Abstract：
BACKGROUND:The ICU is a scarce resource within a high-stress, high-stakes, time-sensitive environment where critically ill patients with life-threatening conditions receive expensive life-sustaining care under the guidance of expert qualified personnel. The implications of decisions such as suitability for admission into ICU are potentially dire and difficult. OBJECTIVES:To conduct a systematic review of clinicians' subjective perceptions of factors that influence the decision to accept or refuse patients referred to ICU. RESULTS:Twenty studies yielded 56 different factors classified into patient, physician and environmental. Common, important factors were: acute illness severity and reversibility; presence and severity of comorbidities; patient age, functional status, state-of-mind and wishes; physician level of experience and perception of patient QOL; and bed availability. Within-group variability among physicians and thought-deed discordance were demonstrated. CONCLUSIONS:The complex and dynamic ICU triage decision is affected by numerous interacting factors. The literature provides some indication of these factors, but fail to show complexities and interactions between them. A decision tree is proposed. Further research should include a reflection on how decisions for admission to ICU are made, such that a better understanding of these processes can be achieved allowing for improved individual and group consistency.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Gopalan PD,Pershad Sdoi
10.1016/j.jcrc.2018.11.027subject
Has Abstractpub_date
2019-04-01 00:00:00pages
99-110eissn
0883-9441issn
1557-8615pii
S0883-9441(18)31420-5journal_volume
50pub_type
abstract：PURPOSE:Decisions to withdraw life-sustaining therapy (WDLS) are relatively common in intensive care units across Canada. As part of preliminary work to develop guidelines for WDLS, we performed a narrative review of the literature to identify published studies of WDLS. MATERIALS AND METHODS:A search of MEDLINE and EM...
journal_title：Journal of critical care
pub_type： 杂志文章,评审
doi：10.1016/j.jcrc.2016.04.006
更新日期：2016-10-01 00:00:00
abstract：PURPOSE:We hypothesized that the predictability of stroke volume variation (SVV) on fluid responsiveness would be reduced in patients with coronary disease who have wide pulse pressure (PP). METHODS:Sixty-six patients undergoing coronary surgery were divided into 2 groups according to the PP measured 1 day before surg...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2012.09.011
更新日期：2013-06-01 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：BACKGROUND:Quality improvement (QI) is a central tenant of trauma center accreditation in most countries, but its effectiveness is largely unknown. We sought to explore opportunities for improving trauma QI. METHODS:We performed a qualitative research study using grounded theory analyses of interviews with medical dir...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2012.07.010
更新日期：2012-12-01 00:00:00
abstract：PURPOSE:Increasingly, hospitals are engaging in continuous quality improvement (CQI) endeavors, aimed at optimizing patient care. Physician involvement is critical to the success of such initiatives. Little is known about any mediating factors that affect physician participation in these projects, though such knowledge...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1053/jcrc.2001.30165
更新日期：2001-12-01 00:00:00
abstract：PURPOSE:The Fas ligand (FasL)/Fas system is an apoptosis induction system that plays an important role in homeostasis and biophylaxis. We measured tumor necrosis factor alpha (TNF-alpha), soluble FasL (sFasL), and soluble Fas (sFas) in patients with acute hepatic failure to determine the relation between such failure a...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1053/jcrc.2001.25470
更新日期：2001-06-01 00:00:00
abstract：PURPOSE:Under-triage is a major threat when admitting patients at the Intermediate Care Unit (IMCU). This study aims to identify risk factors and predict early deterioration of IMCU admissions, to reduce the risk of under-triage. MATERIALS AND METHODS:This retrospective cohort study included all admissions to the mixe...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2018.08.012
更新日期：2018-12-01 00:00:00
abstract：PURPOSE:Few guidelines exist regarding the selection of a particular type or size of tracheostomy tube. Although nonstandard tubes can be placed over the percutaneous kit dilator, clinicians often place standard tracheostomy tubes and change to nonstandard tubes only after problems arise. This practice risks early trac...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.05.025
更新日期：2017-02-01 00:00:00
abstract：PURPOSE:To determine the neurologic outcome of patients with intracranial hypertension treated with barbiturate-induced coma. MATERIALS AND METHODS:The records of 49 patients who were admitted to a 31-bed medicosurgical intensive care unit over a 5-year period in whom a barbiturate coma was induced to control intracra...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1053/jcrc.2002.33032
更新日期：2002-03-01 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：INTRODUCTION:In the absence of a reference standard, a probabilistic approach to the diagnosis of ventilator-associated pneumonia (VAP) has been proposed; and clinician judgment augmented by microbiological tests is used to guide therapy for patients having a clinical suspicion of VAP (CSVAP). However, the correlation ...
