Journal of critical care
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Journal of critical care · Oct 2021
Meta AnalysisEffect of thiamine supplementation in critically ill patients: A systematic review and meta-analysis.
Several studies have previously shown the benefit of thiamine supplementation in critically ill patients. In order to fully appraise the available data, we performed a meta-analysis of 18 published studies. ⋯ Thiamine supplementation in critically ill patients showed a reduction in the incidence of ICU delirium among RCTs. However, there was no significant benefit in terms of overall mortality, and mortality in patients with sepsis. Further, large scale randomized prospective studies are warranted to investigate the role of thiamine supplementation in critically ill patients.
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Journal of critical care · Oct 2021
Randomized Controlled TrialEvolution of practice patterns in the management of acute respiratory distress syndrome: A secondary analysis of two successive randomized controlled trials.
We sought to examine changes in acute respiratory distress syndrome (ARDS) management over a 12-year period of two successive randomized trials. ⋯ Clear trends were apparent in tidal volume, airway pressures, ventilator modes, adjuncts and rescue therapies. With the exception of prone positioning, and outside the context of rescue therapy, these trends appear consistent with the evolving literature on ARDS management.
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Journal of critical care · Oct 2021
The burden of implementation: A mixed methods study on barriers to an ICU follow-up program.
It has been suggested that ICU follow-up clinics can offer support for ICU survivors and their relatives. However, implementation of such clinics can be challenging. We explored the barriers to implementation of an ICU follow-up program from the healthcare providers' perspective. ⋯ Awareness of those barriers can help healthcare providers and ICU managers in developing strategies adapted to overcome constraints, thus facilitating the implementation process.
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Journal of critical care · Oct 2021
ReviewThe burden they bear: A scoping review of physician empathy in the intensive care unit.
Research shows that physician empathy can improve patients' reporting of symptoms, participation in care, compliance, and satisfaction; however, success in harnessing these advantages in the ICU hinges on a myriad of contextual factors. This study describes the current state of knowledge about intensivists' empathy. ⋯ Empathy among intensivists is not a dichotomous phenomenon. It instead exists on continua. Four steps are recommended for optimizing empathy in the ICU: clearly defining empathy, addressing risks and benefits transparently, providing education regarding reflective practice, and developing supportive environments. Overall, this review revealed that the state of knowledge about empathy as experienced by intensivists still has room to grow and be further explored.
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Journal of critical care · Oct 2021
Thromboelastograph:A prognostic marker in sepsis with organ dysfunction without overt bleeding.
Coagulation abnormalities are not infrequent in sepsis. It is unclear if abnormalities in thromboelastogram (TEG) are associated with mortality in patients with severe sepsis without overt bleeding. ⋯ A subset of patients with severe sepsis without overt bleeding are hypocoagulable. Hypocoagulability is associated with mortality and need for transfusion.