Abstract:
:Realizing the vast medical benefits of validated protocols, recommendations and practice guidelines requires acceptance and implementation by frontline care providers. Knowledge translation is the science of accelerating the transfer of knowledge to practice by understanding and creatively addressing the barriers that prevent adoption of new professional standards. In an attempt to improve patient care and reduce mortality, the Surviving Sepsis Campaign and The Institute for Healthcare Improvement created the resuscitation and management bundles for patients with severe sepsis and septic shock. These bundles have been accepted as best practice by many clinicians since multiple clinical trials have produced similar positive results when they were implemented. However, transferring these research outcomes-based guidelines to the clinical practice arena has been associated with poor compliance due to important barriers to implementation. Delays in the adoption of sepsis bundles are not surprising since the time from validation to implementation of a new clinical practice is typically 17 years. Using sepsis bundles as a model, this article explores why guidelines are important, examines physician adherence to protocols, and reviews the literature on strategies to improve clinical compliance and enhance knowledge translation.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Stoneking L,Denninghoff K,Deluca L,Keim SM,Munger Bdoi
10.1177/0885066610387988subject
Has Abstractpub_date
2011-05-01 00:00:00pages
172-82issue
3eissn
0885-0666issn
1525-1489pii
0885066610387988journal_volume
26pub_type
杂志文章,实务指引abstract::A 70-year-old woman was admitted to the intensive care unit with refractory nonconvulsive status epilepticus. Extensive evaluation including neuroimaging and cerebrospinal fluid examination was unrevealing. Brain biopsy revealed spongiosis, and prion disease was confirmed by immunostaining, providing the diagnosis of ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066604269771
更新日期:2004-11-01 00:00:00
abstract::Venous thromboembolism (VTE) is a major health concern associated with significant morbidity and mortality. Critically ill patients are at an increased risk of VTE compared to general medical patients due to unique risk factors: prolonged immobilization, invasive lines and devices, certain medications, and acquired th...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066618796486
更新日期:2019-11-01 00:00:00
abstract::The brain reacts to injury or disease by cascades of cellular and molecular responses. Evidence suggests that immune-inflammatory processes are key elements in the physiopathological processes associated with brain injury or damage. Cytokines are among major mediators implicated in these processes. Cytokine responses ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066608318458
更新日期:2008-07-01 00:00:00
abstract::Patients admitted to the cardiac intensive care unit (CICU) are often in shock and require hemodynamic support. Identifying and addressing the pathophysiology mechanisms operating in an individual patient is crucial to achieving a successful outcome, while initiating circulatory support therapy to restore adequate tis...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620917630
更新日期:2020-04-13 00:00:00
abstract::The aim of the study was to describe our experience with bi-level positive airway pressure (BiPAP) ventilation in oncology children with acute respiratory failure, hospitalized in a single tertiary pediatric tertiary center. This was a retrospective cohort study of all pediatric oncology patients in our center admitte...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066609344956
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) portends poor prognoses in intensive care unit patients with sepsis. However, AF research is challenging: Previous studies demonstrate that International Classification of Disease (ICD) codes may underestimate the incidence of AF, but chart review is expensive and often not feasible....
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619866172
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe se...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,meta分析
doi:10.1177/0885066616671710
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Agitation is common in the intensive care unit (ICU). Although antipsychotics are frequently used as first-line therapy, chlorpromazine has fallen out of favor due to risk of cardiovascular complications and severe hypotension. Although chlorpromazine is used anecdotally, there is a lack of data regarding it...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618818787
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:SARS-CoV2 can cause pulmonary failure requiring prolonged invasive mechanical ventilation (MV). Lung protective ventilation strategies are recommended in order to minimize ventilator induced lung injury. Whether patients with COVID-19 have the same risk for complications including barotrauma is still unknown...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620954364
更新日期:2020-09-22 00:00:00
abstract::Hypercalcemia may be seen in a variety of clinical settings and often requires intensive management when serum calcium levels are dramatically elevated. All of the many etiologies of mild hypercalcemia can lead to severe hypercalcemia. Knowledge of the physiologic mechanisms involved in maintaining normocalcemia and b...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613507530
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:When patients deteriorate after decannulation from extracorporeal membrane oxygenation (ECMO), a second run of extracorporeal support may be considered. However, repeat cannulation can be difficult and poor outcomes associated with multiple ECMO runs are a concern. The aim of this study was to evaluate outcom...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620981903
更新日期:2020-12-22 00:00:00
abstract::Aspergillus fumigatus hyphae is often found in the lung tissue of patients with bronchocentric granulomatosis (BCG). This organism is believed to be one agent responsible for inciting the hypersensitivity response and subsequent development of the characteristic pathology that defines BCG. The definitive etiology of t...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/088506669501000106
更新日期:1995-01-01 00:00:00
abstract::Patients undergoing surgery for pituitary tumors represent a heterogeneous population each with unique clinical, biochemical, radiologic, pathologic, neurologic, and/or ophthalmologic considerations. The postoperative management of patients following pituitary surgery often occurs in the context of a dynamic state of ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066605275247
更新日期:2005-05-01 00:00:00
