Academic literature on the topic 'Critical care patients'

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Journal articles on the topic "Critical care patients"

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Schwartz, Denise B. "Critical care patients." TOPICS IN CLINICAL NUTRITION 1, no. 4 (October 1986): 1–7. http://dx.doi.org/10.1097/00008486-198610000-00003.

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Nicolaides, A., J. Fareed, A. K. Kakkar, A. J. Comerota, S. Z. Goldhaber, R. Hull, K. Myers, et al. "Critical Care Medical Patients." Clinical and Applied Thrombosis/Hemostasis 19, no. 2 (March 25, 2013): 171–72. http://dx.doi.org/10.1177/1076029612474840j.

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Boeing, Marianne H., and Cheryl O. Mongera. "Powerlessness in Critical Care Patients." Dimensions of Critical Care Nursing 8, no. 5 (September 1989): 274–79. http://dx.doi.org/10.1097/00003465-198909000-00004.

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Shedd, Peggy, Marie Bakitas Whedon, Wayne Barlow, Ellen Gnaedinger, and Betty Hauger. "Oncology Patients in Critical Care." Dimensions of Critical Care Nursing 10, no. 2 (March 1991): 84–95. http://dx.doi.org/10.1097/00003465-199103000-00009.

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Holland, Cecilia, Carolyn L. Cason, and Lucy R. Prater. "Patients Recollections of Critical Care." Dimensions of Critical Care Nursing 16, no. 3 (May 1997): 132–43. http://dx.doi.org/10.1097/00003465-199705000-00003.

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KILPATRICK, SARAH J., and MICHAEL A. MATTHAY. "Obstetric Patients Requiring Critical Care." Obstetrical & Gynecological Survey 48, no. 2 (February 1993): 73–74. http://dx.doi.org/10.1097/00006254-199302000-00004.

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FERRARIS, VICTOR A., and MANCIA E. PROPP. "Outcome in critical care patients." Critical Care Medicine 20, no. 7 (July 1992): 967–76. http://dx.doi.org/10.1097/00003246-199207000-00012.

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Laske, Rita Ann, and Barbara Stephens. "Delirium in critical care patients." Nursing Critical Care 11, no. 1 (January 2016): 18–23. http://dx.doi.org/10.1097/01.ccn.0000475514.04388.d9.

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Prat, Dominique, Jonathan Messika, Maude Millereux, Corentin Gouezel, Olfa Hamzaoui, Nadège Demars, Frédéric Jacobs, Pierre Trouiller, Jean-Damien Ricard, and Benjamin Sztrymf. "Constipation in critical care patients." European Journal of Gastroenterology & Hepatology 30, no. 9 (September 2018): 1003–8. http://dx.doi.org/10.1097/meg.0000000000001165.

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Divatia, J. V. "Critical care for cancer patients." Indian Journal of Critical Care Medicine 11, no. 1 (January 2007): 1–3. http://dx.doi.org/10.4103/0972-5229.32429.

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Dissertations / Theses on the topic "Critical care patients"

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Abelha, Fernando José Pereira Alves. "Outcome in surgical critical care patients." Doctoral thesis, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/55332.

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Abelha, Fernando José Pereira Alves. "Outcome in surgical critical care patients." Tese, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/55332.

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Comeau, Odette. "Delirium Screening in Adult Critical Care Patients." ScholarWorks, 2016. http://scholarworks.waldenu.edu/dissertations/1675.

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Delirium is an acute change in cognition accompanied by inattention, which affects up to 88% of adult critical care patients. Delirium causes increased hospital complications, longer lengths of hospital stay, functional disability, cognitive impairment, and increased mortality. The purpose of this evidence-based quality-improvement project was to implement and evaluate a delirium screening process in adult intensive care units at a large medical center. This included education of nurses, implementation of a structured, validated tool, and review of tool use documentation. The implementation of this project was guided by an evidence-based practice model, Disciplined Clinical Inquiry© and Lewin's change theory. Evaluation of this quality-improvement project used audits of the electronic medical record. The audits included the presence and accuracy of delirium screening documentation in the patients' medical records. Results of 3 sequential documentation audits revealed a gradual adoption of this practice change by nurse clinicians. The percentage of charts with missing, incomplete, or inaccurate data decreased from 50% on the first week to 27.9% and 25.0% on the 2nd and 3rd weeks, respectively. These findings were an indication of practice change by validating the requirement for delirium screening on the units. In the first 3 weeks alone, 17 patient audits were positive for delirium, indicating the potential for poor short-term and long-term patient outcomes if not addressed promptly. Implementation of delirium screening ensures the dignity and worth of adult critical care patients by decreasing the poor outcomes associated with the diagnosis, which is an important contribution to positive social change.
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Doran, Carmen. "Modelling and control of hyperglycemia in critical care patients." Thesis, University of Canterbury. Mechanical Engineering, 2004. http://hdl.handle.net/10092/6478.

