Relevant bibliographies by topics / Acute intensive care unit

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Academic literature on the topic 'Acute intensive care unit'

Author: Grafiati
Published: 4 June 2021
Last updated: 4 February 2022

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Journal articles on the topic "Acute intensive care unit"

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Mumtaz, Hassan. "Etiology of acute kidney injury in intensive care unit settings." Endocrinology and Disorders 4, no. 2 (December 24, 2020): 01–06. http://dx.doi.org/10.31579/2640-1045/059.

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Introduction: Acute kidney injury (AKI) is defined as a rapid loss of kidney function occurring over few hours or days. In intensive care unit settings, acute kidney injury (AKI) is a very prevalent condition as most of the patients who are admitted in intensive care units are critically ill. The incidence of acute kidney injury is increasing throughout the world mainly because of aging population and comorbidities which are associated with aging. In intensive care unit settings, the incidence of AKI may reach up to 67%. Though AKI effects depend on clinical situation yet associated with high morbidity and mortality. Objective: To determine the frequency of etiology of acute kidney injury in medical intensive care unit of KRL Hospital. Setting: Medical ICU, KRL Hospital, Islamabad. Duration: six months from 17th May 2017 to 17th November 2017. Study design: Descriptive case series. Material and method: In this study 118 patients were observed. After screening and application of exclusion criteria, a total of 118 patients who were fulfilling the inclusion criteria were selected as the study sample and were included in the final analysis regarding prevalence of risk factors associated with AKI. AKI was further classified using acute kidney injury network (AKIN) classification system. Patient age, gender, serum creatinine, etiology and outcome in form of recovery or mortality was recorded on specific proforma. Results: Overall incidence of AKI in ICU settings in this study was 37.8%(n=118) .Out of 118 patients who had AKI, 59.3%(n=70) were male , whereas 40.7% (n=48) were females. Most common risk factor associated with development of AKI was sepsis secondary to infectious illnesses and 39% (n=46) of the patients who developed AKI were suffering from infectious illnesses. Gastrointestinal, drugs and cardiac causes constitutes the 32.2% (n=38), 18.6% (n=22) and 10.2% (n=12) respectively of the AKI in ICU settings. Conclusion: Our study concludes that the frequency of etiology including infectious causes was 39%, cardiac pathology 10%, GI causes 32%, drugs was 19%.
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KHAN, HUMAYUN IQBAL, NAILA KHALIQ, and MUHAMMAD FAHEEM AFZAL. "PEDIATRIC INTENSIVE CARE UNIT." Professional Medical Journal 13, no. 03 (June 25, 2006): 358–61. http://dx.doi.org/10.29309/tpmj/2006.13.03.4982.

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Intensive care is predominantly concerned with the managementof patients with acute life threatening conditions in a specialized unit. Children having acute neurological deterioration,respiratory distress, cardiovascular compromise, severe infections and accidental poisonings constitute the majoradmission to a pediatric intensive care unit. Objective: To document the number, disease pattern and outcome ofpatients admitted to Pediatric intensive care unit. Design: Descriptive study. Place and Duration: The study wasconducted in the intensive care unit of department of Pediatrics, King Edward Medical University/Mayo hospital, Lahorefrom July 01, 2004 to June 30, 2005. Patients and Methods: The data of all the admitted patients was analyzed forage, sex, cause of admission and outcome. Results: A total of 1012 children were admitted during the study period.Among them 59.68% were male and 40.32% were female. Bronchopneumonia was the major cause of admission(29.05%) followed by septicemia (14.43%), acute bacterial meningitis (8.1%), acute watery diarrhea (6.92%), congenitalheart diseases (5.14%), tetanus (3.75%) ,acute myocarditis (2.67%) and others (29.94%) including acute bronchialasthma, hepatic encephalopathy, diabetic ketoacidosis, encephalitis, tuberculous meningitis, accidental poisoning andGuillain-Barre syndrome. Out of total admissions, 64.43% were shifted to different units of the department, 4.05%discharged in satisfactory condition, 9.49% left against medical advice (LAMA) and 22.03% died. The case fatality ofsepticemia (65.07%) was highest. Conclusion: Bronchopneumonia and septicemia were the major causes ofadmission while case fatality was highest for septicemia in intensive care unit.
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Pachucki, Marcin A., Erina Ghosh, Larry Eshelman, Krishnamoorthy Palanisamy, Timothy Gould, Matthew Thomas, and Chris P. Bourdeaux. "Descriptive study of differences in acute kidney injury progression patterns in General and Cardiac Intensive Care Units." Journal of the Intensive Care Society 20, no. 3 (April 30, 2018): 216–22. http://dx.doi.org/10.1177/1751143718771261.