abstract::Cardiomyopathy secondary to toxic shock syndrome (TSS) is an uncommon but potentially life-threatening problem. We report the case of a 51-year-old male who presented with profound cardiogenic shock and multiorgan failure that could not be managed by conventional therapy with intravenous fluids, vasopressors and inotr...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066613517069
更新日期:2015-02-01 00:00:00
abstract::Thrombolytic therapy has been established as a safe and effective therapeutic strategy in acute myocardial infarction (MI). Its efficacy is improved with early administration, although modest benefits can be demonstrated for up to 12 hours. Tissue plasminogen activator (TPA) appears to offer benefits over streptokinas...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/088506669501000202
更新日期:1995-03-01 00:00:00
abstract:INTRODUCTION:Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,meta分析
doi:10.1177/0885066618755334
更新日期:2020-05-01 00:00:00
abstract::Cardiac transplantation has now become accepted therapy for the treatment of end-stage heart disease in both children and adults, and literally thousands of patients are bearers of cardiac grafts. Because of these patients' susceptibility to infections, rejection, coronary disease, and malignancy, as well as to serio...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/088506669100600201
更新日期:1991-03-01 00:00:00
abstract:INTRODUCTION:The use of transesophageal echocardiography (TEE) by intensivist physicians (IPs) and emergency physicians (EPs) in critically ill patients is increasing in the intensive care unit, emergency department, and prehospital environments. Coagulopathy and thrombocytopenia are common in critically ill patients. ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619887693
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND::Patients with septic shock by multidrug resistant (MDR) microorganism maybe considered a specific population of critical patients at very high risk of death in whom the effects of standard sepsis treatment has never been assessed. The objective of this retrospective analysis was to evaluate the risk factors...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066616688165
更新日期:2019-01-01 00:00:00
abstract::The role of percutaneous transluminal coronary angioplasty (PTCA) in the management of acute myocardial infarction (AMI) has not yet been precisely defined. The longest experience with PTCA in this setting has been in patients who are not candidates for thrombolytic therapy and in patients in whom thrombolysis has fai...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/088506669501000402
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The efficacy of routinely obtained chest radiographs (CXRs) on admission to the intensive care unit (ICU) is largely unknown. The current study investigated the efficacy of routinely obtained admission CXRs and determined whether the value of this diagnostic test was dependent on patient categ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066610366925
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:A 25-hydroxyvitamin D, 25(OH)D, deficiency is common among critically ill patients and correlated with increased mortality. Furthermore, deficiency is associated with advanced liver disease. However, there are no studies available comparing the dimensions and consequences of a 25(OH)D deficiency between pa...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618803844
更新日期:2020-10-01 00:00:00
abstract::Acute adrenocortical insufficiency is a critical care emergency characterized by hemodynamic instability, lethargy, and cardiovascular collapse. Acute adrenal insufficiency has many etiologies, from rapid withdrawal of exogenous glucocorticoids to adrenocortical destruction to poor adrenal reserve after administration...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066606298140
更新日期:2007-03-01 00:00:00
abstract::Pulmonary embolus (PE) is estimated to cause 200 000 to 300 000 deaths annually. Many deaths occur in hemodynamically unstable patients and the estimated mortality for inpatients with hemodynamic instability is between 15% and 25%. The diagnosis of PE in the critically ill is often challenging because the presentation...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066610392658
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:At this time, there are no studies evaluating the risk of delirium or coma with the use of ketamine in mechanically ventilated adult patients, compared to conventional therapies such as propofol or dexmedetomidine. OBJECTIVE:The objective of this study was to evaluate the number of days alive without deliri...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618767619
更新日期:2020-06-01 00:00:00
abstract::Hyponatremia is one of the newer and emerging risk factors for an adverse prognosis in chronic heart failure. Why decreased serum sodium is associated with worse prognosis remains unclear. It may reflect worsening heart failure and the deleterious effects of activation of neurohormones. The mechanism of hyponatremia i...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066609344941
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Aspiration past the tracheal tube cuff has been recognized to be a risk factor for the development of ventilator-associated pneumonia (VAP). This study investigated the effect of closed tracheal suctioning on aspiration of fluid past the tracheal tube cuff in an in vitro benchtop model. METHODS:High-volume ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066610392516
更新日期:2011-09-01 00:00:00
abstract::Extracorporeal membrane oxygenation (ECMO) comprises a commonly used method of extracorporeal life support. It has proven efficacy and is an accepted modality of care for isolated respiratory or cardiopulmonary failure in neonatal and pediatric populations. In adults, there are conflicting studies regarding its benefi...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066610384061
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:The process of controlled donation after circulatory death (cDCD) is strongly connected with the process of withdrawal of life-sustaining therapy. In addition to impacting cDCD success, actions comprising withdrawal of life-sustaining therapy have implications for quality of palliative care. We examined pilot...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066615571529
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Cognitive impairment after sepsis is an important clinical problem. Determinants of postseptic cognitive impairment are not well understood. We thus undertook a systems biology approach to exploring a possible role for apolipoprotein E (APOE) in postseptic cognitive impairment. DESIGN:Prospective, observati...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619897604
更新日期:2020-01-09 00:00:00