Abstract:
BACKGROUND:To assess the impact of a real-time random safety tool on structure, process and outcome indicators. METHODS:Prospective study conducted over a period of 12 months in two adult patient intensive care units. Safety rounds were conducted three days a week ascertaining 37 safety measures (grouped into 10 blocks). In each round, 50% of the patients and 50% of the measures were randomized. The impact of this safety tool was analysed on indicators of structure (safety culture, healthcare protocols), process (improvement proportion related to tool application, IPR) and outcome (mortality, average stay, rate of catheter-related bacteraemias and rate of ventilator-associated pneumonia, VAP). RESULTS:A total of 1214 patient-days were analysed. Structure indicators: the use of the safety tool was associated with an increase in the safety climate and the creation/modification of healthcare protocols (sedation/analgesia and weaning). Process indicators: Twelve of the 37 measures had an IPR > 10%; six showed a progressive decrease in the IPR over the study period. Nursing workloads and patient severity on the day of analysis were independently associated with a higher IPR in half of the blocks of variables. Outcome indicators: A significant decrease in the rate of VAP was observed. CONCLUSIONS:The real-time random safety tool improved the care process and adherence to clinical practice guidelines and was associated with an improvement in structure, process and outcome indicators.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Bodí M,Oliva I,Martín MC,Gilavert MC,Muñoz C,Olona M,Sirgo Gdoi
10.1186/s13613-017-0245-xsubject
Has Abstractpub_date
2017-12-01 00:00:00pages
23issue
1issn
2110-5820pii
10.1186/s13613-017-0245-xjournal_volume
7pub_type
杂志文章abstract:BACKGROUND:The initial management of a trauma patient is a critical and demanding period. The use of extended focused assessment sonography for trauma (eFAST) has become more prevalent in trauma rooms, raising questions about the real "added value" of chest X-rays (CXRs) and pelvic X-rays (PXR), particularly in haemody...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0166-0
更新日期:2016-12-01 00:00:00
abstract::The death of a loved one is often an ordeal and a tragedy for those who witness it, as death is not merely the end of a life, but also the end of an existence, the loss of a unique individual who is special and irreplaceable. In some situations, end-of-life signs, such as agonal gasps, can be an almost unbearable "sig...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/2110-5820-4-23
更新日期:2014-07-08 00:00:00
abstract:BACKGROUND:Infection and sepsis are a main cause of acute-on-chronic liver failure (ACLF). Adequate dosing of antimicrobial therapy is of central importance to improve outcome. Liver failure may alter antibiotic drug concentrations via changes of drug distribution and elimination. We studied the pharmacokinetics of mer...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00666-8
更新日期:2020-04-22 00:00:00
abstract:BACKGROUND:Delayed intubation is associated with high mortality. There is a lack of objective criteria to decide the time of intubation. We assessed a recently described combined oxygenation index (ROX index) to predict intubation in immunocompromised patients. The study is a secondary analysis of randomized trials in ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-021-00801-z
更新日期:2021-01-27 00:00:00
abstract:BACKGROUND:Mortality of critically ill hematology (HM) patients has improved over time. Thus, those patients require an extensive diagnostic workup and the optimal use of available treatments. There are no data regarding nutrition strategy for critically ill HM patients, while nutritional support is crucial for both HM...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0527-6
更新日期:2019-05-07 00:00:00
abstract:BACKGROUND:Hypoxic hepatitis (HH) is a type of acute hepatic injury that is histologically characterized by centrilobular liver cell necrosis and that is caused by insufficient oxygen delivery to the hepatocytes. Typical for HH is the sudden and significant increase of aspartate aminotransferase (AST) in response to ca...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0356-z
更新日期:2018-01-30 00:00:00
abstract:BACKGROUND:Sepsis-associated acute kidney injury (SA-AKI) is an independent risk factor for death in patients with sepsis, but treatment for it is limited. To improve the diagnosis and treatment of SA-AKI, we must first understand its pathogenesis. Recently, interleukin (IL)-17A has been shown to be associated with the...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0157-1
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Data on respiratory mechanics of COVID-19 ARDS patients are scarce. Respiratory mechanics and response to positive expiratory pressure (PEEP) may be different in obese and non-obese patients. METHODS:We investigated esophageal pressure allowing determination of transpulmonary pressures (PL ) and elastances ...
