journal of critical care · Aug 2018
Urinary potassium excretion and its association with acute kidney injury in the intensive care unit.
Using urinary indices as a quick bedside test to assist management of oliguria and acute kidney injury (AKI) has long been sought. This study assessed whether urinary potassium excretion is related to simultaneously calculated creatinine clearance (CrCl) and can predict AKI in the critically ill. ⋯ Urinary potassium excretion correlates with CrCl and predicts AKI in the critically ill without recent furosemide exposure. Given 2-h urinary potassium excretion can be measured easily, its potential as a marker of renal function deserves further study.
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Journal of critical care · Aug 2018
Multicenter StudyVariation in mortality rates after admission to long-term acute care hospitals for ventilator weaning.
We sought to examine variation in long-term acute care hospital (LTACH) quality based on 90-day in-hospital mortality for patients admitted for weaning from mechanical ventilation. ⋯ LTACHs vary widely in mortality rates, underscoring the need to better understand the sources of this variation and improve the quality of care for patients requiring long-term ventilator weaning.