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Background Acute kidney injury is common in critically ill patients with detrimental effects on mortality, length of stay and post-discharge outcomes. The Acute Kidney Injury Network developed guidelines based on urine output and serum creatinine to classify patients into stages of acute kidney injury. Methods In this analysis we utilize the Acute Kidney Injury Network guidelines to evaluate the acute kidney injury stage in patients admitted to general and cardiac intensive care units over a period of 18 months. Acute kidney injury stage was calculated in real time hourly based on the guidelines and using these temporal stage scores calculated for the population; the prevalence and progression of acute kidney injury stage was compared between the two units. We hypothesized that the prevalence and progression of acute kidney injury stage between the two units may be different. Results More cardiac intensive care unit patients had no acute kidney injury (stage <1) during their intensive care unit stay but more cardiac intensive care unit patients developed acute kidney injury (stage >1), compared to the General Intensive Care Unit. Both at intensive care unit admission and discharge, more General Intensive Care Unit patients had acute kidney injury; however, the number of cardiac intensive care unit patients with acute kidney injury was three times higher at discharge than admission. Acute kidney injury developed in a different pattern in the two intensive care units over five days of intensive care unit stay. In the General Intensive Care Unit, acute kidney injury was most prevalent on second day of intensive care unit stay and in cardiac intensive care unit acute kidney injury was most prevalent on the third day of intensive care unit stay. We observed the biggest increase in new acute kidney injury in the first day of General Intensive Care Unit and second day of the cardiac intensive care unit stay. Conclusions The study demonstrates the different trends of acute kidney injury pattern in general and cardiac intensive care unit patient populations highlighting the earlier development of acute kidney injury on General Intensive Care Unit and more prevalence of acute kidney injury on discharge from cardiac intensive care unit.
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Zochodne, Douglas. "Myopathies in the Intensive Care Unit." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 25, S1 (February 1998): S40—S42. http://dx.doi.org/10.1017/s0317167100034727.

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AbstractMyopathies that occur in the intensive care unit can be divided into preexisting myopathies or newly acquired myopathies that develop in the intensive care unit. Myotonic dystrophy is an example of a preexisting myopathy that may render patients susceptible to acute respiratory failure following surgical procedures and anaesthesia. A group of myopathies that develop within the intensive care unit have been labelled acute necrotizing myopathy of intensive care, thick filament myopathy and acute steroid myopathy. Corticosteroids and nondepolarizing muscle blocking agents may play a role in their development.
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ROLLAS, Kazım, Atila KARA, Nazmiye Ebru ORTAÇ ERSOY, Kezban ÖZMEN SÜNER, Mehmet Nezir GÜLLÜ, Serpil ÖCAL, and Arzu TOPELİ. "Acute tuberculosis in the intensive care unit." TURKISH JOURNAL OF MEDICAL SCIENCES 45 (2015): 882–87. http://dx.doi.org/10.3906/sag-1408-118.

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Kalabalik, Julie, Luigi Brunetti, and Radwa El-Srougy. "Intensive Care Unit Delirium." Journal of Pharmacy Practice 27, no. 2 (December 10, 2013): 195–207. http://dx.doi.org/10.1177/0897190013513804.

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Purpose: The recent literature regarding intensive care unit (ICU) delirium and updated clinical practice guidelines are reviewed. Summary: Recent studies show that ICU delirium in critically ill patients is an independent predictor of higher mortality, longer ICU and hospital stay, and is associated with multiple clinical complications. Delirium has been reported to occur in greater than 80% of hospitalized critically ill patients, yet it remains an underdiagnosed condition. Several subtypes of delirium have been identified including hypoactive, hyperactive, and mixed presentation. Although the exact mechanism is unknown, several factors are thought to interact to cause delirium. Multiple risk factors related to medications, acute illness, the environment, and patient characteristics may contribute to the development of delirium. Practical bedside screening tools have been validated and are recommended to identify ICU patients with delirium. Nonpharmacologic interventions such as early mobilization have resulted in better functional outcomes, decreased incidence and duration of delirium, and more ventilator-free days. Data supporting pharmacologic treatments are limited. Conclusion: Clinicians should become familiar with tools to identify delirium in order to initiate treatment and remove mitigating factors early in hospitalization to prevent delirium. Pharmacists are in a unique position to reduce delirium through minimization of medication-related risk factors and development of protocols.
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Pellathy, Tiffany Purcell, Michael R. Pinsky, and Marilyn Hravnak. "Intensive Care Unit Scoring Systems." Critical Care Nurse 41, no. 4 (August 1, 2021): 54–64. http://dx.doi.org/10.4037/ccn2021613.

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Background Illness severity scoring systems are commonly used in critical care. When applied to the populations for whom they were developed and validated, these tools can facilitate mortality prediction and risk stratification, optimize resource use, and improve patient outcomes. Objective To describe the characteristics and applications of the scoring systems most frequently applied to critically ill patients. Methods A literature search was performed using MEDLINE to identify original articles on intensive care unit scoring systems published in the English language from 1980 to 2020. Search terms associated with critical care scoring systems were used alone or in combination to find relevant publications. Results Two types of scoring systems are most frequently applied to critically ill patients: those that predict risk of in-hospital mortality at the time of intensive care unit admission (Acute Physiology and Chronic Health Evaluation, Simplified Acute Physiology Score, and Mortality Probability Models) and those that assess and characterize current degree of organ dysfunction (Multiple Organ Dysfunction Score, Sequential Organ Failure Assessment, and Logistic Organ Dysfunction System). This article details these systems’ differing features and timing of use, score calculation, patient populations, and comparative performance data. Conclusion Critical care nurses must be aware of the strengths, limitations, and specific characteristics of severity scoring systems commonly used in intensive care unit patients to effectively employ these tools in clinical practice and critically appraise research findings based on their use.
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Mumtaz, Hassan. "Etiology & Outcome of Acute kidney Injury in Intensive Care Unit Settings of a Tertiary Care Hospital." Endocrinology and Disorders 4, no. 2 (December 24, 2020): 01–05. http://dx.doi.org/10.31579/2640-1045/058.

