Showing papers in "Journal of Critical Care in 2008"

TL;DR: The historical roots of simulation might be described with the broadest definition of medical simulation: "an imitation of some real thing, state of affairs, or process" for the practice of skills, problem solving, and judgment.

TL;DR: The use of the comprehensive unit-based safety program was associated with significant improvements in safety culture and may serve as a model to implement feasible and methodologically rigorous methods to improve and sustain patient safety on a larger scale.

TL;DR: There are a growing number of evidence-based strategies for VAP prevention, which, if applied in practice, may reduce the incidence of this serious nosocomial infection.

TL;DR: Observations of excess risk associated with admission to or discharge from ICU at night merits further exploration as to whether it may reflect inconsistencies in care after hours.

TL;DR: There appears to be an association between initial inappropriate antimicrobial therapy and increased mortality in patients with VAP and BSI.

TL;DR: Evidence-based recommendations for the diagnosis and treatment of Ventilator-associated pneumonia are presented and implementation of these recommendations into clinical practice may lessen the morbidity and mortality of patients who develop VAP.

TL;DR: Correct application of the sepsis bundles was associated with reduced mortality and length of ICU stay and earlier implementation of the 24-hour management bundle could result in better outcomes.

TL;DR: In this patient population, the incidence of high-risk organisms newly acquired during an ICU stay is low, however, the presence of high risk pathogens is associated with worse clinical outcomes.

TL;DR: A large and increasing volume of information was documented during the course of critical illness, suggesting that the volume of documented information is a marker of therapeutic intensity.

TL;DR: The impact of VAP on the Canadian health care system is considerable and eradication of this preventable nosocomial infection would save lives and conserve scarce health care resources.

TL;DR: Respiratory tract Candida colonization is associated with worse clinical outcomes and is independently associated with increased hospital mortality, however, it is unclear whether CandIDA colonization is causally related to poor outcomes or whether it is a marker for increased morbidity and mortality.

TL;DR: Mechanically ventilated patients with sepsis or hypoalbuminemia were more vulnerable to develop delirium in their early stay in the ICU, leading to a higher mortality and higher incidence of nosocomial pneumonia.

TL;DR: As bacteria in intensive care unit patients often exceed this threshold, it is recommended to use higher doses of ciprofloxacin (1200 mg daily) to ensure optimal bacterial killing and avoid antibiotic resistance.

TL;DR: Patients receiving MET calls for respiratory distress or hypotension were elderly and had a mortality greater than 35%.

TL;DR: Statistically significantly higher mortality was observed in critically ill septic patients with new-onset AF, as were longer duration of mechanical ventilation, ICU, and hospital LOS.

TL;DR: Different methodologies used to capture team performance metrics including clinical surveys, direct observation, and video-based analyses of real-life clinical performance are described.

TL;DR: In patients with severe TBI and refractory intracranial hypertension, the frequency of favorable neurologic outcomes was low and similar to predicted values, and a future multicenter phase III trial involving 18 neurotrauma centers would require at least 5 years to achieve an estimated 210-patient sample size.

TL;DR: Septic shock patients have a very high incidence of intra-abdominal hypertension (IAH), which seems to be associated with the severity of shock and could be related to the development of organ dysfunctions, particularly renal dysfunction.

TL;DR: Family satisfaction and understanding in the ICU may improve if the doctors are more accessible to provide information and the staff strive to better explain the patient's condition.

TL;DR: Multiscale entropy and HRVi measured within the first 24 hours each identify trauma patients at increased risk of subsequent hospital death.

TL;DR: Using a PICU daily patient goal sheet can improve communication between health care providers, help nurses identify the in-charge physicians, and be helpful for patient care.

TL;DR: E-V AP and L-VAP have different risk factors, highlighting the need for developing specific preventive measures, and there is a need for further study to compare risk factors.

TL;DR: There remain large gaps in understanding of guideline implementation in the intensive care unit, specifically as it applies to guidelines for the prevention, diagnosis, and treatment of VAP.

TL;DR: Findings show that the proposed cyclic OR planning policy may benefit OR utilization and reduce surgical case cancellation and peak demands on the ICU.

TL;DR: The purpose of this article is to portray simulation as an educational strategy in the context of a curriculum, to explore emerging theories from educational psychology, and to provide concrete examples of their application in simulation-based education.

TL;DR: It is concluded that in acute brain injury patients, low variability, low baroreflex sensitivity, and sustained decrease in LF/HF of HR signals are linked with a high mortality rate.

TL;DR: Targeted therapy is associated with less antibiotic use and no evidence of harm in the management of patients with VAP, and the TT group had more days alive and off broad-spectrum antibiotics.

TL;DR: The use of prone ventilation is associated with improved oxygenation and may be associated with an increased incidence of pressure sores, which is not associated with a reduction in mortality, pneumonia, or ICU stay.

TL;DR: After algorithm implementation in the SICU, pain intensity at rest decreased and quality of sleep improved and the effectiveness of a quality improvement postoperative pain treatment program after cardiac surgery was tested.

TL;DR: Pretest probability and a modified CPIS, which excludes culture results, are of limited utility in the diagnosis of late-onset ventilator-associated pneumonia.