Articles: patients.
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Multicenter Study Observational Study
Intravenous fluid use after cardiac surgery: a multicentre, prospective, observational study.
The optimal strategy for fluid replacement after major surgery remains unclear and there is considerable interest in the investigation of more restrictive fluid regimens. ⋯ We showed that fluid boluses are responsible for a large proportion of the positive fluid balance seen in patients after cardiac surgery. These data justify further study to evaluate whether modification of fluid bolus administration can improve patient outcomes.
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Multicenter Study
Computerized physician order entry and decision support improves emergency department analgesic ordering for renal colic.
Computerized physician order entry (CPOE) offers the potential for safer, faster patient care, as well as greater use of evidence-based therapy via built-in decision support. However, the effectiveness of CPOE in yielding these benefits has shown mixed results in the emergency department (ED) setting. Our objective was to evaluate the impact of CPOE implementation on analgesic prescribing and dosing practices for renal colic presentations. ⋯ The introduction of CPOE is associated with an increase in ketorolac use for ED renal colic visits. This may reflect the inclusion of ketorolac in the renal colic order set. Computerized physician order entry implementation with condition-specific electronic order sets and decision support may improve evidence-based practice.
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Intensive care medicine · Sep 2014
Multicenter Study Observational StudyEligibility for organ donation following end-of-life decisions: a study performed in 43 French intensive care units.
A persistent shortage of available organs for transplantation has driven French medical authorities to focus on organ retrieval from patients who die following the withdrawal of life-sustaining therapy. This study was designed to assess the theoretical eligibility of patients who have died in French intensive care units (ICUs) after a decision to withhold or withdraw life-sustaining therapy to organ donation. ⋯ A significant number of patients who died during the study period in French ICUs under withholding/withdrawal conditions would have been eligible for organ donation. Brain-injured patients were more likely to die in circumstances which would have been compatible with such practice.
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J Bone Joint Surg Am · Aug 2014
Review Multicenter StudyImpact of Resident Involvement on Orthopaedic Surgery Outcomes: An Analysis of 30,628 Patients from the American College of Surgeons National Surgical Quality Improvement Program Database.
Operative procedural training is a key component of orthopaedic surgery residency. The influence of intraoperative resident participation on the outcomes of surgery has not been studied extensively using large, population-based databases. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Anesthesia and analgesia · Aug 2014
Randomized Controlled Trial Multicenter StudySupplemental postoperative oxygen does not reduce surgical site infection and major healing-related complications from bariatric surgery in morbidly obese patients: a randomized, blinded trial.
12-16h of post-op supplemental O2 (80%) does not reduce wound infection or complication in the morbidly obese undergoing gastric bypass.
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