Journal of critical care
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Journal of critical care · Dec 2019
Comparative StudyComparison between logistic regression and machine learning algorithms on survival prediction of traumatic brain injuries.
To compare twenty-two machine learning (ML) models against logistic regression on survival prediction in severe traumatic brain injury (STBI) patients in a single center study. ⋯ The twenty-two ML models selected have capabilities comparable to classical LR model for outcome prediction in STBI patients. Of these, Cubic SVM, Quadratic SVM, Linear SVM performed significantly better than LR.
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Journal of critical care · Dec 2019
Multicenter StudyCommunication with patients' families in the intensive care unit: A point prevalence study.
We aimed to describe point of care communication encounters with patients' families in centers with open visitation practices. ⋯ ICUs adopt multiple ways of communicating with family members of critically ill patients. Significant interactions occur outside of traditional family meetings, in a less formal and more frequent fashion. Our study supports development of tools to support best practices within contemporary communication paradigms to support provider, patients and family needs.
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Journal of critical care · Dec 2019
Subtherapeutic piperacillin concentrations in neurocritical patients.
Increased renal elimination is the leading cause for subtherapeutic concentrations of renally cleared antibiotics and it has been hypothesized that brain damaged patients in the intensive care unit (ICU) are particularly at risk. The objective of this study is to determine the prevalence of subtherapeutic piperacillin concentrations in neurocritical patients and to investigate if having a neurocritical diagnosis is a risk factor for this. ⋯ Subtherapeutic piperacillin concentrations are common in neurocritical patients yet having a neurocritical admission diagnosis was not identified as an independent risk factor.
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Journal of critical care · Dec 2019
Enhancing care of patients requiring a tracheostomy: A sustained quality improvement project.
Within the UK approximately 5000 surgical and 12,000 percutaneous tracheostomies are performed annually. Whilst an essential component of patient care, the presence of a tracheostomy is not without concern. Landmark papers have demonstrated recurrent themes related to the provision of training, staff and equipment, leading to avoidable patient harm, life-altering morbidity and mortality. The development of the Global Tracheostomy Collaborative (GTC) and the Improving Tracheostomy Care (ITC) project have provided the necessary infrastructure to make improvements, with individual organizations responsible for its implementation. ⋯ This QI project, supported by involvement with the GTC and ITC, resulted in reductions in adverse events, improved patient safety, non-significant reduction in time to achieve weaning milestones and a reduction in hospital length of stay.