Critical care medicine
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Critical care medicine · Jan 2007
Comparative StudyTympanic temperature measurements: are they reliable in the critically ill? A clinical study of measures of agreement.
Accurate measurement of temperature is vital in the intensive care setting. A prospective trial was performed to compare the accuracy of tympanic, urinary, and axillary temperatures with that of pulmonary artery (PA) core temperature measurements. ⋯ Agreement of tympanic with pulmonary temperature was inferior to that of urinary temperature, which, on overall assessment, seemed more likely to reflect PA core temperature.
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Critical care medicine · Jan 2007
Randomized Controlled Trial Multicenter StudySelenium in Intensive Care (SIC): results of a prospective randomized, placebo-controlled, multiple-center study in patients with severe systemic inflammatory response syndrome, sepsis, and septic shock.
Sepsis is associated with an increase in reactive oxygen species and low endogenous antioxidative capacity. We postulated that high-dose supplementation of sodium-selenite would improve the outcome of patients with severe sepsis and septic shock. ⋯ The adjuvant treatment of patients with high-dose sodium-selenite reduces mortality rate in patients with severe sepsis or septic shock.
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Critical care medicine · Jan 2007
Randomized Controlled TrialFeed intolerance in critical illness is associated with increased basal and nutrient-stimulated plasma cholecystokinin concentrations.
Delayed gastric emptying and intolerance to gastric feeding occur frequently in the critically ill. In these patients, gastric motor responses to nutrients are disturbed. Cholecystokinin (CCK) slows gastric emptying. The aim of this study was to determine plasma CCK concentrations during fasting and in response to small-intestine nutrient infusion in critically ill patients. ⋯ Both fasting and nutrient-stimulated plasma CCK concentrations are increased in critically ill patients, particularly in those with feed intolerance. This may provide a humoral mechanism for delayed gastric emptying seen in critical illness.
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Critical care medicine · Jan 2007
Meta AnalysisOpen and closed endotracheal suction systems in mechanically ventilated intensive care patients: a meta-analysis.
Closed suction systems (CSS) are increasingly replacing open suction systems (OSS) to perform endotracheal toilet in mechanically ventilated intensive care unit patients. Yet effectiveness regarding patient safety and costs of these systems has not been carefully analyzed. ⋯ Based on the results of this meta-analysis, there is no evidence to prefer CSS more than OSS.
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Critical care medicine · Jan 2007
Comparative StudyPerceptions of safety culture vary across the intensive care units of a single institution.
To determine whether safety culture factors varied across the intensive care units (ICUs) of a single hospital, between nurses and physicians, and to explore ICU nursing directors' perceptions of their personnel's attitudes. ⋯ Significant safety culture variation exists across ICUs of a single hospital. ICU nursing directors tend to overestimate their personnel's attitudes, particularly for teamwork. Culture assessments based on institutional level analysis or director opinion may be flawed.