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Critically ill patients are known to experience stress-induced hyperglycemia. Inhibiting the physiological response to increased glycemic levels in these patients are factors such as increased insulin resistance, increased dextrose input, absolute or relative insulin deficiency, and drug therapy. Although hyperglycemia can be a marker for severity of illness, it can also worsen outcomes, leading to an increased risk of further complications. Hyperglycemia has been quantified in critically ill patients showing the need for glucose control. The development of a relatively simple system model and the verification of both generic and patient specific parameters have been successful in control trials and simulations over a range of critically ill patients. Stepwise reduction of blood glucose values by adaptive control was shown to be accurate to within 20%, and average long-term fitting errors are within the measurement error of the glucose sensor. A control algorithm capable of tight regulation for a glucose intolerant ICU patient would thus reduce mortality, as well as the burden on medical resources and time with current experience-based control approaches used in most critical care units. Overall, the research presented is a significant step towards fully automated adaptive control of hyperglycaemia in critically ill patients.
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Bourne, Richard Stanley. "Melatonin, sleep and circadian rhythms in critical care patients." Thesis, University of Sheffield, 2009. http://etheses.whiterose.ac.uk/15108/.

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Critical care patients commonly experience sleep fragmentation, in which sleep quality is poor and distributed throughout the 24 hour cycle. This irregular sleep wake pattern is a form of circadian rhythm sleep disorder. The causes of sleep disturbances are multifactorial and contribute to patient morbidity. Conventional hypnotic treatment is often ineffective and, indeed, may cause delirium and reduced sleep quality. Administration of exogenous melatonin has been shown to re-enforce circadian rhythm disorders and improve sleep in other patient groups. An open evaluation of 5 mg oral melatonin was undertaken in a group of 12 critical care patients exhibiting sleep disturbances resistant to conventional hypnotics. Melatonin significantly increased observed sleep quantity by night 3, compared to baseline. An oral solution of melatonin was formulated to allow administration by enteral feeding tubes. It was shown to have a 1 year shelf life when refrigerated and protected from light. A randomised controlled trial was undertaken in 24 critical care patients weaning from mechanical ventilation. Melatonin 10 mg orally increased nocturnal bispectral index sleep quantity over nights 3 and 4 compared to placebo. Agreement of the other sleep measurement techniques with the bispectral index was poor. Actigraphy was not a useful measure of sleep in critical care patients and nurse observation overestimated sleep quantity. The clearance of melatonin appeared to be decreased in critical care patients compared to that in healthy subjects. Doses of 1-2 mg should be used in future critical care studies. 11 Acute administration of melatonin did not have a significant effect over placebo on rest-activity rhythms, which remained delayed, fragmented and reduced. Similar disturbances were present in plasma melatonin and cortisol rhythms, which were no longer phase locked. Melatonin therapy may prove beneficial in the treatment of sleep and circadian rhythms in critical care patients, and further larger studies should be pursued.
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Kaczmarski, Lorelei Jean 1960. "Perceived needs of family members of critical care patients." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/558127.

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Appel, Ilse Nadine. "Acquired infections in paediatric patients after cardiac surgery." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/19899.

