Critical care medicine
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Critical care medicine · Nov 2013
Multicenter StudyProfile of the Risk of Death After Septic Shock in the Present Era: An Epidemiological Study.
To investigate mortality of ICU patients over a 3-month period after an initial episode of septic shock and to identify factors associated with mortality. ⋯ This is the most recent large-scale epidemiological study to investigate medium-term mortality in nonselected patients hospitalized in the ICU for septic shock. Advances in early management have improved survival at the initial phase, but risk of death persists in the medium term. Flexible modeling techniques yield insights into the profile of the risk of death in the first 3 months.
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Critical care medicine · Nov 2013
Multicenter StudyA Greater Analgesia, Sedation, Delirium Order Set Quality Score Is Associated With a Decreased Duration of Mechanical Ventilation in Cardiovascular Surgery Patients.
Protocols and order sets for the delivery of analgesia, sedation, and delirium care of the critically ill, mechanically ventilated patient have been shown to improve outcomes but are not uniform in hospitals across geographic areas. The extent to which greater order set quality is associated with improved patient outcomes is not known. We hypothesized that cardiac surgery patients cared for at hospitals with a greater analgesia, sedation, and delirium order set quality score (more guideline-concordant order sets) would have a shorter average duration of mechanical ventilation. ⋯ Cardiac surgery hospitals with more guideline-adherent analgesia, sedation, and delirium order sets have patients with shorter mean durations of mechanical ventilation than hospitals with lower order set quality scores.
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Critical care medicine · Nov 2013
Multicenter StudyValidity of Low-Intensity Continuous Renal Replacement Therapy.
To study the hospital mortality of patients with severe acute kidney injury treated with low-intensity continuous renal replacement therapy. ⋯ Continuous renal replacement therapy at a mean intensity of 14.3 mL/kg/hr did not have worse outcome compared with 20-25 mL/kg/hr of continuous renal replacement therapy, currently considered the standard intensity. However, our study is insufficient to support the use of low-intensity continuous renal replacement therapy, and more studies are needed to confirm our findings.