Journal of critical care
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Journal of critical care · Sep 2009
Randomized Controlled Trial Multicenter StudyA controlled trial of noninvasive ventilation for chronic obstructive pulmonary disease exacerbations.
This prospective, multicenter, double-blind, placebo-controlled study tested the hypothesis that noninvasive positive pressure ventilation reduces the need for endotracheal intubation in patients hospitalized in a pulmonary ward because of acute exacerbation of chronic obstructive pulmonary disease. ⋯ These results demonstrate that noninvasive positive pressure ventilation, in a pulmonary ward, reduces the need for endotracheal intubation, particularly in the more severe patients, and leads to a faster recovery in patients with acute exacerbation of chronic obstructive pulmonary disease.
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Journal of critical care · Sep 2009
The diagnosis of myocardial infarction in critically ill patients: an agreement study.
The aim of the study was to assess agreement among 4 intensivists in diagnosing myocardial infarction (MI) in critically ill patients based on screening electrocardiograms (ECGs) and cardiac troponin (cTn) levels. ⋯ Diagnosing MI in the ICU remains a challenge due to variable agreement in 12-lead ECG interpretation. Such variation in practice may contribute to underrecognition of MI during critical illness.
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Journal of critical care · Sep 2009
Multicenter StudyTime series analysis of use patterns for common invasive technologies in critically ill patients.
Critically ill patients are frequently managed with invasive technologies as part of their medical care. Little is known about use patterns. We examined use trends for invasive technologies used in critically ill patients. ⋯ The use of invasive technologies in critically ill patients is changing and may have important implications for resource use, clinician education, and patient care. Initiatives should be considered for ensuring clinician competency during technology transitions.
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Journal of critical care · Sep 2009
Effect of interhospital transfer on resource utilization and outcomes at a tertiary pediatric intensive care unit.
The study aimed to examine the effect of interhospital transfer on resource utilization and clinical outcomes at a tertiary pediatric intensive care unit (PICU) among patients with sepsis or respiratory failure. ⋯ Interhospital transfer, particularly inter-PICU transfer, was associated with significant hospital resource consumption that often correlated with admission illness severity. Future prospective studies should identify determinants of pretransfer illness severity and investigate decision making underlying interhospital transfer.
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The aim of this study was to evaluate the factors related to outcome regarding in-intensive care unit (ICU) cardiac arrest (IICA) in a university hospital. ⋯ Shorter resuscitation duration and initial VT/VF are predictors for both ROSC and hospital survival, whereas lower Acute Physiology and Chronic Health Evaluation II scores predict the latter.