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Introduction: Hospital acquired infections (HAIs) are an important cause of morbidity and mortality following paediatric cardiac surgery. Aim: To determine the incidence, risk factors for and outcome of postoperative HAIs in the Paediatric Intensive Care Unit (PICU) of the Red Cross War Memorial Children's Hospital (RCWMCH) in Cape Town. Methods: A prospective observational study of all postoperative cardiac patients admitted to PICU from September 2011 to March 2012. The definitions of laboratory confirmed blood stream infections (BSI), urinary tract infections (UTI), and surgical site infections were based on the Centres of Disease Control criteria. Ventilator associated pneumonia (VAP) was diagnosed using a modification of the Clinical Pulmonary Infection Score (CPIS). Results: 110 patients (median age 19 months; 43% male) undergoing 126 surgical procedures were enrolled. Sixty HAIs occurred in 43 (39%) patients (68.3% pulmonary; 13.3% blood; 11.7% wound; 3.3% urine; 3.3% tissue). Nine (8.2%) patients died and their deaths were not related to HAIs.
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Oswald, Sharon. "A retrospective case note analysis of the recognition and management of deteriorating patients prior to critical care admission." Thesis, University of Stirling, 2017. http://hdl.handle.net/1893/27289.

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This study explores the use of early warning scores (EWS) in deteriorating patients. These are widely used tools to measure vital signs and highlight abnormal physiology in acutely unwell patients. Measurements of the process in the management of the deteriorating patient includes time to first assessment of such patients. The level of clinician involved in the subsequent management is also investigated to determine whether escalation of care was appropriate. This work is a retrospective case note analysis of the recognition and management of deteriorating patients prior to critical care admission. Research Questions 1. What violations in the optimum process are associated with sub-optimal recognition and management of deteriorating patients and delayed critical care admission in patients triggering early warning scores in acute care wards? 2. Are there independent variables which can predict the delay in the recognition and management of deteriorating patients and subsequent critical care admission? Methods The literature was reviewed to determine the optimum process of recognition and management of deteriorating patients in acute care wards. A data collection tool was then specifically designed and locally validated to extract objective data from the case records. A sample of 157 patients admitted to critical care from acute wards over a 6 month period were included in the study. The case records were then retrospectively reviewed and information was extracted using the data collection tool. Results The accuracy and frequency of early warning scores were measured and findings demonstrated that 59% of Early Warning Scores (EWS) were miscalculated. The most frequent of those miscalculated were the intermediate scores (4 or 5) (error rate - 52%) followed by the higher scores (6 or more) (error rate - 32%). The least frequently miscalculated were the lower scores (0 -3) (error rate 15%). Descriptive data from the sample such as age, ward, diagnosis, time of hospital admission, time and day of transfer / EWS triggering were included. From the total case records reviewed, 110 patients had abnormal Early Warning Scores (4 or more) and were included in the inferential data analysis. The independent variables related to the processes objectively measurable in the recognition and management of deteriorating patients were included. After descriptive analysis the independent variables were cross-tabulated with the dependent variable using Pearson chi-square. The dependent variable was identified from the literature. This was whether time from triggering an abnormal EWS to critical care admission was delayed more than 6 hours. The subsequent predictor variables were then entered in to a binary logistic regression model for statistical analysis using SPSS version 21 software. Binominal Logistic Regression Analysis identified three significant variables predicting delay of the recognition and management of deteriorating patients. • Frequency of EWS measurement not increased appropriately • Length of stay prior to critical care admission 12-36 hours • If no consultant review during 6 hours of abnormal EWS Implications for Future Practice This study highlights areas of risk in the detection of patients’ clinical deterioration in acute wards. These findings should guide quality improvement to prevent unnecessary morbidity and mortality. As a key area of patient risk included the lack of frequency and accuracy of EWS measurements, staff education is required to ensure staff are given the appropriate knowledge to understand the use of the tool. Regular review of the frequency of measurement is also required as this was statistically significant in the delay to critical care admission. The high risk time from admission of 12-36 hours needs further investigation. This study also highlights the need for senior decision makers to be involved in the care of deteriorating patients to improve outcomes.
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Pattison, Natalie A. "Cancer patients' care at the end of life in a critical care environment : perspectives of families, patients and practitioners." Thesis, Northumbria University, 2011. http://nrl.northumbria.ac.uk/1009/.

