Critical Illness

Publication Title: 
Journal of Critical Care

PURPOSE: Sepsis and severe sepsis are the most common cause of death among critically ill patients admitted in medical intensive care units. As more than one-third of the adult population of the United States is obese; we undertook a systematic review of the association between obesity and mortality among patients admitted with sepsis, severe sepsis, or septic shock. MATERIALS AND METHODS: A systematic review was conducted to identify pertinent studies using a comprehensive search strategy. Studies reporting mortality in obese patients admitted with sepsis were identified.

Author(s): 
Trivedi, Vrinda
Bavishi, Chirag
Jean, Raymonde
Publication Title: 
New Horizons (Baltimore, Md.)

Dietary manipulation may influence outcome after infection and injury by altering production of inflammatory mediators and disease activity. Restricted nutrient intake may have beneficial effects on life-span, development of degenerative disease, autoimmune processes, renal injury, susceptibility to infection, and survival rate after infection. Nutritional therapies that serve to maximize nitrogen balance may adversely affect the host response to injury, especially when given in excess of energy and protein needs.

Author(s): 
Zaloga, G. P.
Roberts, P.
Publication Title: 
Journal of Critical Care

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 included age at least 35 years and self-identifying as the surrogate for a spouse/parent. The primary outcome was the surrogate's election of code status.

Author(s): 
Patel, Dev
Cohen, Elan D.
Barnato, Amber E.
Publication Title: 
Medical Care

Voluntary informed consent is a hard problem--one that inheres in the domain of research. The standard definition requires four criteria for consent to be morally valid: disclosure, understanding, voluntariness, and competence. These standards apply across the continuum of activities that comprise research. This paper concentrates on consent for the desperately sick, for whom enrollment in a research trial represents the last best hope of rescue. The literature indicates that many of these subjects enroll in research on the basis of feelings of hope or trust.

Author(s): 
Bosk, Charles L.
Publication Title: 
Medical Care

Voluntary informed consent is a hard problem--one that inheres in the domain of research. The standard definition requires four criteria for consent to be morally valid: disclosure, understanding, voluntariness, and competence. These standards apply across the continuum of activities that comprise research. This paper concentrates on consent for the desperately sick, for whom enrollment in a research trial represents the last best hope of rescue. The literature indicates that many of these subjects enroll in research on the basis of feelings of hope or trust.

Author(s): 
Bosk, Charles L.
Publication Title: 
Intensive & Critical Care Nursing

The aim of this study is to describe how people who have been critically ill, and their close relatives experience a post-discharge, follow-up visit to the intensive care unit (ICU) that provided the care. There is a lack of studies from such a standpoint. The study design is qualitative. A total of 18 adults participated; nine had been critically ill and nine were close relatives, all made a post-discharge follow-up visit to an ICU in the northern part of Sweden. The study data was collected through personal interviews, conducted after the follow-up visit, using a narrative approach.

Author(s): 
Engstrˆm, Asa
Andersson, Staffan
Sˆderberg, Siv
Publication Title: 
Chest

OBJECTIVE: We undertook the current investigation to explore how the pressures of serving as a surrogate decision-maker (SDM) for an acutely ill family member influence attitudes regarding clinical investigation. METHODS: We conducted a prospective study involving SDMs for critically ill patients cared for in the ICUs of two urban hospitals. Measurements included participation in focus groups designed to explore perceptions of ICU care and clinical research. Audiotapes were transcribed and analyzed to identify common patterns and themes using grounded theory.

Author(s): 
Iverson, Ellen
Celious, Aaron
Kennedy, Carie R.
Shehane, Erica
Eastman, Alexander
Warren, Victoria
Bolcic-Jankovic, Dragana
Clarridge, Brian
Freeman, Bradley D.
Publication Title: 
Trials

BACKGROUND: A rigorous research response is required to inform clinical and public health decision-making during an epi/pandemic. However, the ethical conduct of such research, which often involves critically ill patients, may be complicated by the diminished capacity to consent and an imperative to initiate trial therapies within short time frames. Alternative approaches to taking prospective informed consent may therefore be used.

Author(s): 
Gobat, Nina H.
Gal, Micaela
Francis, Nick A.
Hood, Kerenza
Watkins, Angela
Turner, Jill
Moore, Ronald
Webb, Steve A. R.
Butler, Christopher C.
Nichol, Alistair
Publication Title: 
Anales De Pediatría (Barcelona, Spain: 2003)

The Bispectral Index (BIS) is a single numeric value that indicates the depth of hypnosis by estimating the level of electrical activity in the brain through analysis of the frequency bands in the electroencephalogram. The BIS was primarily developed to monitor the level of hypnosis during surgery and has recently begun to be used in critically-ill patients. Currently, there is little experience of the BIS in critically-ill children. We present 6 cases that illustrate the utility of BIS monitoring in the PICU.

Author(s): 
Mencía Bartolomé, S.
López-Herce Cid, J.
Lamas Ferreiro, A.
Borrego Domínguez, R.
Sancho Pérez, L.
Carrillo Alvarez, A.
Publication Title: 
Intensive Care Medicine

OBJECTIVE: To assess whether the Entropy Module (GE Healthcare, Helsinki, Finland), a device to measure hypnosis in anesthesia, is a valid measure of sedation state in critically ill patients by comparing clinically assessed sedation state with Spectral Entropy DESIGN: Prospective observational study. SETTING: Teaching hospital general ICU. PATIENTS AND PARTICIPANTS: 30 intubated, mechanically ventilated patients without primary neurological diagnoses or drug overdose receiving continuous sedation.

Author(s): 
Walsh, Timothy S.
Ramsay, Pamela
Lapinlampi, T. Petteri
Särkelä, Mika O. K.
Viertiö-Oja, Hanna E.
Meriläinen, Pekka T.

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