Failure of anticoagulant thromboprophylaxis: Risk factors in medical-surgical critically ill patients. Critical Care Medicine, Feb 2015, Vol. 43(2), p.401-10.
Lim, W., et al.
http://journals.lww.com/ccmjournal/Abstract/2015/02000/Failure_of_Anticoagulant_Thromboprophylaxis___Risk.17.aspx
Failure of standard thromboprophylaxis using low-molecular-weight heparin or unfractionated heparin is more likely in ICU patients with elevated body mass index, those with a personal or family history of venous thromboembolism, and those receiving vasopressors. Alternate management or incremental risk reduction strategies may be needed in such patients.
Thursday, 22 January 2015
A lesson on induction of hypothermia and measurement of efficacy
A lesson on induction of hypothermia and measurement of efficacy. Critical Care 2014, 18:710
Harris, B.A. and Andrews, P.J.D.
http://ccforum.com/content/18/6/710
Brain injuries caused by stroke are common and costly in human and resource terms. The result of stroke is a cascade of molecular and physiological derangement, cell death, damage and inflammation in the brain. This, together with infection, if present, commonly results in patients having an increased temperature, which is associated with worse outcome. The usual clinical goal in stroke is therefore to reduce temperature to normal, or below normal (hypothermia) to reduce swelling if brain pressure is increased. However, research evidence does not yet conclusively show whether or not cooling patients after stroke improves their longer-term outcome (reduces death and disability). It is possible that complications of cooling outweigh the benefits. Cooling therapy may reduce damage and potentially improve outcome, and head cooling targets the site of injury and may have fewer side effects than systemic cooling, but the evidence base is unclear.
Harris, B.A. and Andrews, P.J.D.
http://ccforum.com/content/18/6/710
Brain injuries caused by stroke are common and costly in human and resource terms. The result of stroke is a cascade of molecular and physiological derangement, cell death, damage and inflammation in the brain. This, together with infection, if present, commonly results in patients having an increased temperature, which is associated with worse outcome. The usual clinical goal in stroke is therefore to reduce temperature to normal, or below normal (hypothermia) to reduce swelling if brain pressure is increased. However, research evidence does not yet conclusively show whether or not cooling patients after stroke improves their longer-term outcome (reduces death and disability). It is possible that complications of cooling outweigh the benefits. Cooling therapy may reduce damage and potentially improve outcome, and head cooling targets the site of injury and may have fewer side effects than systemic cooling, but the evidence base is unclear.
Development and validation of severe hypoxemia associated risk prediction model in 1000 mechanically ventilated patients
Development and validation of severe hypoxemia associated risk prevention model in 1000 mechanically ventilated patients. Critical Care Medicine, Feb. 2015, Vol. 43(2), p.308-17.
Pannu, S.R., et al.
http://journals.lww.com/ccmjournal/Abstract/2015/02000/Development_and_Validation_of_Severe_Hypoxemia.7.aspx
Patients with severe, persistent hypoxemic respiratory failure have a higher mortality. Early identification is critical for informing clinical decisions, using rescue strategies, and enrollment in clinical trials. The objective of this investigation was to develop and validate a prediction model to accurately and timely identify patients with severe hypoxemic respiratory failure at high risk of death, in whom novel rescue strategies can be efficiently evaluated.
Pannu, S.R., et al.
http://journals.lww.com/ccmjournal/Abstract/2015/02000/Development_and_Validation_of_Severe_Hypoxemia.7.aspx
Patients with severe, persistent hypoxemic respiratory failure have a higher mortality. Early identification is critical for informing clinical decisions, using rescue strategies, and enrollment in clinical trials. The objective of this investigation was to develop and validate a prediction model to accurately and timely identify patients with severe hypoxemic respiratory failure at high risk of death, in whom novel rescue strategies can be efficiently evaluated.
Delirium transitions in the medical ICU
Delirium transitions in the medical ICU: Exploring the role of sleep quality and other factors. Critical Care Medicine, Jan 2015, Vol. 43(1), p.135-141.
Kamdar, B., et al.
http://journals.lww.com/ccmjournal/Abstract/2015/01000/Delirium_Transitions_in_the_Medical_ICU__.16.aspx
Disrupted sleep is a common and potentially modifiable risk factor for delirium in the ICU. As part of a quality improvement project to promote sleep in the ICU, we examined the association of perceived sleep quality ratings and other patient and ICU risk factors with daily transition to delirium.
Kamdar, B., et al.
http://journals.lww.com/ccmjournal/Abstract/2015/01000/Delirium_Transitions_in_the_Medical_ICU__.16.aspx
Disrupted sleep is a common and potentially modifiable risk factor for delirium in the ICU. As part of a quality improvement project to promote sleep in the ICU, we examined the association of perceived sleep quality ratings and other patient and ICU risk factors with daily transition to delirium.
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