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Innovations in cancer care requiring intensive support, and improved cancer patient survival in and out of critical care, have led to greater numbers of cancer patients than ever accessing critical care. Of these, however, a fair proportion will die. Current research points to around one in six patients dying in general critical care units and even higher numbers for cancer patients. End-of-life care (EOLC) for critically ill patients is problematic and rarely addressed beyond satisfaction or chart review studies, while palliative care is an established domain in cancer. It is not known whether dying, critically ill cancer patients experience good EOLC. In the context of a cancer critical care unit, this thesis explores the provision of EOLC for cancer patients in a critical care unit. Exploring measures for comfort care and palliative principles of care helped identify what is important for patients and families, and what those measures meant for all participants. The diagnosis of cancer and how it impacts on EOLC provision for critically ill cancer patients was also explored from the perspective of patients, families, doctors and nurses. A Heideggerian phenomenological interview approach was undertaken, in order to gain personal experiences. Families of those patients who died after decisions to forgo life-sustaining treatment (DFLSTs) were interviewed. Patients who have experienced critical care were also interviewed, since patients‘ views about EOL care provision are very rarely explored. Doctors and nurses also contribute their vision for, and experiences of, EOL care in a cancer critical care unit. Thirty one interviews with 37 participants were carried out. Cancer prognosis together with critical illness prognosis contributed to difficulties in deciding to move to, and enact EOLC. The nursing voice in DFLSTs was minimal and their role in EOLC depended on experience and confidence. Achieving a good death was possible through caring activities that made best use of technology to prevent prolonged dying. EOLC was an emotive experience. Decision-making and EOLC could be difficult to separate out which, in turn, affects prospects for EOLC. A continuum of dying in cancer critical illness is presented with different participants‘ experiences along that continuum. Three main themes included: Dual Prognostication; The Meaning of Decision-Making; and Care Practices at EOL: Choreographing a Good Death with two organising themes: Thinking the Unthinkable and Involvement in Care. These themes outlined the essence of moving along a continuum toward patients‘ deaths and the impact that had on opportunities for care and a good death. Nurses could use the care of patients dying in critical care as an opportunity to develop specialist knowledge and lead in care, but this requires mastery and reconciliation of both technology and EOLC. This work builds on Seymour‘s (2001) theory of a negotiated and natural death related to achieving a good death in critical care. Trajectories of dying, part of Seymour‘s (2001) theory, are extrapolated on with reference to Glaser and Strauss (1965) and Lofland (1978)‘s theories on dying trajectories. Nursing theory is developed through examination of Falk Rafael‘s (1996) and Locsin‘s (1998) theories of empowered caring. Implications and propositions are presented for nursing and wider practice around EOL care for critically ill cancer patients.
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LeBlanc, Allana E. "The Experience of Intensive Care Nurses Caring for Patients with Delirium." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/34266.

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The purpose of this research was to seek a deep understanding of the lived experience of intensive care nurses caring for patients with delirium. Delirium affects a large proportion of adult patients in the intensive care unit (ICU). Delirium has been linked to increased morbidity and mortality, longer intensive care and hospital length of stay, long-term cognitive impairments, short-term and long-term psychological distress, and increased hospital and health system costs. Critical care nurses play central roles in preventing, identifying, and treating ICU patients with delirium. Semi-structured interviews were conducted with eight intensive care nurses working in an ICU in a tertiary level, university-affiliated hospital in Ontario, Canada. The researcher analyzed the interviews using an interpretive phenomenological approach as described by van Manen (1990). The essence of the experience of critical care nurses caring for ICU patients with delirium was revealed to be finding a way to help them come through it. Six main themes emerged: It's Exhausting; Making a Picture of the Patient's Mental Status; Keeping Patients Safe: It's a Really Big Job; Everyone Is Unique; Riding It Out With Families; and Taking Every Experience With You. The findings describe how intensive care nurses find a way to help patients and their families through this complex and often distressing experience. This study has contributed to the understanding of the lived experience of ICU nurses caring for patients with delirium.
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Books on the topic "Critical care patients"

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American Academy of Orthopaedic Surgeons. Critical care transport. Edited by American College of Emergency Physicians. Sudbury, Mass: Jones and Bartlett Publishers, 2011.

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Brunner, Josef X., and Gunther Wolff. Pulmonary Function Indices in Critical Care Patients. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-73040-5.

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Dabbagh, Ali, Fardad Esmailian, and Sary F. Aranki, eds. Postoperative Critical Care for Cardiac Surgical Patients. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-40418-4.

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Dabbagh, Ali, Fardad Esmailian, and Sary Aranki, eds. Postoperative Critical Care for Adult Cardiac Surgical Patients. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-75747-6.

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Corporation, Springhouse, ed. Responding to patients in crisis. Springhouse, Pa: Springhouse Corp., 1993.

