Critical care medicine
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Critical care medicine · Jun 2018
Multicenter Study Comparative StudyActivated Prothrombin Complex Concentrate Versus 4-Factor Prothrombin Complex Concentrate for Vitamin K-Antagonist Reversal.
To compare the international normalized ratio normalization efficacy of activated prothrombin complex concentrates and 4-factor prothrombin complex concentrates and to evaluate the thrombotic complications in patients treated with these products for warfarin-associated hemorrhage. ⋯ A low, fixed dose of activated prothrombin complex concentrate was as effective as standard dose 4-factor prothrombin complex concentrate for normalization of international normalized ratio. In addition, we did not see an increase in thrombotic events.
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Critical care medicine · Jun 2018
Randomized Controlled Trial Multicenter StudyPrevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness.
Little is known about the experience of financial stress for patients who survive critical illness or their families. Our objective was to describe the prevalence of financial stress among critically ill patients and their families, identify clinical and demographic characteristics associated with this stress, and explore associations between financial stress and psychologic distress. ⋯ Financial stress after critical illness is common and associated with symptoms of anxiety and depression. Our findings provide direction for potential interventions to reduce this stress and improve psychologic outcomes for patients and their families.
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Critical care medicine · Jun 2018
Observational StudyUltrasound-Guided Laryngeal Air Column Width Difference as a New Predictor for Postextubation Stridor in Children.
To assess the efficacy of ultrasound-guided laryngeal air column width difference in predicting postextubation stridor in children. ⋯ Laryngeal air column width difference measurement may serve as a simple reliable noninvasive method for predicting postextubation stridor in children.
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Critical care medicine · Jun 2018
Climate of Respect Evaluation in ICUs: Development of an Instrument (ICU-CORE).
To develop a valid, reliable measure that reflected the environment of respectfulness within the ICU setting. ⋯ We created a reliable set of scales to measure the climate of respectfulness in intensive care settings. These measures can be used for ongoing quality improvement that aim to enhance the experience of ICU patients and their families.
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Critical care medicine · Jun 2018
Open Lung Biopsy in Nonresolving Acute Respiratory Distress Syndrome Commonly Identifies Corticosteroid-Sensitive Pathologies, Associated With Better Outcome.
Approximately half of the patients undergoing lung biopsy for nonresolving acute respiratory distress syndrome exhibit another histologic pattern than diffuse alveolar damage, with some of the pathologies characterized by a potential response to corticosteroids. This study aimed to assess whether open lung biopsy performed in the ICU for nonresolving acute respiratory distress syndrome was able to identify steroid-sensitive diseases and whether patients with a steroid-sensitive pathology experienced different clinical courses and outcomes. ⋯ Open lung biopsy was able to identify a steroid-sensitive pathology in a significant proportion of nonresolving acute respiratory distress syndrome patients. These patients had a better outcome, with lower hospital mortality and 180-day mortality.