Journal of critical care
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Journal of critical care · Feb 2015
Multicenter Study Comparative StudyAdults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units.
The purpose of the study is to compare demographics, intensive care unit (ICU) admission characteristics, and ICU outcomes among adults with childhood-onset chronic conditions (COCCs) admitted to US pediatric and adult ICUs. ⋯ There are marked differences in characteristics between young adults with COCC admitted to pediatric ICUs and adult ICUs. Barriers to accommodating these young adults may be reasons why many such adults have not transitioned from pediatric to adult critical care.
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Journal of critical care · Feb 2015
Multicenter Study Observational StudyAssociation between serum total antioxidant capacity and mortality in severe septic patients.
Total antioxidant capacity (TAC) in severe septic patients has been analyzed in few studies with limited number of subjects. In addition, no association between TAC serum levels and mortality in patients with sepsis has been investigated. We aimed at assessing a possible relationship between TAC serum levels and mortality using a large cohort of patients with severe sepsis. ⋯ The most relevant and new findings of our study, the largest cohort of septic patients providing data on circulating TAC levels so far, were that serum TAC levels are associated with mortality and could be used as biomarker to outcome prediction in severe septic patients.
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Journal of critical care · Dec 2014
Multicenter Study Observational StudyPharmacoepidemiology of stress ulcer prophylaxis in the United States and Canada.
This study sought to identify the medication class most commonly prescribed for stress ulcer prophylaxis (SUP), assess trends in SUP utilization, and report the use of acid suppressive therapy stratified by bleeding risk. ⋯ Stress ulcer prophylaxis is frequently administered to patients who are not at high risk for clinically important bleeding. Proton pump inhibitors are the overwhelming first choice among practitioners. Several opportunities exist for improvement regarding the provision of SUP.
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Journal of critical care · Dec 2014
Multicenter StudyExperiences with capnography in acute care settings: A mixed-methods analysis of clinical staff.
Although capnography is being incorporated into clinical guidelines, it is not used to its full potential. We investigated reasons for limited implementation of capnography in acute care areas and explored facilitators and barriers to its implementation. ⋯ We observed varied responsiveness to capnography and identified factors that work to foster or discourage its use. These data can guide future implementation strategies. A deliberate strategy to foster utilization, mitigate barriers, and broadly accelerate implementation has the potential to profoundly impact use of capnography in acute care areas with the goal of improving patient care.
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Journal of critical care · Dec 2014
Multicenter Study Observational StudyCentral venous pressure after coronary artery bypass surgery: Does it predict postoperative mortality or renal failure?
Although hemodynamic monitoring is often performed after coronary artery bypass grafting (CABG), the role of monitoring postoperative central venous pressure (CVP) measurement as a predictor of clinical outcomes is unknown. As such, this study tests the hypothesis that postoperative CVP is predictive of operative mortality or renal failure. ⋯ Patients' CVP at 6 hours after CABG surgery was highly predictive of operative mortality or renal failure, independent of cardiac index and other important clinical variables. Future studies will need to assess whether interventions guided by postoperative CVP can improve patient outcomes.