Articles: critical-care.
-
Comment Randomized Controlled Trial Multicenter Study
Sedation in the intensive-care unit: good and bad?
-
Multicenter Study Comparative Study
Prevalence of sleep disturbances and long-term reduced health-related quality of life after critical care: a prospective multicenter cohort study.
The aim of the present prospective multicenter cohort study was to examine the prevalence of sleep disturbance and its relation to the patient's reported health-related quality of life after intensive care. We also assessed the possible underlying causes of sleep disturbance, including factors related to the critical illness. ⋯ There is little change in the long-term quality of sleep patterns among hospitalised patients with an ICU stay. This applies both to the comparison before and after critical care as well as between 6 and 12 months after the ICU stay. Furthermore, sleep disturbances for this group are common. Concurrent disease was found to be most important as an underlying cause, which emphasises that it is essential to include assessment of concurrent disease in sleep-related research in this group of patients.
-
Critical care medicine · Jan 2008
Multicenter StudyInformed consent in the critically ill: a two-step approach incorporating delirium screening.
Sedation-agitation and delirium are common in critically ill patients and may be important barriers to informed consent. We describe a two-step process for informed consent and evaluate the natural history of patients' competency by repeated application of this process during their hospitalization. ⋯ More than three fourths of critically ill patients are unable to provide informed consent throughout their ICU stay, even after extubation. Sedation-agitation and delirium are common barriers to consent. A two-step consent process, using validated instruments for sedation-agitation and delirium, provides a means of rapidly screening critically ill patients before a more detailed traditional assessment of competency is conducted.
-
Multicenter Study Comparative Study
Intensive care for the adult population in Ireland: a multicentre study of intensive care population demographics.
This prospective observational study was conducted to describe the nature of the intensive care population across Ireland, identify adherence to international benchmarks of practice, and describe patient outcomes in critically ill patients. ⋯ Intensive care medicine in Ireland serves a patient population with high requirement for mechanical ventilation and support of the function of multiple organs. The overall mortality compares favourably with international benchmarks.
-
Multicenter Study
A registry of patients treated with drotrecogin alfa (activated) in Belgian intensive care units--an observational study.
Drotrecogin alfa (activated) [DrotAA] is the only specific sepsis therapy that has been shown to reduce mortality. The objectives of this study were to document the profile of patients treated with DrotAA in Belgian intensive care units (ICUs), using data from a database established as part of drug reimbursement conditions in Belgium, and to compare the observed hospital mortality of these patients with their expected mortality, calculated using data from non-DrotAA-treated patients from the Belgian section of PROGRESS, a separate, voluntary, international sepsis registry collecting data from patients with severe sepsis. ⋯ Comparing Belgian reimbursement registry data with those of a voluntary severe sepsis register provides support for the observation that DrotAA reduces mortality rates in severe sepsis and septic shock.