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Introduction: Acute kidney injury (AKI) is defined as a rapid loss of kidney function occurring over few hours or days. In intensive care unit settings, acute kidney injury (AKI) is a very prevalent condition as most of the patients who are admitted in intensive care units are critically ill. The incidence of acute kidney injury is increasing throughout the world mainly because of aging population and co morbidities which are associated with aging. In intensive care unit settings, the incidence of AKI may reach up to 67%. Though AKI effects depend on clinical situation yet associated with high morbidity and mortality. The rationale of this study is that, as acute kidney is one of major factors contributing in mortality and morbidity of ICU patients, this study will be helpful in identifying important risk factor for development of acute kidney injury in ICU settings, leading to its early detection and thus decreasing associated morbidity and mortality. Objective: To determine the frequency of etiology and outcome of acute kidney injury in medical intensive care unit of KRL Hospital. Setting: Medical ICU, KRL Hospital, Islamabad. Duration: six months from 17th May 2017 to 17th November 2017. Study design: Descriptive case series. Material and method: In this study 118 patients were observed. After screening and application of exclusion criteria, a total of 118 patients who were fulfilling the inclusion criteria were selected as the study sample and were included in the final analysis regarding prevalence of risk factors associated with AKI and the outcome associated with AKI. AKI was further classified using acute kidney injury network (AKIN) classification system. Patient age, gender, serum creatinine, etiology and outcome in form of recovery or mortality was recorded. Results: Overall incidence of AKI in ICU settings in this study was 37.8% (n=118). Out of 118 patients who had AKI, 59.3% (n=70) were male, whereas 40.7% (n=48) were females. Most common risk factor associated with development of AKI was sepsis secondary to infectious illnesses and 39% (n=46) of the patients who developed AKI were suffering from infectious illnesses. Gastrointestinal, drugs and cardiac causes constitutes the 32.2 % (n=38), 18.6% (n=22) and 10.2% (n=12) respectively of the AKI in ICU settings. In terms of outcome, mortality rate in patients with AKI was significantly higher as compared to patients without AKI(P =<0.001) and 56.8%(n=67) of the patients who had AKI died during their ICU stay as compared to 30.4%(n=59) in patients without AKI. Conclusion: Our study concludes that the frequency of etiology including infectious causes was 39%, cardiac pathology 10%, GI causes 32%, drugs was 19% and mortality was 56.8% in patients with acute kidney injury.
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Holyoak, A. L., M. J. Trout, R. P. White, S. Prematuranga, and S. Senthuran. "Toxic Leukoencephalopathy in the Intensive Care Unit." Anaesthesia and Intensive Care 42, no. 6 (November 2014): 782–88. http://dx.doi.org/10.1177/0310057x1404200615.

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In this article, we report two cases of acute toxic leukoencephalopathy to highlight this acute clinicoradiological syndrome as an important, although uncommon, consideration in the undifferentiated comatose patient who fails to wake following drug overdose or has unexplained neurology with a history of drug exposure. We then review the current literature and discuss potential differential diagnoses in this setting, along with proposed treatments for this condition. The cases presented demonstrate a more fulminant onset than previously well-defined acute toxic leukoencephalopathy subtypes and highlight the prognostic importance of magnetic resonance imaging in diagnosing a condition from which significant functional recovery seems possible.
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Grignola, Juan C., and Enric Domingo. "Acute Right Ventricular Dysfunction in Intensive Care Unit." BioMed Research International 2017 (2017): 1–15. http://dx.doi.org/10.1155/2017/8217105.

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The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients. Our aim is to clarify the complex effects of mechanical ventilation, fluid therapy, vasoactive drug infusions, and other therapies to resuscitate the critical patient optimally.
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Dissertations / Theses on the topic "Acute intensive care unit"

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Llano-Diez, Monica. "Mechanisms Underlying Intensive Care Unit Muscle Wasting : Intervention Strategies in an Experimental Animal Model and in Intensive Care Unit Patients." Doctoral thesis, Uppsala universitet, Klinisk neurofysiologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-173466.

