February 08, 2010
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| Long-Term Outcomes in Patients Surviving Acute Respiratory Distress Syndrome - Seminars in Respiratory and Critical Care Medicine |
| Wilcox ME et al. – Persistent for years after hospital discharge, decrements in functional and neuropsychological outcomes result in lost savings, employment reduction, and a reduction in HRQL among survivors and their caregivers. Future research should focus on the early identification of patients and their family members at risk for long–term sequelae, the mechanisms of injury leading to long–term ARDS consequences, and therapeutic modalities designed to prevent or decrease these morbidities. Clinicians, caregivers, and patients should be made aware of the deleterious long–term effects of the intensive care unit stay because they are currently poorly recognized and potentially modifiable.... |
February 01, 2010
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| Factors Associated with Congruence Between Preferred and Actual Place of Death - Journal of Pain and Symptom Management |
| Bell CL et al. – Congruence between preferred and actual place of death may be an essential component in terminal care. Most patients prefer a home death, but many patients do not die in their preferred location...A physician–led home care program reported 91% congruence. Of the 10 studies without specialized home care for all patients, seven reported 56%–71% congruence and most reported unique care programs. Of the remaining three studies without specialized home care for all patients, two reported 43%–46% congruence among hospital inpatients, and one elicited patient preference “if everything were possible,” with 30% congruence. Physician support, hospice enrollment, and family support improved congruence in multiple studies. Research in this important area must consider potential sources of bias, the method of eliciting patient preference, and the absence of a single ideal place of death.... |
| Dexmedetomidine in the Neurointensive Care Unit - Discovery Medicine |
| Farag E – Dexmedetomidine is a new alpha–2 agonist with high specificity to alpha–2 receptors. The aim of this review is to present the most recent topics regarding the advantages in using dexmedetomidine in clinical anesthesia and intensive care, while discussing the controversial issue of its harmful effect on cerebral blood flow.... |
January 28, 2010
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| Postoperative pain and nursing activities - Agri |
| Ay F et al. – The results showed that 146 out of 189 nurses (%77.2) administered analgesic medication more often than using other techniques for pain management. The other nursing activities for pain management were as following: Patient control analgesia (PCA), massage, visual analog scale (VAS), teaching relaxation techniques, helping with mobilization, assessment of vital signs.... |
January 27, 2010
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| Corticosteroid Treatment and Intensive Insulin Therapy for Septic Shock in Adults - JAMA |
| Compared with conventional insulin therapy, intensive insulin therapy did not improve in–hospital mortality among patients who were treated with hydrocortisone for septic shock. The addition of oral fludrocortisone did not result in a statistically significant improvement in in–hospital mortality.... |
| A European survey of non-invasive ventilation (NIV) practices - European Respiratory Journal |
| Crimi C et al. – The use of NIV in Europe is generally relatively high, especially among Pulmonologists, and in AHRF. Dedicated NIV ventilators and ICU ventilators with NIV modules are preferably used in AHRF and in de–novo hypoxic respiratory failure, respectively, together with oro–nasal masks.... |
January 26, 2010
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| Understanding Cost-Effectiveness in the ICU - Seminars in Respiratory and Critical Care Medicine |
| Zilberberg MD – The intensive care unit (ICU) has not been exempt from the quest for increased efficiency of health care delivery. This movement demands that physicians understand not only the effectiveness but also the cost of their interventions. Cost–effectiveness and cost–utility analyses have become critical evaluative tools in medicine. Explicit articulation of comparative cost–effectiveness is helpful in making choices about allocating limited resources in the setting of increasing competition for these resources. This article provides a primer for understanding the methods and applications of cost–effectiveness and cost–utility analyses in the ICU.... |
January 25, 2010
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| End-of-life care pathways for improving outcomes in caring for the dying - Cochrane Reviews |
| Chan R et al. – No studies meeting the inclusion criteria were found that used an end–of–life care pathway in caring for the dying. Therefore, there is insufficient data at present to make recommendations regarding the use of such end–of–life care pathways for the dying.... |
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