Showing papers in "Journal of Critical Care in 2016"

TL;DR: In patients with ARF and pneumonia, the ROX index can identify patients at low risk for HFNC failure in whom therapy can be continued after 12 hours, even after adjusting for potential confounding.

TL;DR: Moral distress is higher in ICU nurses and other non-physician professionals than in physicians, is lower with older age for other non thephysicians professionals but greater with more years of experience in nurses, and is associated with tendency to leave the job.

TL;DR: The incidence of severe sepsis continues to increase, whereas mortality decreases, however, one third of patients (those with ≥3 organ system failures) account for two thirds of the total number of deaths.

TL;DR: There are many data indicating that the therapeutic action of albumin is mediated not only through the impact on plasma volume expansion but also through a modulatory effect on inflammation and oxidative stress, relevant to diseases associated with systemic inflammation including sepsis and decompensated cirrhosis.

TL;DR: Until well-designed randomized controlled trials show that gelatin is safe, it is cautioned against the use of gelatins because cheaper and safer fluid alternatives are available.

TL;DR: The complexity of end-of-life care in the ICU, particularly relating to withholding and withdrawing life-sustaining treatment while ensuring the alleviation of suffering, within different ethical and cultural environments is recognized.

TL;DR: Examining the causes of moral distress in diverse members of the intensive care unit (ICU) team in both community and tertiary ICUs found all groups are amenable to improvement.

TL;DR: Fluid resuscitation with human albumin is less likely to cause nephrotoxicity than with artificial colloids, and albumin infusion has the potential to preserve renal function in critically ill patients, and Sepsis is a candidate condition in which humanalbumin infusion to preserve kidneys function should be substantiated.

TL;DR: It is concluded that triage should be led by intensivists considering input from nurses, emergency medicine professionals, hospitalists, surgeons, and allied professionals and not on the basis of the principle of distributive justice.

TL;DR: Physical restraint was common in mechanically ventilated adults managed with a sedation protocol and except for alcohol use, patient characteristics and treatment factors did not predict restraint use.

TL;DR: To minimize the risk of immortal time bias in observational studies of survival outcomes, it is strongly suggested time-dependent exposures be included as time- dependent variables in hazard-based analyses.

TL;DR: Patients with high syndecan-1 may represent a cohort at particular risk for intubation after large-volume fluid administration, and patients with high Syndicate-1 levels may representA cohort at particularly risk forIntubation in patients with a low syndecon-1 level.

TL;DR: Music listening can abate the stress response, decrease anxiety during mechanical ventilation, and induce an overall relaxation response without the use of medication, which can lower cardiac workload and oxygen consumption resulting in more effective ventilation.

TL;DR: This is the first study to find a difference depending on sex in the range of ONSD in a healthy cohort of volunteers, suggesting the possible need for separate reference ranges for men and women.

TL;DR: Capillary refill time and skin mottling may be correlated with the pulsatility index, a sonographic surrogate of vascular tone, of visceral organs in early septic shock.

TL;DR: This work demonstrates that the DSE can be effectively used to predict difficult laryngoscopy, and combining DSE with the modified Mallampati score in a decision tree significantly improves the predictive power over either test alone.

TL;DR: The implementation of a nonpharmacologic delirium prevention protocol resulted in a significant decrease in the percentage of time patients spent delirious in a medical intensive care unit (MICU) that already uses a sedation and mobility protocol.

TL;DR: Hypocaloric nutrition could provide a more physiologic approach with lower need for care and metabolic impact, except lower insulin requirements, in critically ill patients receiving enteral nutrition.

TL;DR: How physiotherapists could use this tool in their clinical decision-making processes in various cases of respiratory disorders is described and how thoracic ultrasound semiology alongside typical examinations may allow for the guiding, monitoring, and evaluating of chest physiotherapy treatments.

TL;DR: Antipsychotic use is common in the ICU setting, and a significant number of newly initiated patients have therapy continued upon discharge from the hospital, despite adjustment for clinical factors.

TL;DR: Thrombotic and infectious complications were uncommon following PICC and CICC insertion, with no significant difference in complication rates observed.

TL;DR: This article reviews the pertinent literature describing the use of inferior vena cava and lung ultrasound for fluid responsiveness and presents an evidence-informed algorithm using these measures to guide fluid resuscitation decisions in the critically ill.

TL;DR: Most intensivists routinely use ultrasound guidance to insert internal jugular CVCs but not subclavian CVC’s, and most physicians reported not being comfortable with real-time needle tracking at the subClavian site.

TL;DR: The majority of rural sepsis patients are transferred, and these transferred patients have higher mortality and significantly increased cost of care.

TL;DR: Its mechanisms included: (1) renal macrocirculatory and microcirculatory disturbance, (2) surge of inflammatory markers and oxidative stress, (3) coagulation cascade activation, and (4) bioenergetics adaptive response with controlled cell-cycle arrest aiming to prevent cell death.

TL;DR: Thrombocytopenia is associated with poor prognosis and a distinct serum cytokine profile and receiver operating characteristic curve analysis was used to determine the best cutoff value for mortality prediction.

TL;DR: In adult patients, EIT has been successfully validated for assessing ventilation distribution, measuring changes in lung volume, studying regional respiratory mechanics, and investigating nonventilatory parameters.

TL;DR: Procalcitonin measured on intensive care unit admission was diagnostic of sepsis, and IL-6 was predictive of mortality, and addition of IL- 6 concentration to SOFA score improved risk assessment for prediction of mortality.

TL;DR: The high P(v-a)CO2/C(a-v)O2 ratio is associated with poor LC after resuscitation and may provide useful information for assessing the LC potential and optimizing the LC rate.

TL;DR: Ketamine has a unique pharmacological profile compared with more traditional agents such as opioids, which makes it an appealing alternative agent for analgosedation in the intensive care unit setting.