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High dependency nursing care: Observation, intervention and support for level 2 patients. 2nd ed. London: Routledge, 2009.

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Philip, Jevon, Ewens Beverley, and Humphreys Melanie, eds. Nursing medical emergency patients. Oxford: Wiley-Blackwell Pub., 2008.

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Gillian, Craig, ed. Patients in danger: The dark side of medical ethics. Northampton: Enterprise House, 2006.

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Goldhill, D. R. Levels of critical care for adult patients: Standards and guidelines. London: Intensive Care Society, 2002.

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Moore, Tina. High dependency nursing care: Observation, intervention, and support for level 2 patients. 2nd ed. Milton Park, Abingdon, Oxon: Routledge, 2009.

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Book chapters on the topic "Critical care patients"

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Hoyt, John W. "Globalization of Critical Care." In Three Patients, 111–16. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0939-4_16.

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Vincent, Jean-Louis. "Should Patient B Receive Critical Care?" In Three Patients, 139–44. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0939-4_19.

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Gowda, Lohith, and Chitra Hosing. "Hyperleukocytosis in Cancer Patients." In Oncologic Critical Care, 1147–53. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74588-6_94.

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Plata, Juan David, and Ximena Castañeda. "Parasites in Cancer Patients." In Oncologic Critical Care, 1–11. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74698-2_126-1.

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Kim, Peter, Abdulrazzak Zarifa, Mohammed Salih, and Kaveh Karimzad. "Arrhythmias in Cancer Patients." In Oncologic Critical Care, 1–20. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74698-2_68-1.

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Gowda, Lohith, and Chitra Hosing. "Hyperleukocytosis in Cancer Patients." In Oncologic Critical Care, 1–7. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74698-2_94-1.

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Plata, Juan David, and Ximena Castañeda. "Parasites in Cancer Patients." In Oncologic Critical Care, 1441–50. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74588-6_126.

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Kim, Peter, Abdulrazzak Zarifa, Mohammed Salih, and Kaveh Karimzad. "Arrhythmias in Cancer Patients." In Oncologic Critical Care, 733–51. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74588-6_68.

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Granwehr, Bruno P., Nikolaos V. Sipsas, and Dimitrios P. Kontoyiannis. "Fungal Infections in Cancer Patients." In Oncologic Critical Care, 1–24. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74698-2_121-1.

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Sinclair Ávila, Jorge Enrique, Jorge Enrique Sinclair De Frías, and Felix Liu Wu. "Tropical Diseases in Cancer Patients." In Oncologic Critical Care, 1–14. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-74698-2_128-1.

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Conference papers on the topic "Critical care patients"

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Pacheco-Acosta, Fernando, and L. Fernando Borjon. "Determination of pulmonary mechanics in critical care patients." In 1992 14th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1992. http://dx.doi.org/10.1109/iembs.1992.5761516.

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Pacheco-Acosta and Borjon. "Determination Of Pulmonary Mechanics In Critical Care Patients." In Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1992. http://dx.doi.org/10.1109/iembs.1992.592727.

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Steele, Tom, Rachel McDonald, Jessica Lee, Graham Holland, Susan Oakes, Jeanette Renshaw, Andrew Khodabukus, and Helen Bonwick. "86 Caring for dying patients in critical care settings: survey of palliative care and critical care practices and perspectives." In Accepted Oral and Poster Abstract Submissions, The Palliative Care Congress 1 Specialty: 3 Settings – home, hospice, hospital 19–20 March 2020 | Telford International Centre. British Medical Journal Publishing Group, 2020. http://dx.doi.org/10.1136/spcare-2020-pcc.106.

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Teng, Chia-Chi, Brady Redfearn, Craig Nuttall, Sabrina Jarvis, James Carr, Jarin Jensen, Sandy Kanuch, Jordon Peterson, and David Taylor. "Mixed Reality Patients Monitoring Application for Critical Care Nurses." In the third International Conference. New York, New York, USA: ACM Press, 2019. http://dx.doi.org/10.1145/3340037.3340050.

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Price, Laura, Colm Mccabe, Sophie Herbert, Tc Aw, David Alexander, Susanna Price, Stephan Ledot, et al. "Critical care admissions in patients with pulmonary arterial hypertension." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa3091.

