Journal of critical care
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Journal of critical care · Aug 2019
Multicenter Study Comparative StudyNighttime and non-business days are not associated with increased risk of in-hospital mortality in patients with severe sepsis in intensive care units in Japan: The JAAM FORECAST study.
Hospital services are reduced during off-hour such as nighttime or weekend. Investigations of the off-hour effect on initial management and outcomes in sepsis are very limited. Thus, we tested the hypothesis that patients who were diagnosed with severe sepsis during the nighttime or on non-business days had altered initial management and clinical outcomes. ⋯ Nighttime and weekends were not associated with increased in-hospital mortality of severe sepsis.
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Journal of critical care · Aug 2019
Multicenter Study Observational StudyThe furosemide stress test for prediction of worsening acute kidney injury in critically ill patients: A multicenter, prospective, observational study.
To validate the furosemide stress test (FST) for predicting the progression of acute kidney injury (AKI). ⋯ In ICU patients without severe CKD with mild AKI, a UFR of less than 200mls in the first 2 h after an FST is predictive of progression to stage III AKI. Future studies should focus on incorporating a FST as part of a clinical decision tool for further management of critically ill patients with AKI.
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Journal of critical care · Aug 2019
Randomized Controlled TrialEffect of physostigmine on recovery from septic shock following intra-abdominal infection - Results from a randomized, double-blind, placebo-controlled, monocentric pilot trial (Anticholium® per Se).
The cholinergic anti-inflammatory pathway has been shown to be accessible by physostigmine salicylate in animal models. However, the cholinesterase inhibitor is not approved for adjunctive therapy in sepsis, and tolerability and safety of high initial doses followed by continuous infusion have not been investigated. ⋯ Treatment with physostigmine salicylate was feasible and safe. Further studies are justified to assess the effect on recovery from septic shock.
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Journal of critical care · Aug 2019
Multicenter StudyDevelopment and daily use of a numeric rating score to assess sleep quality in ICU patients.
Insufficient sleep burdens critically ill patients, optimizing sleep may enhance patient's outcomes. Current assessment methods may unnecessary burden patients. Therefore, a single numeric rating score was validated for sleep assessment. ⋯ A single numeric rating score for sleep is interchangeable for the RCSQ score for assessment of sleep quality. Optimal cut-off is >5. Use of a numeric rating score for sleep is a practical way to evaluate and monitor sleep as perceived by patients in daily ICU practice.
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Journal of critical care · Aug 2019
Randomized Controlled Trial Comparative StudyThe hospital-based evaluation of laxative prophylaxis in ICU (HELP-ICU): A pilot cluster-crossover randomized clinical trial.
Prophylactic laxative regimens may prevent constipation but may increase diarrhea and subsequent rectal tube insertion. Our aim was to compare three prophylactic laxative regimens on the rate of rectal tube insertion (primary outcome) and major constipation- or diarrhea-associated complications. ⋯ Earlier commencement of a prophylactic coloxyl-based laxative regimen (day 1 or 3) did not affect the rates of complications associated with constipation or diarrhea when compared to delayed introduction (day 6).