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Critically ill patients admitted to the intensive care unit (ICU) commonly develop severe muscle wasting and weakness and consequently impaired muscle function. This not only delays respirator weaning and ICU discharge, but has deleterious effects on morbidity, mortality, financial costs, and quality of life of survivors. Acute Quadriplegic Myopathy (AQM) is one of the most common neuromuscular disorders underlying ICU muscle wasting and paralysis, and is a consequence of modern intensive care interventions, although the exact causes remain unclear. Muscle gene/protein expression, intracellular signalling, post-translational modifications, muscle membrane excitability, and contractile properties at the single muscle fibre level were explored in order to unravel the mechanisms underlying the muscle wasting and weakness associated with AQM and how this can be counteracted by specific intervention strategies. A unique experimental rat ICU model was used to address the mechanistic and therapeutic aspects of this condition, allowing time-resolved studies for a period of two weeks. Subsequently, the findings obtained from this model were translated into a clinical study. The obtained results showed that the mechanical silencing of skeletal muscle, i.e., absence of external strain (weight bearing) and internal strain (myosin-actin activation) due to the pharmacological paralysis or sedation associated with the ICU intervention, is likely to be the primary mechanism triggering the preferential myosin loss and muscle wasting, features specifically characteristic of AQM. Moreover, mechanical silencing induces a specific gene expression pattern as well as post-translational modifications in the motor domain of myosin that may be critical for both function and for triggering proteolysis. The higher nNOS expression found in the ICU patients and its cytoplasmic dislocation are indicated as a probable mechanism underlying these highly specific modifications. This work also demonstrated that passive mechanical loading is able to attenuate the oxidative stress associated with the mechanical silencing and induces positive effects on muscle function, i.e., alleviates the loss of force-generating capacity that underlie the ICU intervention, supporting the importance of early physical therapy in immobilized, sedated, and mechanically ventilated ICU patients.
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Mumba, Jesse Musokota. "Audit of acute limb ischaemia in a paediatric intensive care unit." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20838.

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Objective:Iatrogenic acute limb ischaemia in paediatric patients is a well-recognised complication of vascular access. This retrospective review of a paediatric intensive care unit identified patients who developed iatrogenic acute limb ischaemia between January 2008 and July 2013. Methods: The medical records of inpatients diagnosed with acute limb ischaemia during the study period were reviewed. Patients with other causes of acute limb ischaemia were excluded. A descriptive analysis of demographics, primary diagnosis, type of vascular access used, affected anatomical region, clinical presentation, type of therapy, type of block, response to intervention used and outcomes was conducted. Results:A total of 28 patients presented with signs of acute limb ischaemia, of whom 28.6% were aged <30 days, 46.4 % were between one and 12 months and 25% were between one and five years old; 78.6% of the affected limbs were lower limbs. Four patients had resolution of ischaemia upon removal of the vascular access devices. 23 patients received various forms of pharmacological sympathectomy, in addition to conservative therapy. One patient had missing data on the type of sympathectomy that was done. The response to the sympathectomies was: 60.9% good, 8.7% moderate, 8.7% poor and in 21.7% no responses. Documented tissue loss related to the ischaemia occurred in six (21.4%) of the 28 patients. Conclusions: Iatrogenic acute limb ischaemia in children are usually managed without surgical intervention. Pharmacological sympathectomies lead to increased blood flow to the affected limb via vasodilatation of collateral vessels, with an added advantage of reducing ischemic pain. The improved blood flow is postulated to avoid and/or minimise the amount of tissue loss. Pharmacological sympathectomies may, thus, have a role to play in th e management of iatrogenic acute limb ischaemia in the paediatric population.
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Vaaler, Arne E. "Effects of a Psychiatric Intensive Care Unit in an Acute Psychiatric Ward." Doctoral thesis, Norwegian University of Science and Technology, Department of Neuroscience, 2007. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-1190.

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The psychiatric acute departments are intensive units serving patients with a broad spectrum of psychiatric conditions. Patients with the most florid psychiatric symptoms are admitted to Psychiatric Intensive Care Units (PICUs). These units are supposed to provide the necessary diagnostic and acute therapeutic help, control inappropriate behaviours, and provide the services in an environment which assists the patients’ recovery and is acceptable to patients, health workers and the general society. PICUs are criticised for poor environments, high levels of coercion and lack of evidence base from controlled trials or post occupancy evaluations. Long term studies of the rate of seclusion indicate no decrease in spite of changing political attitudes and hospital environments. There is a need fo new methods to treat violent or threatening incidents in psychiatric wards. Norwegian PICUs use segregation nursing with the patients placed in separately locked areas with staff. This model may be an alternative to seclusion. Controlled trials regarding effects of principles and facilities for such treatment are lacking. The general aim of the present study was to investigate effects of facilities for segregation, and several assumed risk factors in a Norwegian PICU.

The current thesis is based on data from 118 consecutively admitted patients to the PICU at St. Olavs University Hospital, Trondheim, Norway. The thesis has the following conclusions:

Main conclusions

1: Interior and furnishing like an ordinary home in the PICU create an environment with comparable treatment outcomes to the traditional dismal interior and has positive effects on many patients’ well being. Patient selfrating were significantly in favour of the ordinary home interior compared to the traditional interior

2: The principles of patient segregation in PICUs have favourable effects on behaviours associated with and the actual numbers of violent and threatening incidents. The changes in assessments of behaviour measured by differences in BVC ratings from baseline (admittance) to day 3 were significantly in favour of segregating the patients in the PICU compared to not segregating the patients in the same area. There were significantly lower reported incidents of violent or threatening incidents when using the PICU as a segregation area compared to not using the PICU as a segregation area.