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Mathews, Kusum S., Grace Y. Jenq, Jonathan M. Siner, Elisa F. Long, and Margaret A. Pisani. ""Short-Stay" Patients In The Intensive Care Unit: Characterizing Patient Acuity, Throughput, And Critical Care Resource Utilization." In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a6731.

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Dai, Yang, Sharukh Lokhandwala, William Long, Roger Mark, and Li-wei H. Lehman. "Phenotyping hypotensive patients in critical care using hospital discharge summaries." In 2017 IEEE EMBS International Conference on Biomedical & Health Informatics (BHI). IEEE, 2017. http://dx.doi.org/10.1109/bhi.2017.7897290.

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Bahry, Stanley, Ferry Dwi Kurniawan, and Teuku Zulfikar. "Outcomes of COVID-19 Critical Care Patients in Indonesia Periphery." In ERS International Congress 2021 abstracts. European Respiratory Society, 2021. http://dx.doi.org/10.1183/13993003.congress-2021.pa2431.

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Srinivasaiah, Rajesha, Martin Bamber, D. Vadivel, and Sandeep Lakhani. "A0013 Patient Satisfaction Survey on Quality of Anesthesia in Neurosurgical Patients: A Tertiary Care Neuro Center Experience." In 20th Annual Conference of Indian Society of Neuroanaesthesiology and Critical Care (ISNACC). Thieme Medical and Scientific Publishers Private Ltd., 2019. http://dx.doi.org/10.1055/s-0039-1684120.

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S., Bharath, Radhakrishnan M., G. Umamaheshwara Rao, and Dhritiman Chakrabarti. "Intraoperative haemodynamic changes during emergency surgical decompression in head injury patients." In 17th Annual Conference of Indian Society of Neuroanaesthesiology and Critical Care. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0038-1667573.

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Reports on the topic "Critical care patients"

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Villa, Michele, Massimo Le Pera, and Michela Bottega. Quality of Abstracts in Randomized Controlled Trials Published in Leading Critical Care Nursing Journals. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, June 2022. http://dx.doi.org/10.37766/inplasy2022.6.0039.

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Review question / Objective: This review aims to evaluate the methodological quality of RCT-abstracts in leading critical care nursing journals. A methodological quality review with the Consolidated Standards of Reporting Trials (CONSORT) criteria will be performed in RCT-abstracts published between 2011-2021 in the first Scopus-ranking (2021) nursing journals. Eligibility criteria: Abstracts of scientific articles will be included if they fulfil the following inclusion criteria: 1) they report the results of parallel and/or cross-over group RCTs, 2) they are written in English, 3) they refer to the care of adult patients with acute/critical illness or conducted in adult ICUs.Manuscripts reporting results of pilot or feasibility studies, cluster trials, observational or cohort studies, interim analyses, economic analyses of RCTs, post-trial follow-up studies, subgroup and secondary analyses of previously published RCTs, editorials and RCTs without an abstract such as RCTs published as letters to the editor, single-subject clinical trials will be excluded.
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Jalil, Yorschua, and Ruvistay Gutierrez. Myokines secretion and their role in critically ill patients. A scoping review protocol. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2021. http://dx.doi.org/10.37766/inplasy2021.9.0048.

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Review question / Objective: 1-How and by which means stimulated muscle from critically ill patients can liberate myokines?, 2-Which are the main characteristics of the critically ill population studied and if some of these influenced myokine´s secretion?, 5-Can myokines exert local or distant effects in critically ill patients?, 5-Which are the potential effects of myokines in critically ill patients? Eligibility criteria: Participants and context: We will include primary studies (randomized or non-randomized trials, observational studies, case series or case report) that consider hospitalized critically ill adult patients (18 years or older) in risk for developing some degree of neuromuscular disorders such as ICU-AW, diaphragmatic dysfunction, or muscle weakness, therefore the specific setting will be critical care. Concept: This review will be focused on studies regarding the secretion or measure of myokines or similar (exerkines, cytokines or interleukin) by any mean of muscle activation or muscle contraction such as physical activity, exercise or NMES, among others. The latter strategies must be understood as any mean by which muscle, and there for myocytes, are stimulated as result of muscle contraction, regardless of the frequency, intensity, time of application and muscle to be stimulated (upper limb, lower limb, thoracic or abdominal muscles). We also will consider myokine´s effects, local or systemic, over different tissues in terms of their structure or function, such as myocytes function, skeletal muscle mass and strength, degree of muscle wasting or myopathies, among others.
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Fuentes-Aspe, Rocío, Felipe González-Seguel, Catalina Merino-Osorio, Ruvistay Gutiérrez-Arias, Gabriel Nasri Marzuca-Nassr, and Pamela Serón. Risk factors associated with the loss of physical functioning in critical care patients. A protocol of overview of systematic reviews and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2020. http://dx.doi.org/10.37766/inplasy2020.9.0069.