journal_title:Annals of intensive care
pub_type: 信件
doi:10.1186/s13613-020-00745-w
更新日期:2020-10-01 00:00:00
abstract::Pharmacological interventions are commonly considered in acute respiratory distress syndrome (ARDS) patients. Inhaled nitric oxide (iNO) and neuromuscular blockers (NMBs) are used in patients with severe hypoxemia. No outcome benefit has been observed with the systematic use of iNO. However, a sometimes important impr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-20
更新日期:2013-07-03 00:00:00
abstract:BACKGROUND:Empirical antimicrobial therapy (EAT) is a challenge for community-acquired, hospital-acquired and ventilator-associated pneumonia, particularly in the context of the increasing occurrence of third-generation cephalosporin-resistant Enterobacterales (3GCR-E), including extended-spectrum beta-lactamase Entero...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00754-9
更新日期:2020-10-29 00:00:00
abstract:BACKGROUND:Occlusion pressure at 100 ms (P0.1), defined as the negative pressure measured 100 ms after the initiation of an inspiratory effort performed against a closed respiratory circuit, has been shown to be well correlated with central respiratory drive and respiratory effort. Automated P0.1 measurement is availab...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0576-x
更新日期:2019-09-13 00:00:00
abstract:BACKGROUND:Optimal anti-bacterial activity of meropenem requires maintenance of its plasma concentration (Cp) above the minimum inhibitory concentration (MIC) of the pathogen for at least 40% of the dosing interval (fT > MIC > 40). We aimed to determine whether a 3-h extended infusion (EI) of meropenem achieves fT > MI...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0622-8
更新日期:2020-01-10 00:00:00
abstract:BACKGROUND:Knowledge of patients' height is essential for daily practice in the intensive care unit. However, actual height measurements are unavailable on a daily routine in the ICU and measured height in the supine position and/or visual estimates may lack consistency. Clinicians do need simple and rapid methods to e...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0154-4
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Pneumonia is one of the major complications of drowning, but the optimal empirical antibiotic treatment is not clearly defined. Multidrug-resistant (MDR) bacteria and fungi have been identified in a recent series of freshwater drowning-associated pneumonia. However, microbial data in seawater drowning are sc...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0267-4
更新日期:2017-12-01 00:00:00
abstract:: Thrombocytopenia is a very frequent disorder in the intensive care unit. Many etiologies should be searched, and therapeutic approaches differ according to these different causes. However, no guideline exists regarding optimum practices for these situations in critically ill patients. We present recommendations for t...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-42
更新日期:2012-08-28 00:00:00
abstract:BACKGROUND:Acute lung injury and the acute respiratory distress syndrome (ALI/ARDS) are characterized by pulmonary oedema, measured as extravascular lung water (EVLW). The chest radiograph (CXR) can potentially estimate the quantity of lung oedema while the transpulmonary thermodilution method measures the amount of EV...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-25
更新日期:2013-08-11 00:00:00
abstract:: Microbiologists have extensively worked during the past decade on a particular phase of the bacterial cell cycle known as biofilm, in which single-celled individuals gather together to form a sedentary but dynamic community within a complex structure, displaying spatial and functional heterogeneity. In response to th...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-1-19
更新日期:2011-06-13 00:00:00
abstract:: Cancer is a leading cause of death in children. In the past decades, there has been a marked increase in overall survival of children with cancer. However, children whose treatment includes hematopoietic stem cell transplantation still represent a subpopulation with a higher risk of mortality. These improvements in m...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-14
更新日期:2012-06-12 00:00:00
abstract:: Multiple experimental and human trials have shown that microcirculatory alterations are frequent in sepsis. In this review, we discuss the characteristics of these alterations, the various mechanisms potentially involved, and the implications for therapy. Sepsis-induced microvascular alterations are characterized by ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-1-27
更新日期:2011-07-19 00:00:00
abstract:BACKGROUND:Intravenous crystalloid solutions are administered commonly for critically ill patients. We performed this meta-analysis of randomized trials with trial sequential analysis (TSA) to evaluate effects of chloride content of intravenous crystalloid solutions on clinical outcomes among critically ill adult patie...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0506-y
更新日期:2019-02-13 00:00:00
abstract:BACKGROUND:Venous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0315-0
更新日期:2017-09-12 00:00:00
abstract:BACKGROUND:The consequences of the ageing population concerning ICU hospitalisation need to be adequately described. We believe that this discussion should be disease specific. A focus on respiratory infections is of particular interest, because it is strongly associated with old age. Our objective was to assess trends...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0430-6
更新日期:2018-08-15 00:00:00
abstract:BACKGROUND:Ultrafast cooling by total liquid ventilation (TLV) provides potent cardio- and neuroprotection after experimental cardiac arrest. However, this was evaluated in animals with no initial lung injury, whereas out-of-hospital cardiac arrest is frequently associated with early-onset pneumonia, which may lead to ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0404-8
更新日期:2018-05-02 00:00:00
abstract:BACKGROUND:Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduce physiological dead space. We hypothesized that HFNT and NIV would similarly reduce work of breathi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0432-4
更新日期:2018-09-05 00:00:00
abstract:BACKGROUND:cRel, a subunit of NF-κB, is implicated in the inflammatory response observed in autoimmune disease. Hence, knocked-out mice for cRel had a significantly higher mortality, providing new and important functions of cRel in the physiopathology of septic shock. Whether genetic variants in the human REL gene are ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0130-z
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infect...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00705-4
更新日期:2020-07-08 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) occurs in up to 50% of all critically ill patients and hemodynamic abnormalities are assumed to contribute, but their nature and share is still unclear. We explored the associations between hemodynamic variables, including cardiac index and right ventricular function, and the occurr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0513-z
更新日期:2019-03-13 00:00:00
abstract:INTRODUCTION:Capillary leak in critically ill patients leads to interstitial edema. Fluid overload is independently associated with poor prognosis. Bedside measurement of intra-abdominal pressure (IAP), extravascular lung water index (EVLWI), fluid balance, and capillary leak index (CLI) may provide a valuable prognost...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-S1-S1
更新日期:2012-07-05 00:00:00
abstract:BACKGROUND:Despite advances in supportive care, moderate-severe acute respiratory distress syndrome (ARDS) is associated with high mortality rates, and novel therapies to treat this condition are needed. Compelling pre-clinical data from mouse, rat, sheep and ex vivo perfused human lung models support the use of human ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-014-0022-z
更新日期:2014-07-03 00:00:00
abstract:BACKGROUND:During passive mechanical ventilation, the driving pressure of the respiratory system is an important mediator of ventilator-induced lung injury. Monitoring of driving pressure during assisted ventilation, similar to controlled ventilation, could be a tool to identify patients at risk of ventilator-induced l...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0477-4
更新日期:2019-01-03 00:00:00