Journal of critical care
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Journal of critical care · Apr 2019
ReviewDecision-making in ICU - A systematic review of factors considered important by ICU clinician decision makers with regard to ICU triage decisions.
The ICU is a scarce resource within a high-stress, high-stakes, time-sensitive environment where critically ill patients with life-threatening conditions receive expensive life-sustaining care under the guidance of expert qualified personnel. The implications of decisions such as suitability for admission into ICU are potentially dire and difficult. ⋯ The complex and dynamic ICU triage decision is affected by numerous interacting factors. The literature provides some indication of these factors, but fail to show complexities and interactions between them. A decision tree is proposed. Further research should include a reflection on how decisions for admission to ICU are made, such that a better understanding of these processes can be achieved allowing for improved individual and group consistency.
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Journal of critical care · Apr 2019
Comparative StudyLacosamide versus phenytoin for the prevention of early post traumatic seizures.
To compare the efficacy and safety of lacosamide versus phenytoin for seizure prophylaxis following TBI. ⋯ There was no difference between lacosamide and phenytoin in the prevention of early post traumatic seizures in patients following TBI. Lacosamide may have a more tolerable side effect profile.
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Journal of critical care · Apr 2019
Postdischarge long-term cardiovascular outcomes of intensive care unit survivors who developed dialysis-requiring acute kidney injury after cardiac surgery.
Dialysis-requiring acute kidney injury (AKI-D) after cardiac surgery is a major cause of in-hospital mortality. However, the long-term outcome has not been previously examined. ⋯ AKI-D following cardiac surgery was associated with worse long-term postdischarge mortality and elevated risks of dialysis dependency and MACE development. The outcomes were consistent even in the patients who recovered from the dialysis.
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Journal of critical care · Apr 2019
Observational StudySurvival of amyotrophic lateral sclerosis patients after admission to the intensive care unit for acute respiratory failure: an observational cohort study.
Amyotrophic lateral sclerosis (ALS) entails a risk of acute respiratory failure (ARF). The decision to admit such patients to the intensive care unit (ICU) is difficult given the inexorable prognosis of ALS. To fuel this discussion, this study describes the ICU and post-ICU survival of ALS-related ARF. ⋯ The prognosis of ALS-related ARF requiring ICU admission resembles that of ARF complicating other conditions with high short-term mortality (e.g. lung cancer).