Journal of critical care
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Journal of critical care · Feb 2020
Performance of a quick sofa-65 score as a rapid sepsis screening tool during initial emergency department assessment: A propensity score matching study.
We sought to elucidate the performance of a Quick Sequential Organ Function Assessment-65 (qSOFA-65) score in recognizing sepsis and to compare the qSOFA-65 score to systemic inflammatory response syndrome (SIRS) and qSOFA scores. ⋯ We found that qSOFA-65 was more likely to identify patients with sepsis on the initial ED visit relative to qSOFA or SIRS. This may have quality improvement implications in predicting sepsis.
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Journal of critical care · Feb 2020
Intensive care unit occupancy and premature discharge rates: A cohort study assessing the reporting of quality indicators.
ICU occupancy fluctuates. High levels may disadvantage patients. Currently, occupancy is benchmarked annually which may inaccurately reflect strained units. Outcomes potentially sensitive to occupancy include premature (early) ICU discharge and non-clinical transfer (NCT). This study assesses the association between daily occupancy and these outcomes, and evaluates benchmarking care across Scotland using daily occupancy. ⋯ We demonstrate a clear association between daily ICU occupancy and early discharge/NCT. Daily occupancy may better benchmark care quality than mean annual occupancy.
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Journal of critical care · Feb 2020
Cost-effectiveness of second-line vasopressors for the treatment of septic shock.
To determine the cost-effectiveness of escalating doses of norepinephrine or norepinephrine plus the adjunctive use of vasopressin or angiotensin II as a second-line vasopressor for septic shock. ⋯ Vasopressin is the most cost-effective second-line vasopressor in both the short- and long-term evaluations. Vasopressor price is a minor contributor to overall cost.
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Journal of critical care · Feb 2020
Randomized Controlled Trial Multicenter StudyGender differences in mortality and quality of life after septic shock: A post-hoc analysis of the ARISE study.
To assess the impact of gender and pre-menopausal state on short- and long-term outcomes in patients with septic shock. ⋯ This post-hoc analysis of a large multi-center trial in early septic shock has shown no short- or long-term survival effect for women overall as well as in the pre-menopausal age-group.
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Journal of critical care · Feb 2020
Review Historical ArticleThe history of critical care in Kenya.
Critical care is a young specialty in Kenya. From its humble beginnings in the 1960s to present day Kenya, the bulk of this service has largely been provided by anaesthetists. We provide a detailed account of the growth and development of this specialty in our country, the attempts made by our people to grow this service within our borders and the vital role our international partners have played throughout this process. We also share a selection of our successes over the years, the challenges we have faced and our aspirations as we look to the future.