Articles: intensive-care-units.
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Randomized Controlled Trial
Treatment of candidemia and invasive candidiasis in the intensive care unit: post hoc analysis of a randomized, controlled trial comparing micafungin and liposomal amphotericin B.
Invasive candidiasis and candidemia are life-threatening nosocomial infections in intensive care patients. ⋯ Overall, ICU subjects had lower treatment success rates than non-ICU subjects for both liposomal amphotericin B and micafungin. Multivariate regression after controlling for potential confounding factors suggested the APACHE II score remained a potential explanatory factor associated with treatment success, mortality at day 8, and mortality at day 30.
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Critical care medicine · Jan 2009
Randomized Controlled TrialEvaluation of the effect of prospective patient diaries on emotional well-being in intensive care unit survivors: a randomized controlled trial.
To evaluate the effect of a prospective diary intervention on levels of anxiety and depression in a group of intensive care unit survivors. ⋯ Survivors of critical illnesses are likely to experience clinically significant symptoms of anxiety and depression following their discharge from hospital. The prospective diary intervention designed to help patients understand what happened to them in intensive care and it has a significant positive impact on anxiety and depression scores almost 2 months after patients' discharge from intensive care unit. Attempts to replicate these results using larger samples are therefore encouraged, with the aim of informing best practice guidelines.
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Randomized Controlled Trial Multicenter Study
Effect of evidence-based feeding guidelines on mortality of critically ill adults: a cluster randomized controlled trial.
Evidence demonstrates that providing nutritional support to intensive care unit (ICU) patients within 24 hours of ICU admission reduces mortality. However, early feeding is not universally practiced. Changing practice in complex multidisciplinary environments is difficult. Evidence supporting whether guidelines can improve ICU feeding practices and patient outcomes is contradictory. ⋯ Using a multifaceted practice change strategy, ICUs successfully developed and introduced an evidence-based nutritional support guideline that promoted earlier feeding and greater nutritional adequacy. However, use of the guideline did not improve clinical outcomes. Trial Registration anzctr.org.au Identifier: ACTRN12608000407392.
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Am. J. Respir. Crit. Care Med. · Oct 2008
Randomized Controlled Trial Multicenter Study Comparative StudyDuration of withdrawal of life support in the intensive care unit and association with family satisfaction.
Most deaths in the intensive care unit (ICU) involve withholding or withdrawing multiple life-sustaining therapies, but little is known about how to proceed practically and how this process affects family satisfaction. ⋯ Withdrawal of life support is a complex process that depends on patient and family characteristics. Stuttering withdrawal is a frequent phenomenon that seems to be associated with family satisfaction. Extubation before death should be encouraged if possible.
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Infect Control Hosp Epidemiol · Sep 2008
Randomized Controlled TrialProspective randomized trial of 3 antiseptic solutions for prevention of catheter colonization in an intensive care unit for adult patients.
To compare the effectiveness for prevention of central venous and arterial catheter colonization of 3 skin antisepsis with 1 of 3 antiseptic solutions: 10% aqueous povidone iodine (aqueous PI), 2% aqueous chlorhexidine gluconate (aqueous CG), and 0.5% alcoholic chlorhexidine gluconate (alcoholic CG). ⋯ The aqueous and alcoholic CG solutions for cutaneous antisepsis were similarly effective in preventing colonization of central venous catheters and arterial catheters. Both had significantly lower incidences of colonization than did the aqueous PI solution; this effect seems to be related to the CG solutions' more efficacious prevention of colonization with gram-positive bacteria.