Abstract：
PURPOSE:Mortality in severe sepsis and septic shock (SS/SS) remains high. Surviving Sepsis Campaign (SSC) guidelines were published in 2004 with the goal of improving outcomes in SS/SS. We tested the hypothesis that adherence to SSC guidelines and management of patients with SS/SS were influenced by physician specialty. MATERIALS AND METHODS:A survey was mailed to 4998 randomly selected physicians, 1666 each for emergency medicine (EM), critical care medicine (CCM), and internal medicine (IM) from the American Medical Association database. Demographics, compliance with SSC guidelines, and approaches to management of patients with SS/SS were analyzed by specialty. RESULTS:Four hundred ninety-nine respondents were included for final analysis. There were no differences between 3 specialties in obtaining blood cultures and in administering intravenous fluids, pressors, and antibiotics. The CCM physicians were more likely to measure serum lactate and central venous pressure, use corticosteroids and drotrecogin α, and aim for normoglycemia and plateau pressures less than 30 cm H(2)O in mechanically ventilated patients (all P < .001). CONCLUSIONS:We observe that adherence with SSC guidelines continues to be a challenge for CCM, IM, and EM physicians. Significant differences in management of SS/SS exist for the 3 specialties. Because guideline implementation impacts patient outcomes, further evaluation of these differences is warranted.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Djurkovic S,Baracaldo JC,Guerra JA,Sartorius J,Haupt MTdoi
10.1016/j.jcrc.2010.04.005subject
Has Abstractpub_date
2010-12-01 00:00:00pages
658.e1-6issue
4eissn
0883-9441issn
1557-8615pii
S0883-9441(10)00088-2journal_volume
25pub_type
杂志文章abstract：BACKGROUND:Extracorporeal membrane oxygenation (ECMO) is an effective support method for acute fulminant myocarditis (AFM) with cardiogenic shock. However, deciding whether to bridge to a left ventricular assist device (LVAD) or to maintain ECMO support until heart recovery is still controversial. MATERIAL AND METHODS...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2020.03.007
更新日期：2020-06-01 00:00:00
abstract：PURPOSE:Automated weaning modes are available in some mechanical ventilators, but no studies compared them hitherto. We compared the performance of 3 automated modes under standard and challenging situations. METHODS:We used a lung simulator to compare 3 automated modes, adaptive support ventilation (ASV), mandatory r...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2011.12.021
更新日期：2012-12-01 00:00:00
abstract：PURPOSE:To investigate microorganisms causing central venous catheter contamination and how this contamination differs across different catheter metrics. MATERIALS AND METHODS:After obtaining IRB approval and informed consent, 830 cultures were prospectively obtained from 45 ICU patients with central venous catheter o...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.02.035
更新日期：2017-06-01 00:00:00
abstract：PURPOSE:The purpose was to determine prognosis of patients presenting extreme acidosis (pH <7) on admission to the intensive care unit (ICU) and to identify mortality risk factors. MATERIALS AND METHODS:We retrospectively analyzed all patients who presented with extreme acidosis within 24 hours of admission to a polyv...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2015.09.025
更新日期：2016-02-01 00:00:00
abstract：OBJECTIVE:To describe the associations between right ventricular (RV) function and outcomes of patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). METHODS:This is a retrospective study, conducted 2006-2015 at an academic hospital in USA. We included patients with AKI requirin...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2020.11.022
更新日期：2020-11-30 00:00:00
abstract：INTRODUCTION:The aim of our study was to compare the reliability and safety of the classical I-AT with the continuous positive airway pressure apnea test (CPAP-AT). MATERIAL AND METHODS:In the group of 48 patients (group O), an I-AT was performed at the end of BD diagnostic procedures, and approximately 1-1.5h later C...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.10.038
更新日期：2018-04-01 00:00:00
abstract：PURPOSE:To explore the effect of emotion priming and physician communication behaviors on optimism bias. MATERIALS AND METHODS:We conducted a 5 × 2 between-subject randomized factorial experiment using a Web-based interactive video designed to simulate a family meeting for a critically ill spouse/parent. Eligibility i...
journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrc.2015.11.015
更新日期：2016-04-01 00:00:00
abstract：PURPOSE:Diaries summarizing intensive care are routine practice in some countries, although evidence to support diary use is limited. The purpose of this study was to identify whether distress post-intensive care influences patients' and relatives' choice as to whether they would like to receive a diary and what inform...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.12.003
更新日期：2017-04-01 00:00:00
abstract：PURPOSE:The purpose of the study is to reduce unnecessary ordering of routine-priority blood tests. METHODS:In this before-after study, we studied all patients admitted to a 15-bed tertiary intensive care unit (ICU) from July 1, 2011, to June 27, 2013. Based on input from intensivists, acceptable indications for order...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2015.09.013
更新日期：2016-02-01 00:00:00
abstract：PURPOSE:Acute kidney injury (AKI) is prevalent in critically ill patients and associated with poor outcomes. Current AKI diagnostics- changes to serum creatinine (SCr) and urine output- are imprecise. Integration of injury biomarkers with SCr may improve diagnostic precision. METHODS:We performed a secondary analysis ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2019.05.017
更新日期：2019-10-01 00:00:00
abstract：:Integral to the management of the neurocritically injured patient are the prevention and treatment of hypotension, maintenance of cerebral perfusion pressure, and occasionally blood pressure augmentation. When adequate volume resuscitation fails to meet perfusion needs, vasopressors are often used to restore end-organ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.04.004
更新日期：2016-08-01 00:00:00
abstract：:Appropriate fluid resuscitation has been a major focus of critical care medicine since its inception. Currently, the most accurate method to guide fluid administration decisions uses "dynamic" measures that estimate the change in cardiac output that would occur in response to a fluid bolus. Unfortunately, their use re...
journal_title：Journal of critical care
pub_type： 杂志文章,评审
doi：10.1016/j.jcrc.2015.09.016
更新日期：2016-02-01 00:00:00
abstract：:Quantitative lung computed tomographic (CT) analysis yields objective data regarding lung aeration but is currently not used in clinical routine primarily because of the labor-intensive process of manual CT segmentation. Automatic lung segmentation could help to shorten processing times significantly. In this study, w...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.11.001
更新日期：2017-12-01 00:00:00
abstract：PURPOSE:The ability of the global end-diastolic volume index (GEDVI) and respiratory variations in left ventricular outflow tract velocity (ΔVTI(LVOT)) for prediction of fluid responsiveness is still under debate. The aim of the present study was to challenge the predictive power of GEDVI and ΔVTI(LVOT) compared with p...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2011.07.073
更新日期：2012-06-01 00:00:00
abstract：OBJECTIVE:To evaluate the effectiveness of steroids therapy on postextubation stridor (PES) depending on the clinical response, the ultrasound guided laryngeal air column width difference (LACWD) and the cuff leak volume (CLV). DESIGN:Prospective, observer-blinded study. SETTING:Carried out in intensive care unit in ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.07.007
更新日期：2016-12-01 00:00:00
abstract：PURPOSE:The aim of the present study was to explain why extravascular lung water index (EVLWI) is higher and why global end-diastolic blood volume index (GEDVI) is lower in young children when measured with the PiCCO system (Pulsion, Munich, Germany). MATERIALS AND METHODS:We pooled available data from literature from...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2010.10.014
更新日期：2011-08-01 00:00:00
abstract：PURPOSE:To determine the feasibility of conducting a multicenter ICU RCT of AFS compared to either protocol-directed sedation (PDS) or both PDS and daily sedation interruption (DSI) in North America. MATERIALS AND METHODS:This single-center RCT compared AFS [fentanyl (bolus ± infusions) to reach CPOT ≤2; if RASS ≥1, C...
journal_title：Journal of critical care
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jcrc.2019.06.008
更新日期：2019-10-01 00:00:00
abstract：PURPOSE:Nebulized heparin may reduce fibrin cast formation and reduce the degree of airway obstruction in burn inhalation injury. METHODS:Twenty-nine patients admitted to burn intensive care unit (ICU) within 24 hours of burn inhalation injury were included in this prospective double-blinded randomized study. Group H5...
journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrc.2013.06.017
更新日期：2014-02-01 00:00:00
abstract：PURPOSE:The prognosis of allogeneic hematopoietic stem cell transplantation (HSCT) patients admitted to the intensive care unit (ICU) is still poor. Overall, when these patients receive reduced intensity conditioning (RIC) regimens, the survival is better. To date, no study has specifically evaluated the outcome of RIC...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2015.06.020
更新日期：2015-10-01 00:00:00
abstract：PURPOSE:We sought to investigate the relationship between high CVP, AKI, and mortality in patients undergoing cardiac surgery with cardiopulmonary bypass. MATERIALS:All patients aged 18 years or older who underwent cardiac surgery with CPB were prospectively reviewed. Patients were excluded when renal artery were invo...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2018.08.034
更新日期：2018-12-01 00:00:00
abstract：PURPOSE:The maintenance of patient-specific optimal cerebral perfusion pressure (CPPopt) is crucial for patients with traumatic brain injury (TBI). The goal of the study was to explore the influence of CPP declination from CPPopt value on the TBI patients' outcome. METHODS:The CPP and cerebrovascular autoregulation (C...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.04.029
更新日期：2017-10-01 00:00:00
abstract：BACKGROUND:It is known that acute respiratory distress syndrome and acute lung injury are independent risk factors for developing acute kidney injury (AKI) through complex pathophysiologic mechanisms. Our specific aim is to evaluate the risk factors for AKI postburn injury and whether inhalation thermal injury is an in...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.10.008
更新日期：2017-04-01 00:00:00
abstract：PURPOSE:To validate a brief index of patient and family experiences of respect in the intensive care unit. MATERIAL AND METHODS:A survey including the 10-item ICU-RESPECT scale was administered to patients and family members in one ICU at a large west coast academic medical center. Confirmatory psychometric analyses w...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2018.03.026
更新日期：2018-08-01 00:00:00
abstract：PURPOSE:To evaluate the impact of slow-tempo music listening periods in mechanically ventilated intensive care unit patients. METHODS:A randomized crossover study was performed in a 16-bed, adult critical care unit at a tertiary care hospital. Still-sedated patients, mandating at least 3 more days of mechanical ventil...
journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrc.2013.01.007
更新日期：2013-08-01 00:00:00
abstract：PURPOSE:Optimal red blood cell (RBC) transfusion thresholds in acute brain injury (ABI) are poorly defined. MATERIALS AND METHODS:We conducted a retrospective cohort study of adult patients with ABI and moderate anemia (Hb 7-10 g/dL) in a neurological intensive care unit (ICU) at an academic medical center between 200...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2018.11.006
更新日期：2019-04-01 00:00:00
abstract：PURPOSE:To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS:We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.08.008
更新日期：2017-12-01 00:00:00
abstract：PURPOSE:The study aimed to compare hemoglobin (Hb) values determined using the portable HemoCue system (HemoCue Hb 201+; HemoCue AB, Ängelholm, Sweden) with laboratory Hb level determination. MATERIALS AND METHODS:Adult patients hospitalized in our surgical intensive care unit who required an Hb level determination we...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2010.08.012
更新日期：2011-08-01 00:00:00
abstract：PURPOSE:To investigate predictive powers of S100B and cell-free DNA (cfDNA) levels in patients in the intensive care unit (ICU) who have with intracranial hemorrhage (ICH) for prognosis. METHODS:Ninety-nine patients diagnosed with ICH were included in the study. The blood samples were drawn on the day of admittance to...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2013.03.005
更新日期：2013-10-01 00:00:00
abstract：PURPOSE:Endotracheal suctioning causes significant lung derecruitment. Closed suction (CS) minimizes lung volume loss during suction, and therefore, volumes are presumed to recover more quickly postsuctioning. Conflicting evidence exists regarding this. We examined the effects of open suction (OS) and CS on lung volume...
journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrc.2012.08.019
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:Selective digestive decontamination of the digestive tract involves the routine administration of oral, gastric, and intravenous antibiotics to mechanically ventilated children to prevent hospital-acquired infections. It has a strong evidence base in adults, with limited pediatric evidence. Current utilizati...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.02.024
更新日期：2017-06-01 00:00:00
