Journal of critical care
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Journal of critical care · Aug 2013
Multicenter StudyLength of stay and mortality due to Clostridium difficile infection acquired in the intensive care unit.
The purpose of this study was to determine the attributable intensive care unit (ICU) and hospital length of stay and mortality of ICU-acquired Clostridium difficile infection (CDI). ⋯ C difficile infection acquired in ICU is associated with an increase in length of ICU and hospital stay but not with any difference in ICU or hospital mortality.
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Journal of critical care · Aug 2013
Multicenter StudySevere abnormalities in microvascular perfused vessel density are associated to organ dysfunctions and mortality and can be predicted by hyperlactatemia and norepinephrine requirements in septic shock patients.
The aims of this study are to determine the general relationship of perfused vessel density (PVD) to mortality and organ dysfunctions and to explore if patients in the lowest quartile of distribution for this parameter present a higher risk of bad outcome and to identify systemic hemodynamic and perfusion variables that enhances the probability of finding a severe underlying microvascular dysfunction. ⋯ Perfused vessel density is significantly related to organ dysfunctions and mortality in septic shock patients, particularly in patients exhibiting more severe abnormalities as represented by the lowest quartile of distribution for this parameter. The presence of hyperlactatemia and high norepinephrine requirements increases the odds of finding a severe underlying microvascular dysfunction during a sublingual microcirculatory assessment.
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Journal of critical care · Aug 2013
Multicenter StudyImpaired gastrointestinal transit and its associated morbidity in the intensive care unit.
To determine the proportion of critically ill adults developing impaired gastrointestinal transit (IGT) using a clinically pragmatic definition, its associated morbidity and risk factors. ⋯ Traditional definitions of constipation or ileus in intensive care unit patients are simplistic and lack clinical relevance. Pragmatically defined IGT is a common complication of critical illness and is associated with significant morbidity. Future interventional studies for IGT in critically ill adults should use a more clinically relevant definition and evaluate energy deficits and lengths of stay as clinically relevant outcomes.
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Journal of critical care · Aug 2013
Multicenter StudyRapid response teams, do not resuscitate orders, and potential opportunities to improve end-of-life care: a multicentre retrospective study.
Rapid response teams (RRTs) were created to stabilize acutely ill patients on the ward, but recent studies suggest that RRTs may improve end-of-life care (EOLC). To learn more about the role of the RRT in EOLC at our institutions, we conducted a retrospective review. ⋯ RRT consultation is an important milestone for many patients approaching EOL. RRTs frequently participate in EOL discussions and decision-making, but they may miss opportunities to facilitate EOLC.
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Journal of critical care · Jun 2013
Multicenter StudyMotivation and job satisfaction of Tele-ICU nurses.
Although the first tele-ICU has been in existence for more than 12 years, little is known about the work of tele-ICU nurses. This study examines sources of motivation and satisfaction of tele-ICU nurses. ⋯ Most tele-ICU nurses are satisfied with their job. They like the challenge in their work and the opportunity to learn. For some nurses, the transition from a bedside caregiver to an information manager can be difficult. Other nurses have found a balance by working part-time in the tele-ICU and part-time in the ICU.