Articles: critical-care.
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Critical care medicine · Aug 2008
Multicenter StudyDoubt and belief in physicians' ability to prognosticate during critical illness: the perspective of surrogate decision makers.
Although discussing a prognosis is a duty of physicians caring for critically ill patients, little is known about surrogate decision-makers' beliefs about physicians' ability to prognosticate. We sought to determine: 1) surrogates' beliefs about whether physicians can accurately prognosticate for critically ill patients; and 2) how individuals use prognostic information in their role as surrogate decision-makers. ⋯ Although many surrogate decision-makers harbor some doubt about the accuracy of physicians' prognostications, they highly value discussions about prognosis and use the information for multiple purposes.
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Intensive care medicine · Aug 2008
Multicenter StudyDevelopment and simultaneous application of multiple care protocols in critical care: a multicenter feasibility study.
To test the feasibility of and interactions among three software-driven critical care protocols. ⋯ Multiple software-driven treatment protocols can be simultaneously applied with high acceptance and rapid achievement of primary treatment goals. Time to reach these primary goals may provide a performance indicator.
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Randomized Controlled Trial Multicenter Study
Empirical fluconazole versus placebo for intensive care unit patients: a randomized trial.
Invasive infection with Candida species is an important cause of morbidity and mortality in intensive care unit (ICU) patients. Optimal preventive strategies have not been clearly defined. ⋯ In critically ill adults with risk factors for invasive candidiasis, empirical fluconazole did not clearly improve a composite outcome more than placebo.
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Critical care medicine · Jul 2008
Randomized Controlled Trial Multicenter StudyA randomized trial of daily awakening in critically ill patients managed with a sedation protocol: a pilot trial.
Protocolized sedation (PS) and daily sedative interruption (DI) in critically ill patients have both been shown to shorten the durations of mechanical ventilation (MV) and intensive care unit (ICU) stay. Our objective was to determine the safety and feasibility of a randomized trial to determine whether adults managed with both PS + DI have a shorter duration of MV than patients managed with PS alone. ⋯ This pilot trial comparing PS vs. PS + DI confirmed the safety and acceptability of the sedation protocol and DI, and guided important modifications to the protocol, thus enhancing the feasibility of a future multicenter trial. This trial was not designed to detect small but significant differences in clinically important outcomes.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2008
Multicenter StudyLong-term outcome in patients with critical illness myopathy or neuropathy: the Italian multicentre CRIMYNE study.
Critical illness myopathy (CIM) and polyneuropathy (CIP), alone or in combination (CIP/CIM), are frequent complications in patients in the intensive care unit (ICU). There is no evidence that differentiating between CIP and CIM has any impact on patient prognosis. ⋯ CIM has a better prognosis than CIP. Differential diagnosis is important to predict long-term outcome in ICU patients.