Journal of critical care
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Journal of critical care · Dec 2020
Observational StudyElevated blood pressure after craniotomy: A prospective observational study.
Close hemodynamic monitoring after craniotomy is routine given risk for post-operative hypertension, systemic and neurological complications. Patient and peri-operative variables associated with increased risk of post-craniotomy hypertension and complications are not well understood. Our analysis aims to estimate the incidence and prevalence of post-craniotomy hypertension, its time course, contributing factors, and post-craniotomy complications. ⋯ Development of hypertension after craniotomy is multi-factorial. In this prospective study, a prior history of hypertension was the only associated independent risk factor.
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Journal of critical care · Dec 2020
LetterRenal replacement therapy in critically ill patients with COVID-19: A retrospective study investigating mortality, renal recovery and filter lifetime.
This study aims to investigate mortality and renal recovery in patients with Acute Kidney Injury (AKI) and Renal Replacement Therapy (RRT) due to COVID-19. A secondary aim is to investigate the filter life time in Continuous VenoVenous Hemofiltration (CVVH) and the effect of different methods of anticoagulation. ⋯ The need for RRT in critically ill patients with COVID-19 was reversible in our cohort and RRT was not associated with an increased mortality compared to AKI without the need for RRT. Higher levels of anticoagulation were not associated with prolonged filter life.
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Journal of critical care · Dec 2020
ReviewNovel approaches to facilitate the implementation of guidelines in the ICU.
The effective implementation of evidence-based recommendations in routine intensive care unit (ICU) practice is challenging. Barriers related to the proposed recommendations, local contexts and processes can make the adoption of evidence-based practices difficult, contributing to healthcare inefficiency and worse patient and family outcomes. This review discusses the common barriers to guideline implementation in critical care settings, explores how implementation science provides an important framework for guiding implementation interventions, and discusses some specific and proven implementation strategies to improve adherence to evidence-based practices in the ICU.