3: In PICUs substance use is associated with favourable outcomes compared to patients not using substances. There was a significant difference in the changes of GAF-S –symptom ratings from admittance (baseline) to day three between the patient groups with or without a substance use diagnosis. The largest increase was in the patient group with a substance use diagnosis indicating more reduction of symptoms.

4: Threatening and violent incidents are not common acute manifestations of recent substance use in PICU populations. There was no significant difference in the number of threatening or violent incidents between the patient groups with or without a substance use diagnosis.

5: Substance use predicts shorter length of inpatient stay in PICU populations. The mean length of stay in the PICU was significantly shorter in the patient group with a substance use diagnosis compared to the patient group without a substance use diagnosis.

6: In PICUs prediction of short-term aggressive and threatening incidents should be based on clinical global judgement, and instruments designed to predict short-term aggression in psychiatric inpatients. In the hierarchical multiple linear regression analysis the global clinical evaluation from the physician on duty, the nurse clinicians’ global evaluation of “intensity of testing out and pushing limits”, and the observer rated scale scoring behaviours predicting imminent violence in psychiatric inpatients (BVC), were the factors positively associated with short-term threatening and violent incidents.

7: The predictive properties for BVC in the PICU-setting are satisfactory for the first three days after a single rating at admittance.

Additional conclusions:

1: Patients who have experienced segregation settings like seclusion have desires for alternative treatment conditions. These desires are to a large extent met by Norwegian PICUs. These PICUs are effective.

2: In the architecture and design of PICUs it is important to take into consideration the possibilities for segregation of patients.


Paper III reprinted with kind permission of Elsevier ScienceDirect.com
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Slaymaker, Lora. "A CHILD'S-EYE VIEW OF THE PEDIATRIC INTENSIVE CARE UNIT (ETHNOGRAPHY, ACUTE ILLNESS)." Thesis, The University of Arizona, 1985. http://hdl.handle.net/10150/291273.

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Ostermann, Maria E. "Factors affecting outcome of patients with acute failure in the intensive care unit." Thesis, St George's, University of London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.511951.

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Aare, Sudhakar Reddy. "Intensive Care Unit Muscle Wasting : Skeletal Muscle Phenotype and Underlying Molecular Mechanisms." Doctoral thesis, Uppsala universitet, Klinisk neurofysiologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-180374.

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Acute quadriplegic myopathy (AQM), or critical illness myopathy, is a common debilitating acquired disorder in critically ill intensive care unit (ICU) patients characterized by generalized muscle wasting and weakness of limb and trunk muscles. A preferential loss of the thick filament protein myosin is considered pathognomonic of this disorder, but the myosin loss is observed relatively late during the disease progression. In attempt to explore the potential role of factors considered triggering AQM in sedated mechanically ventilated (MV) ICU patients, we have studied the early effects, prior to the myosin loss, of neuromuscular blockade (NMB), corticosteroids (CS) and sepsis separate or in combination in a porcine experimental ICU model. Specific interest has been focused on skeletal muscle gene/protein expression and regulation of muscle contraction at the muscle fiber level. This project aims at improving our understanding of the molecular mechanisms underlying muscle specific differences in response to the ICU intervention and the role played by the different triggering factors. The sparing of masticatory muscle fiber function was coupled to an up-regulation of heat shock protein genes and down-regulation of myostatin are suggested to be key factors in the relative sparing of masticatory muscles. Up-regulation of chemokine activity genes and down-regulation of heat shock protein genes play a significant role in the limb muscle dysfunction associated with sepsis. The effects of corticosteroids in the development of limb muscle weakness reveals up-regulation of kinase activity and transcriptional regulation genes and the down-regulation of heat shock protein, sarcomeric, cytoskeletal and oxidative stress responsive genes. In contrast to limb and craniofacial muscles, the respiratory diaphragm muscle responded differently to the different triggering factors. MV itself appears to play a major role for the diaphragm muscle dysfunction. By targeting these genes, future experiments can give an insight into the development of innovative treatments expected at protecting muscle mass and function in critically ill ICU patients.
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Celi, Leo Anthony G. "Localized customized mortality prediction modeling for patients with acute kidney injury admitted to the intensive care unit." Thesis, Massachusetts Institute of Technology, 2009. http://hdl.handle.net/1721.1/54457.

