Journal of critical care
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Journal of critical care · Jun 2019
The perils of medico-legal advocacy in ICU conflicts at the end of life: A qualitative study of what happens when advocacy and best interests collide.
An unexplored aspect of conflicts and conflict resolution in the ICU at EOL is the role of advocacy in both medicine and law.
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Journal of critical care · Jun 2019
Measuring antibiotics in exhaled air in critically ill, non-ventilated patients: A feasibility and proof of concept study.
Measurement of antibiotic concentrations is increasingly used to optimize antibiotic therapy. Plasma samples are typically used for this, but other matrices such as exhaled air could be an alternative. ⋯ Piperacillin and meropenem can be detected and quantified in exhaled air of non-ventilated intensive care unit patients; these quantities did not correlate with plasma concentrations of these drugs.
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Journal of critical care · Jun 2019
The effect of the first-year residents orientation period on intensive care and hospital mortality, in a medical intensive care unit, within a developing country.
To determine whether the adaptation of junior residents, during their first week rotation period within the ICU, has any effect on ICU and hospital mortality rates, in a developing country. ⋯ The junior residents first rotation week is an independent risk factor on hospital mortality, in a tertiary medical intensive care unit, within a developing country.
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Journal of critical care · Jun 2019
Ability to predict team members' behaviors in ICU teams is associated with routine ABCDE implementation.
Poor coordination may impede delivery of the Awakening, Breathing Coordination, Delirium monitoring/management and Early exercise/mobility (ABCDE) bundle. Developing a shared mental model (SMM), where all team members are on the same page, may support coordination. ⋯ Increasing awareness of team members' behaviors may be a mechanism to improve the implementation of complex care bundles like ABCDE.
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Journal of critical care · Jun 2019
Implementation of a structured communication tool improves family satisfaction and expectations in the intensive care unit.
Intensive care unit (ICU) physicians should provide relatives of critically ill patients with appropriate and clear information, regarding prognosis, treatment options and expectations. ⋯ A structured communication tool was associated with improved family satisfaction with communication and expectations regarding hospital survival. Further research is required to evaluate this promising intervention.