Journal of critical care
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Journal of critical care · Feb 2021
Consequences of suboptimal communication for patients with limited English proficiency in the intensive care unit and suggestions for a way forward: A qualitative study of healthcare team perceptions.
To understand the healthcare team's perceptions of the negative consequences of suboptimal communication and their recommendations to improve communication with patients and families who have Limited English Proficiency (LEP) in the Intensive Care Unit (ICU). ⋯ Patients with LEP are at risk of experiencing suboptimal communication with the healthcare team in the ICU. There are several educational and quality improvement strategies that ICUs and institutions can take to mitigate these issues.
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Journal of critical care · Feb 2021
Preventing infectious diseases in Intensive Care Unit by medical devices remote control: Lessons from COVID-19.
The management of COVID-19 patients in the ICUs requires several and prolonged life-support systems (mechanical ventilation, continuous infusions of medications and nutrition, renal replacement therapy). Parameters have to be entered continuously into the device user interface by healthcare personnel according to the dynamic clinical condition. ⋯ Cables and tubing extensions have been utilized to make certain devices usable outside the patient's room but at the cost of introducing further hazards. Remote control of these devices decreases the frequency of unnecessary interventions and reduces the risk of exposure for both patients and healthcare personnel.
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Journal of critical care · Feb 2021
Meta AnalysisHypoalbuminemia is associated with increased risk of acute kidney injury in hospitalized patients: A meta-analysis.
Previous systematic review suggested that hypoalbuminemia is associated with increased risk of acute kidney injury (AKI). However, pooled sample size was small, and there was no universal definition for AKI. ⋯ Hypoalbuminemia is associated with AKI in hospitalized patients. However, the effect on mortality is subjected to publication bias.
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Journal of critical care · Feb 2021
ReviewOutcomes of severe Legionella pneumonia requiring extracorporeal membrane oxygenation (ECMO).
Legionella pneumonia with acute respiratory failure may necessitate extracorporeal membrane oxygenation (ECMO). The medical literature in this area is comprised primarily of case reports and small case series. Our goal was to summarize published data and contribute our institutional experience regarding survival in severe Legionella pneumonia requiring ECMO. ⋯ Review of clinical experience with ECMO for severe Legionella pneumonia yields a survival rate of over 70%. The similarity in survival rates among all published cases (78.1%), case series reporting surviving and non-surviving patients (71.7%), our institutional experience (80%), and recently reported Extracorporeal Life Support Organization (ELSO) registry data (71%) supports the veracity of this encouraging survival rate.
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Journal of critical care · Feb 2021
ReviewA mixed methods study to effectively utilize trigger tools in the ICU.
This study aimed to create a trigger tool for our intensive care units (ICUs) to support our departmental quality improvement efforts. ⋯ We used the modified Delphi process to derive consensus-selected triggers to identify ICU specific adverse events with opportunity for improvement in local care. This methodology can be adopted by other centers looking to introduce trigger tools in a manner selective to their practice needs.