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Berkman, Nancy D., Eva Chang, Julie Seibert, Rania Ali, Deborah Porterfield, Linda Jiang, Roberta Wines, Caroline Rains, and Meera Viswanathan. Management of High-Need, High-Cost Patients: A “Best Fit” Framework Synthesis, Realist Review, and Systematic Review. Agency for Healthcare Research and Quality (AHRQ), October 2021. http://dx.doi.org/10.23970/ahrqepccer246.

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Background. In the United States, patients referred to as high-need, high-cost (HNHC) constitute a very small percentage of the patient population but account for a disproportionally high level of healthcare use and cost. Payers, health systems, and providers would like to improve the quality of care and health outcomes for HNHC patients and reduce their costly use of potentially preventable or modifiable healthcare services, including emergency department (ED) and hospital visits. Methods. We assessed evidence of criteria that identify HNHC patients (best fit framework synthesis); developed program theories on the relationship among contexts, mechanisms, and outcomes of interventions intended to change HNHC patient behaviors (realist review); and assessed the effectiveness of interventions (systematic review). We searched databases, gray literature, and other sources for evidence available from January 1, 2000, to March 4, 2021. We included quantitative and qualitative studies of HNHC patients (high healthcare use or cost) age 18 and over who received intervention services in a variety of settings. Results. We included 110 studies (117 articles). Consistent with our best fit framework, characteristics associated with HNHC include patient chronic clinical conditions, behavioral health factors including depression and substance use disorder, and social risk factors including homelessness and poverty. We also identified prior healthcare use and race as important predictors. We found limited evidence of approaches for distinguishing potentially preventable or modifiable high use from all high use. To understand how and why interventions work, we developed three program theories in our realist review that explain (1) targeting HNHC patients, (2) engaging HNHC patients, and (3) engaging care providers in these interventions. Theories identify the need for individualizing and tailoring services for HNHC patients and the importance of building trusting relationships. For our systematic review, we categorized evidence based on primary setting. We found that ED-, primary care–, and home-based care models result in reduced use of healthcare services (moderate to low strength of evidence [SOE]); ED, ambulatory intensive caring unit, and primary care-based models result in reduced costs (low SOE); and system-level transformation and telephonic/mail models do not result in changes in use or costs (low SOE). Conclusions. Patient characteristics can be used to identify patients who are potentially HNHC. Evidence focusing specifically on potentially preventable or modifiable high use was limited. Based on our program theories, we conclude that individualized and tailored patient engagement and resources to support care providers are critical to the success of interventions. Although we found evidence of intervention effectiveness in relation to cost and use, the studies identified in this review reported little information for determining why individual programs work, for whom, and when.
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Ding, Huaze, Yiling Dong, Kaiyue Zhang, Jiayu Bai, and Chenpan Xu. Comparison of dexmedetomidine versus propofol in mechanically ventilated patients with sepsis: A meta-analysis of randomized controlled trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0103.

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Review question / Objective: The aim of the present study was to evaluate the effects of dexmedetomidine compared with propofol in mechanically ventilated patients with sepsis. Condition being studied: Sepsis, which is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, contributes the highest mortality to intensive care units (ICU) worldwide . Because of the high incidence of respiratory failure in sepsis care, mechanical ventilation is always adopted to give life support and minimize lung injury . And sedation is a necessary component of sepsis care who suffers from mechanical ventilation. The Society of Critical Care Medicine suggested using either propofol or dexmedetomidine for sedation in mechanically ventilated adults. However, it remained unknown whether patients with sepsis requiring mechanical ventilation will benefit from sedation with dexmedetomidine.
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Driscoll, Dennis M. Burn Dressings: A Critical Indicator for Patient Care Classification in Burn Units. Fort Belvoir, VA: Defense Technical Information Center, January 1991. http://dx.doi.org/10.21236/ada251390.

