Journal of critical care
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Journal of critical care · Feb 2018
Multicenter StudyInitial fluid resuscitation following adjusted body weight dosing is associated with improved mortality in obese patients with suspected septic shock.
The optimal initial fluid resuscitation strategy for obese patients with septic shock is unknown. We evaluated fluid resuscitation strategies across BMI groups. ⋯ Using AdjBW to calculate initial fluid resuscitation volume for obese patients with suspected shock may improve outcomes compared to other weight-based dosing strategies. The optimal fluid dosing strategy for obese patients should be a focus of future prospective research.
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Journal of critical care · Feb 2018
Randomized Controlled Trial Multicenter Study Comparative StudyEnteral nutrition as stress ulcer prophylaxis in critically ill patients: A randomized controlled exploratory study.
We investigated whether early enteral nutrition alone may be sufficient prophylaxis against stress-related gastrointestinal (GI) bleeding in mechanically ventilated patients. ⋯ We found no benefit when pantoprazole is added to early enteral nutrition in mechanically ventilated critically ill patients. The routine prescription of acid-suppressive therapy in critically ill patients who tolerate early enteral nutrition warrants further evaluation.
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Journal of critical care · Feb 2018
Multicenter StudyEnd-of-life discussions: Who's doing the talking?
To determine, in a tertiary academic medical center, the reported frequency of end-of-life discussions among nurses and the influence of demographic factors on these discussions. ⋯ In a survey conducted in two tertiary care institutions, more than one-third of nurses from all disciplines responded that they never or almost never discuss end-of-life issues with their patients. Specialty influenced the likelihood of discussing end-of-life issues with patients.
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Journal of critical care · Feb 2018
Multicenter Study Comparative StudyHealth-related quality of life after obstetric intensive care admission: Comparison with the general population.
To examine health-related quality of life (HRQoL) in obstetric patients after intensive care discharge, with comparison to age-appropriate reference values from the general Finnish female population. ⋯ The baseline HRQoL of study population was lower than that of the general population, but after six months, the mean values were comparable to reference value. However, one in five patients still experienced impaired QOL at follow-up.
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Journal of critical care · Feb 2018
Multicenter Study Observational StudyPost-ICU psychological morbidity in very long ICU stay patients with ARDS and delirium.
We investigated the impact of delirium on illness severity, psychological state, and memory in acute respiratory distress syndrome patients with very long ICU stay. ⋯ Delirium was associated with memory impairment and PTSS-14 scores suggestive of PTSD, but not illness severity.