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Thesis (S.M.)--Harvard-MIT Division of Health Sciences and Technology, 2009.
Cataloged from PDF version of thesis.
Includes bibliographical references (p. 33-35).
Introduction. Models for mortality prediction are traditionally developed from prospective multi-center observational studies involving a heterogeneous group of patients to optimize external validity. We hypothesize that local customized modeling using retrospective data from a homogeneous subset of patients will provide a more accurate prediction than this standard approach. We tested this hypothesis on patients admitted to the ICU with acute kidney injury (AKI), and evaluated variables from the first 72 hours of admission. Methods. The Multi-parameter Intelligent Monitoring for Intensive Care II (MIMIC II) is a database of patients admitted to the Beth Israel Deaconess Medical Center ICU. Using the MIMIC II database, we identified patients who developed acute kidney injury and who survived at least 72 hours in the ICU. 118 variables were extracted from each patient. Second and third level customization of the Simplified Organ Failure Score (SAPS) was performed using logistic regression analysis and the best fitted models were compared in terms of Area under the Receiver Operating Characteristic Curve (AUC) and Hosmer-Lemeshow Goodness-of-Fit test (HL). The patient cohort was divided into a training and test data with a 70:30 split. Ten-fold cross-validation was performed on the training set for every combination of variables that were evaluated. The best fitted model from the cross-validation was then evaluated using the test set, and the AUC and the HL p value on the test set were reported. Results. A total of 1400 patients were included in the study. Of these, 970 survived and 430 died in the hospital (30.7% mortality). We observed progressive improvement in the performance of SAPS on this subset of patients (AUC=0.6419, HL p=0) with second level (AUC=0.6639, HL p=0.2056), and third level (AUC=0.7419, HL p=0.6738) customization. The best fitted model incorporated variables from the first 3 days of ICU admission. The variables that were most predictive of hospital mortality in the multivariate analysis are the maximum blood urea nitrogen and the minimum systolic blood pressure from the third day. Conclusion. A logistic regression model built using local data for patients with AKI performed better than SAPS, the current standard mortality prediction scoring system.
by Leo Anthony G. Celi.
S.M.
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Norman, Holly. "Cellular and Molecular Mechanisms Underlying Acute Quadriplegic Myopathy : Studies in Experimental Animal Models and Intensive Care Unit Patients." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7133.

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Baker, Norma G. L. "Health care restructuring in acute care settings : implications for registered nurses' attitudes /." St. John's, NF : [s.n.], 2002.

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MONTEIRO, DIEGO LEVI SILVEIRA. "LesÃo renal aguda em unidade de terapia intensiva de hospital geral com emergÃncia de trauma: estudo prospectivo observacional." Universidade Federal do CearÃ, 2015. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=14144.

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Abstract:
nÃo hÃ
IntroduÃÃo: A lesÃo renal aguda (LRA) à um achado comum em pacientes internados em unidade de terapia intensiva (UTI) e està associada a altos Ãndices de mortalidade. O perfil da UTI, o diagnÃstico categÃrico na admissÃo, os fatores socioeconÃmicos da regiÃo e as caracterÃsticas epidemiolÃgicas exercem influÃncia no resultado do tratamento de pacientes com LRA. Objetivo: Determinar a incidÃncia, os fatores associados, e a mortalidade da LRA em pacientes vÃtimas ou nÃo de trauma, que estiveram internados em uma UTI geral de uma regiÃo de baixa renda. MÃtodos: Estudamos consecutivamente 279 pacientes internados em uma UTI durante o perÃodo de um ano. Pacientes com menos de 24 horas de permanÃncia na unidade e com doenÃa renal crÃnica foram excluÃdos. A LRA foi classificada de acordo com os critÃrios propostos pelo Kidney Disease: Improving Global Outcomes (KDIGO) - âAcute Kidney Injury Work Groupâ em trÃs estÃgios. As anÃlises estatÃsticas foram realizadas pelo teste t de Student e de Mann-Whitney para variÃveis contÃnuas, com e sem distribuiÃÃo normal respectivamente. Para comparaÃÃo de frequÃncias foi utilizado o teste de Fisher. A regressÃo logÃstica multivariada foi utilizada para testar variÃveis como preditores de LRA e morte. Resultados: O diagnÃstico categÃrico na admissÃo da UTI foi dividido proporcionalmente em 51.6% nÃo relacionados ao trauma e 48.4% relacionados ao trauma. A maioria dos diagnÃsticos de trauma estava associada ao traumatismo crÃnio encefÃlica (TCE) 79.5%. A incidÃncia global de LRA foi de 32,9% distribuÃdos em trÃs estÃgios: 33,7% LRA estÃgio I; 29,4% LRA estÃgio II e 36,9% LRA estÃgio III. Os pacientes que desenvolveram LRA eram mais idosos, apresentaram maior Ãndice de diabetes mellitus, permaneceram por maior tempo internados em UTI, demonstraram maior valor no escore APACHE II e necessitaram com maior freqÃÃncia de ventilaÃÃo mecÃnica e uso de drogas vasopressoras. Em comparaÃÃo com os pacientes que nÃo tiveram trauma, os que tiveram apresentaram maior prevalÃncia do sexo masculino, maior pontuaÃÃo no escore APACHE II, maior dÃbito urinÃrio e eram mais jovens. NÃo houve diferenÃa no desenvolvimento de LRA e na mortalidade entre pacientes com trauma e sem trauma. A idade, presenÃa de diabetes, escore APACHE II e uso de drogas vasopressoras foram preditores independentes para a LRA. O risco de morte aumentou em dez vezes na presenÃa de LRA (OR = 14.51; IC95% = 7.94-26.61; p<0,001). ConclusÃes: Existe uma alta incidÃncia de LRA nesse estudo. A LRA foi fortemente associada com mortalidade, tanto entre pacientes com trauma, como em pacientes sem trauma. O trauma, especialmente o vinculado com lesÃo cerebral por TCE, devido a acidentes de trÃnsito envolvendo veÃculos motorizados de duas rodas, deve ser visto como uma importante causa evitÃvel de LRA.
Background: Acute kidney injury (AKI) is common among intensive care unit (ICU) patients and is associated with high mortality. Type of ICU, category of admission diagnosis, and socioeconomic characteristics of the region can impact AKI outcomes. We aimed to determine incidence, associated factors and mortality of AKI among trauma and non-trauma patients in a general ICU from a low-income area. Methods: We studied 279 consecutive patients in an ICU during a follow-up of one year. Patients with less than24-hour stay in the ICU and with chronic kidney disease were excluded. AKI was classified according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria in three stages. Comparisons were performed by the Student-t and MannâWhitney tests for continuous variables, respectively with and without normal distribution. Comparisons of frequencies were carried out by the Fisher test. Multivariate logistic regression was used to test variables as predictors for AKI and death. Results: Admission categories were proportionally divided into 51.6% of non-trauma diagnosis and 48.4% of trauma cases. Most trauma cases involved brain injury (79.5%). The overall incidence of AKI was 32.9%, distributed among the three stages: 33.7% stage 1, 29.4% stage 2 and 36.9% stage-3. Patients who developed AKI were older, had more diabetes, stayed longer in the ICU, presented higher APACHE II and more often needed mechanical ventilation and use of vasopressors. In comparison with non-trauma cases, trauma patients had a greater prevalence of males, higher APACHE II score, higher urine output, and younger age. There was no difference concerning development of AKI and crude mortality between trauma and non-trauma patients. Age, presence of diabetes, APACHE score and use of vasopressors were independent predictors for AKI, and AKI increased the risk of death ten-fold (OR = 14.51; CI 95% = 7.94-26.61; p<0.001). Conclusions: There was a high incidence of AKI in this study. AKI was strongly associated with mortality both among trauma and non-trauma patients. Trauma cases, especially brain injury due to traffic accidents involving motorized two-wheeled vehicles, should be seen as an important preventable cause of AKI.
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Books on the topic "Acute intensive care unit"

