Articles: critical-care.
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Artificial Nutrition Support (ANS) is an important therapeutic technique in the care of the critically ill child that is not always implemented appropriately and correctly. There are also different ways of applying it which varies between the different centres and, even among the different health professionals. ⋯ Latin-American PICUs prefer enteral ANS administered by gastric feed soon after admission.
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Multicenter Study
Surrogate decision makers' responses to physicians' predictions of medical futility.
Although physicians sometimes use the futility rationale to limit the use of life-sustaining treatments, little is known about how surrogate decision makers view this rationale. We sought to determine the attitudes of surrogates of patients who are critically ill toward whether physicians can predict futility and whether these attitudes predict surrogates' willingness to discontinue life support when faced with predictions of futility. ⋯ Doubt about physicians' ability to predict medical futility is common among surrogate decision makers. The nature of the doubt may have implications for responding to conflicts about futility in clinical practice.
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Multicenter Study
Australasian resuscitation of sepsis evaluation (ARISE): A multi-centre, prospective, inception cohort study.
Determine current resuscitation practices and outcomes in patients presenting to the emergency department (ED) with sepsis and hypoperfusion or septic shock in Australia and New Zealand (ANZ). ⋯ Management of ANZ patients presenting to ED with sepsis does not routinely include protocolised, ScvO(2)-directed resuscitation. In-hospital mortality compares favourably with reported mortality in international sepsis trials and nationwide surveys of resuscitation practices.
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Critical care medicine · Jul 2009
Multicenter Study Comparative StudyWritten information that relatives of adult intensive care unit patients would like to receive--a comparison to published recommendations and opinion of staff members.
Information booklets have not been assessed by the families of intensive care unit (ICU) patients. This study explored the information that the relatives of adult ICU patients wanted to find in the information booklets. ⋯ Opinions of relatives should be taken into account when designing ICU information booklets. Relatives want more information than that anticipated by physicians or suggested in guidelines, but the youngest or the less-educated ones may respond less favorably to written information.
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Randomized Controlled Trial Multicenter Study
Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial.
Long-term complications of critical illness include intensive care unit (ICU)-acquired weakness and neuropsychiatric disease. Immobilisation secondary to sedation might potentiate these problems. We assessed the efficacy of combining daily interruption of sedation with physical and occupational therapy on functional outcomes in patients receiving mechanical ventilation in intensive care. ⋯ None.