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Zhu, Yi-Bing, Yan Yao, Yuan Xu, and Hui-Bin Huang. Nitrogen balance and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0134.

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Review question / Objective: This study aimed to evaluate the impact of Nitrogen balance (NB) on prognosis in such a patient population. Condition being studied: Nitrogen balance and Outcomes in Critically Ill Patients. Eligibility criteria: 1) The study focused on the association between NB level and the mortality risk in adult (≥18 years old) patients; 2) The outcome data included any reporting form of survival data that could be extracted; and 3) The study design was limited to cohort, case-control, or RCT design.
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Yang, Hui, Xi-Xi Wan, Hui Ma, Zhen LI, Li Weng, Ying Xia, and Xiao-Ming Zhang. Prevalence and mortality risk of low skeletal muscle mass in critically ill patients: an updated systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2022. http://dx.doi.org/10.37766/inplasy2022.11.0132.

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Review question / Objective: The PICOS principle was adopted when we confirmed the study eligibility. The inclusion criteria were as follows: (1) patients were critically ill, which was defined as adult patients who were from the ICU department; (2) exposure: patients had a clear definition of LSMM based on CT scans, anthropometric methods and ultrasound; (3) presented the prevalence of LSMM or could be calculated by the available data from the article; and (4) study design: observational study (cohort study or cross-sectional study). Articles that were reviews, case reports, comments, correspondences, letters or only abstracts were excluded. Condition being studied: Critical illness often results in low skeletal muscle mass for multiple reasons. Multiple studies have explored the association between low skeletal muscle mass and mortality. The prevalence of low skeletal muscle mass and its association with mortality are unclear. This systematic review and meta-analysis aim to identify the prevalence and mortality risk of low skeletal muscle mass among critically ill patients.
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Lowry, Svetlana Z., Matthew T. Quinn, Mala Ramaiah, David Brick, Emily S. Patterson, Jiajie Zhang, Patricia Abbott, and Michael C. Gibbons. A Human Factors Guide to Enhance EHR Usability of Critical User Interactions when Supporting Pediatric Patient Care. National Institute of Standards and Technology, June 2012. http://dx.doi.org/10.6028/nist.ir.7865.

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James-Scott, Alisha, Rachel Savoy, Donna Lynch-Smith, and tracy McClinton. Impact of Central Line Bundle Care on Reduction of Central Line Associated-Infections: A Scoping Review. University of Tennessee Health Science Center, November 2021. http://dx.doi.org/10.21007/con.dnp.2021.0014.

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Purpose/Background Central venous catheters (CVC) are typical for critically ill patients in the intensive care unit (ICU). Due to the invasiveness of this procedure, there is a high risk for central line-associated bloodstream infection (CLABSI). These infections have been known to increase mortality and morbidity, medical costs, and reduce hospital reimbursements. Evidenced-based interventions were grouped to assemble a central line bundle to decrease the number of CLABSIs and improve patient outcomes. This scoping review will evaluate the literature and examine the association between reduced CLABSI rates and central line bundle care implementation or current use. Methods A literature review was completed of nine critically appraised articles from the years 2010-2021. The association of the use of central line bundles and CLABSI rates was examined. These relationships were investigated to determine if the adherence to a central line bundle directly reduced the number of CLABSI rates in critically ill adult patients. A summary evaluation table was composed to determine the associations related to the implementation or current central line bundle care use. Results Of the study sample (N=9), all but one demonstrated a significant decrease in CLABSI rates when a central line bundle was in place. A trend towards reducing CLABSI was noted in the remaining article, a randomized controlled study, but the results were not significantly different. In all the other studies, a meta-analysis, randomized controlled trial, control trial, cohort or case-control studies, and quality improvement project, there was a significant improvement in CLABSI rates when utilizing a central line bundle. The extensive use of different levels of evidence provided an excellent synopsis that implementing a central line bundle care would directly affect decreasing CLABSI rates. Implications for Nursing Practice Results provided in this scoping review afforded the authors a diverse level of evidence that using a central line bundle has a direct outcome on reducing CLABSI rates. This practice can be implemented within the hospital setting as suggested by the literature review to prevent or reduce CLABSI rates. Implementing a standard central line bundle care hospital-wide helps avoid this hospital-acquired infection.
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