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.2007.12.007
更新日期：2008-03-01 00:00:00
abstract：BACKGROUND:Changes in mean perfusion pressure (MPP) from premorbid resting values may contribute to the progression of septic acute kidney injury (AKI). OBJECTIVES:In patients with septic shock, we aimed to investigate the association of changes from premorbid values with AKI severity and progression. METHODS:We obta...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2015.05.003
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:Early rehabilitation in the intensive care unit (ICU) improves patients' physical function. Despite reports of using commercially available interactive video game systems for rehabilitation, there are few data evaluating feasibility and safety as part of routine in-patient rehabilitation, particularly in the...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2011.08.017
更新日期：2012-04-01 00:00:00
abstract：:The Institute of Medicine's (IOMs) report, "To Err is Human," recently addressed patient safety in the United States, alerting the nation to the need for improved systems of health care. Seven main findings were addressed in this report, we focus on 3: (1) patient safety is a nationwide problem, (2) health care worker...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1053/jcrc.2002.34363
更新日期：2002-06-01 00:00:00
abstract：PURPOSE:The aim of this study was to evaluate the causes, incidence, and impact on outcome of admission hyperlactatemia in patients admitted to a general medical intensive care unit (ICU). METHODS:A retrospective cohort study was done in an 8-bed general ICU of tertiary care hospital over 15 months. Data regarding pat...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2010.11.009
更新日期：2011-06-01 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:Rescue organ offers may help to overcome the organ shortage. However, because of initial poor liver function, the recipient may develop a severe lung injury with the requirement for higher positive end-expiratory pressure (PEEP) levels to achieve adequate oxygenation. Positive end-expiratory pressure has been a...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2009.11.002
更新日期：2010-09-01 00:00:00
abstract：PURPOSE:The mortality rate of severe acute pancreatitis (AP) is 20-30% even after admission to intensive care unit (ICU). Thus we aimed to develop a laboratory-based nomogram to identify AP patients at high risk for mortality. MATERIALS AND METHODS:The primary and validation cohorts were extracted from the Medical Inf...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2018.10.030
更新日期：2019-04-01 00:00:00
abstract：OBJECTIVE:Serum concentrations of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, may contribute to endothelial dysfunction and organ failure in sepsis. We aimed at investigating ADMA levels as a potential diagnostic or prognostic biomarker in critically ill patients. METHODS:Two ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2013.05.016
更新日期：2013-12-01 00:00:00
abstract：PURPOSE:We aimed to evaluate the effects of transjugular intrahepatic portosystemic stent shunt (TIPS) on systemic cardiocirculatory parameters in patients treated with TIPS for portal hypertension-associated complications. MATERIALS AND METHODS:This prospective study was conducted in an intensive care unit of a Germa...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2014.06.028
更新日期：2014-12-01 00:00:00
abstract：PURPOSE:To determine if recruitment manoeuvres (RMs) would decrease 28-day mortality of patients with acute respiratory distress syndrome (ARDS) compared with standard care. MATERIALS AND METHODS:Relevant randomized controlled trials (RCTs) published prior to April 26, 2018 were systematically searched. The primary ou...
journal_title：Journal of critical care
pub_type： 杂志文章,meta分析
doi：10.1016/j.jcrc.2018.10.033
更新日期：2019-04-01 00:00:00
abstract：PURPOSE:The primary objective of this survey was to describe pharmacists' attitudes regarding probiotic use in the intensive care unit (ICU); secondary objectives were to evaluate pharmacists' knowledge and use of probiotics for critically ill patients. METHODS:The survey instrument was rigorously designed and pretest...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2015.10.016
更新日期：2016-02-01 00:00:00
abstract：:Invasive pulmonary aspergillosis (IPA) is an emerging and life-threatening infectious disease in patients admitted to the intensive care unit (ICU). Most diagnostic studies are conducted in hematological patients and results cannot readily be transferred to ICU patients lacking classical host factors. In a multicenter...
journal_title：Journal of critical care
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jcrc.2018.07.001
更新日期：2018-10-01 00:00:00
abstract：PURPOSE:It is unclear whether quick sequential (sepsis-related) organ failure assessment (qSOFA) also has prognostic value for organ failure in patients with a suspected infection. The aim of this study was to determine whether qSOFA has prognostic value when compared to systemic inflammatory response syndrome (SIRS) i...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.06.020
更新日期：2017-12-01 00:00:00
abstract：INTRODUCTION:Barotrauma and cardiovascular insufficiency are frequently encountered problems in patients with acute bronchospastic disease who require mechanical ventilation. Permissive hypercapnia is a recognized strategy for minimizing these adverse effects; however, it has potential risks. Tracheal gas insufflation ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/s0883-9441(97)90021-6
更新日期：1997-03-01 00:00:00
abstract：BACKGROUND:Metabolic acidosis is highly prevalent in critically ill patients with acute renal failure. Little is known about the mechanisms by which renal replacement therapy intervenes in such cases. The objective of this study is to analyze the role of hemodialysis in acidosis correction in intensive care unit patien...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2006.03.011
更新日期：2006-12-01 00:00:00
abstract：PURPOSE:We assessed the security and efficiency of intravenously injected agitated saline in conjunction with transthoracic echocardiography to identify recirculation in patients supported with a venovenous extracorporeal membrane oxygenation (VV ECMO) device. MATERIALS AND METHODS:We injected agitated saline 4 consec...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.08.017
更新日期：2017-02-01 00:00:00
abstract：PURPOSE:The purpose was to investigate the value of procalcitonin (PCT) kinetics in predicting the appropriateness of empirical antimicrobial treatment in critically ill patients. MATERIALS AND METHODS:This prospective observational study recruited patients in whom empirical antimicrobial therapy was started for suspe...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.04.007
更新日期：2016-08-01 00:00:00
abstract：PURPOSE:Closed endotracheal suctioning (CES) may impact ventilator-associated pneumonia (VAP) risk by reducing environmental contamination. In developing countries where resource limitations constrain the provision of optimal bed space for critically ill patients, CES assumes greater importance. MATERIALS AND METHODS:...
journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrc.2010.10.002
更新日期：2011-10-01 00:00:00
abstract：PURPOSE:To investigate the relationship between immature granulocyte percentage (IG%) and acute respiratory distress syndrome (ARDS) in patients with acute pancreatitis (AP). MATERIALS AND METHODS:A cohort of 2289 patients with AP was screened; 1933 were enrolled in this prospective multicenter study. Blood samples fo...
journal_title：Journal of critical care
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jcrc.2018.12.002
更新日期：2019-04-01 00:00:00
