Journal of critical care
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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.
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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 evolution of diaphragm activity and function determined by ultrasound during spontaneous breathing trials.
Rapid shallow breathing index (RSBI) is a commonly used index for predicting the outcome of spontaneous breathing trial (SBT). Ultrasound is a non-invasive technique for assessing diaphragm activity and function. This study aimed to investigate changes in diaphragm activity during SBT, and to compare diaphragm function between patients with and without SBT success. ⋯ Patient inspiratory efforts significantly increased during SBT. TFditidal measured by diaphragm ultrasound could not distinguish between patients with SBT success and failure. RSBI was significantly higher during SBT in patients with SBT failure.
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Journal of critical care · Jun 2019
Impact of chronic right ventricular pressure overload in short-term outcomes of acute pulmonary embolism: A retrospective analysis.
Evaluate the association between chronic right ventricle (RV) dysfunction by transthoracic echocardiogram (TTE) and outcomes in patients with acute pulmonary embolism (PE). ⋯ Chronic RVPO patients had lower heart rates and troponin-t values. Despite these differences there were no differences in need for advanced therapeutic interventions or 7 day mortality.