1

European Society of Cardiology. Working Group on Acute Cardiac Care, ed. The ESC textbook of acute and intensive cardiac care. Oxford: Oxford University Press, 2011.

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The PICU book: A primer for medical students, residents and acute care practitioners. Singapore: World Scientific, 2012.

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Stapleton, David C., and Sally J. Kaplan. Ventilator dependent unit demonstration: Outcome evaluation and assessment of post acute care. [Fairfax, Va.?]: Lewin-VHI, 1996.

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2013), Summer Conference in Intensive Care Medicine (10th. Acute cardiac care: Selected proceedings from the 10th Summer Conference in Intensive Care Medicine. Mount Prospect, IL: Society of Critical Care Medicine, 2013.

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Booth, Sara. Palliative care in the acute hospital setting: A practical guide. Oxford: Oxford University Press, 2010.

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Sara, Booth. Palliative care in the acute hospital setting: A practical guide. Oxford: Oxford University Press, 2010.

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Booth, Sara. Palliative care in the acute hospital setting: A practical guide. Oxford: Oxford University Press, 2010.

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Debora, Downey, ed. Augmentative and alternative communication in acute and critical care settings. San Diego: Plural Pub., 2008.

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Bihari, David, and Guy Neild, eds. Acute Renal Failure in the Intensive Therapy Unit. London: Springer London, 1990. http://dx.doi.org/10.1007/978-1-4471-1750-6.

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Daniel, Teres, ed. Gatekeeping in the intensive care unit. Chicago, Ill: Health Administration Press, 1997.

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Book chapters on the topic "Acute intensive care unit"

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Barie, Philip S., Soumitra R. Eachempati, and Jian Shou. "The Intensive Care Unit: The Next-Generation Operating Room." In Acute Care Surgery, 106–24. New York, NY: Springer New York, 2007. http://dx.doi.org/10.1007/978-0-387-69012-4_8.

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Caille, Vincent, Cyril Charron, François Jardin, and Antoine Leenhardt. "Right Ventricular Dysfunction in the Intensive Care Unit." In Acute Heart Failure, 237–46. London: Springer London, 2008. http://dx.doi.org/10.1007/978-1-84628-782-4_22.

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Monnet, Xavier, and Jean-Louise Teboul. "Pulmonary Artery Catheter in the Intensive Care Unit." In Acute Heart Failure, 411–23. London: Springer London, 2008. http://dx.doi.org/10.1007/978-1-84628-782-4_38.

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Thomas, Bradley W., and Ronald F. Sing. "Bedside Laparoscopy in the Intensive Care Unit." In Minimally Invasive Acute Care Surgery, 115–17. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-64723-4_15.

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Vlaar, Alexander P. J., and Nicole P. Juffermans. "Transfusion-Related Acute Lung Injury." In Transfusion in the Intensive Care Unit, 161–69. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-08735-1_15.

