Critical care medicine
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Critical care medicine · May 2011
Multicenter Study Comparative StudyComparing clinician ratings of the quality of palliative care in the intensive care unit.
There are numerous challenges to successfully integrating palliative care in the intensive care unit. Our primary goal was to describe and compare the quality of palliative care delivered in an intensive care unit as rated by physicians and nurses working in that intensive care unit. ⋯ Our study supports the content validity of the ten overall rating items and supports the need for improvement in several aspects of palliative care, including spiritual support for families, emotional support for clinicians, and clinician education about palliative care in the intensive care unit. Furthermore, our findings provide some preliminary support for surveying intensive care unit clinicians as one way to assess the quality of palliative care in the intensive care unit.
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Critical care medicine · May 2011
Comparative StudyThe relationship between hospital and intensive care unit length of stay.
To assess variations in case-mix-adjusted hospital and intensive care unit length of stay and to examine the relationship between intensive care unit and hospital stay. ⋯ Case-mix-adjusted benchmarks for hospital and intensive care unit stays reveal substantial differences in unit efficiency. Hospital and intensive care unit stays are strongly correlated at the patient and unit level, suggesting that there are causal factors common to both.
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Critical care medicine · May 2011
Comparative StudyShort-term mortality prediction for acute lung injury patients: external validation of the Acute Respiratory Distress Syndrome Network prediction model.
An independent cohort of patients with acute lung injury was used to evaluate the external validity of a simple prediction model for short-term mortality previously developed using data from Acute Respiratory Distress Syndrome Network (ARDSNet) trials. ⋯ Evaluation of the ARDSNet prediction model using an external acute lung injury cohort demonstrated similar discrimination of the model as was observed with the ARDSNet validation data set. However, there were substantial differences in observed vs. predicted mortality among intermediate-risk patients with acute lung injury. The ARDSNet model provided reasonable, but imprecise, estimates of predicted mortality when applied to our external validation cohort of patients with acute lung injury.
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Critical care medicine · May 2011
Comparative StudyQualitative analysis of an intensive care unit family satisfaction survey.
To describe the qualitative findings from a family satisfaction survey to identify and describe the themes that characterize family members' intensive care unit experiences. ⋯ The study provided improved understanding of why family members are satisfied or dissatisfied with particular elements of the intensive care unit and this knowledge can be used to modify intensive care units to better meet the physical and emotional needs of the families of intensive care unit patients.
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Critical care medicine · May 2011
Review Meta Analysis Comparative StudyThe effect of heparin administration in animal models of sepsis: a prospective study in Escherichia coli-challenged mice and a systematic review and metaregression analysis of published studies.
If thrombosis contributes to sepsis, heparin titrated using activated partial thromboplastin times may be efficacious. We investigated heparin in preclinical models. ⋯ Coagulopathy with sepsis or other variables, such as type of infectious source, may influence the efficacy of heparin therapy for sepsis.