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Goldstein, Sidney. "Cost Effectiveness of Mobile Intensive Care Unit for an Entire Community." In Acute Coronary Care, 281–86. Boston, MA: Springer US, 1985. http://dx.doi.org/10.1007/978-1-4613-3828-4_29.

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Dultz, Linda A., Vasiliy Sim, and S. Rob Todd. "Surgical Procedures in the Intensive Care Unit." In Common Problems in Acute Care Surgery, 59–71. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-6123-4_5.

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Sonnaike, Emmanuel, and Jeremy L. Ward. "Surgical Procedures in the Intensive Care Unit." In Common Problems in Acute Care Surgery, 55–62. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-42792-8_5.

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Adrie, Christophe, Ivan Laurent, and Mehran Monchi. "Post-Cardiopulmonary Resuscitation Management in the Intensive Care Unit." In Acute Heart Failure, 837–43. London: Springer London, 2008. http://dx.doi.org/10.1007/978-1-84628-782-4_77.

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Oddo, Mauro. "Acute Coma in the Intensive Care Unit." In Clinical Neurophysiology in Disorders of Consciousness, 1–5. Vienna: Springer Vienna, 2014. http://dx.doi.org/10.1007/978-3-7091-1634-0_1.

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Conference papers on the topic "Acute intensive care unit"

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Chesley, C., M. O. Harhay, D. Small, A. Hanish, H. C. Prescott, and M. E. Mikkelsen. "Hospital Readmission and Post-Acute Care Use After Specialty Intensive Care Unit Admissions." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a1659.

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Cook, LE, A. Morris, A. Nersiseyan, and JM Liebler. "Persistent Acute Lung Injury in Medical Intensive Care Unit (MICU) Patients." In American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a4658.

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Aventura, Emily, Mohammed Amari, Theresa Nash, and Stephen Kantrow. "Acute Aspiration And Respiratory Failure In The Medical Intensive Care Unit." 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.a1642.

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Landsperger, Janna S., Kristina J. Williams, and Arthur P. Wheeler. "Outcomes Of A Medical Intensive Care Unit (MICU) Acute-Care Nurse Practitioner (ACNP) Service." 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.a6577.

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Lynch, Y., S. Agarwal, M. E. Modes, S. Elsayed, M. Triplette, E. Estey, J. R. Curtis, and M. Sorror. "Palliative Care Consultation After Intensive Care Unit Admission for Patients with Acute Myeloid Leukemia." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a4158.

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Dhokarh, Rajanigandha, Garrett E. Schramm, and Bekele Afessa. "Outcome Of Adults Admitted To The Intensive Care Unit For Acute Asthma." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a3108.

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Khassawneh, Basheer, Ali Ibnian, Ahmed Yassin, Abdelhameed Al-Mistarehi, Islam E’Leimat, Musaab Ali, Ahmad Shannaq, and Khalid El-Salem. "The outcome of patients with acute stroke requiring intensive care unit admission." In ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa2283.

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Nabors, Spencer G., Theologus Bountourelis, Andrew Schaefer, Gilles Clermont, Louis Luangkesorn, Jeffrey Kharoufeh, Lisa Maillart, and Winston Yang. "Systematic Engineering Of Acute Care Delivery: Predictability Of Intensive Care Unit Patient Throughput Using Process Modeling." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a2371.

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Zhang, Ying. "Predicting occurrences of acute hypoglycemia during insulin therapy in the intensive care unit." In 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 2008. http://dx.doi.org/10.1109/iembs.2008.4649909.

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Mohan, A., G. Sindhu, J. Harikrishna, M. H. Rao, and K. V. S. Sarma. "Acute Respiratory Failure Requiring Admission to Medical Intensive Care Unit: A Prospective Study." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a1633.

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Reports on the topic "Acute intensive care unit"

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Zhang, Wei, Yun Tang, Huan Liu, and Li ping Yuan. Risk prediction models for intensive care unit-acquired weakness in intensive care unit patients: A systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2021. http://dx.doi.org/10.37766/inplasy2021.4.0010.

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Gao, Tingting, Yang Wang, and Hong Jiang. A Meta analysis of Hospice care in Chinese intensive care unit. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, December 2020. http://dx.doi.org/10.37766/inplasy2020.12.0007.

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Pamplin, Jeremy. The Phase of Illness Paradigm: A Checklist Centric Model to Improve Patient Care in the Burn Intensive Care Unit. Fort Belvoir, VA: Defense Technical Information Center, April 2014. http://dx.doi.org/10.21236/ada612755.

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Pamplin, Jeremy. The Phase of Illness Paradigm: A Checklist Centric Model to Improve Patient Care in the Burn Intensive Care Unit. Fort Belvoir, VA: Defense Technical Information Center, April 2016. http://dx.doi.org/10.21236/ada632341.

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Malone, Danna. Analysis of a Joint Department of Veterans Affairs and Department of Defense Intensive Care Unit. Fort Belvoir, VA: Defense Technical Information Center, September 2004. http://dx.doi.org/10.21236/ada433713.

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Whatmore, Douglas N. Effect of Empiric Low-Dose Amphotericin B on the Development of Disseminated Candidiasis in Surgical Intensive Care Unit. Fort Belvoir, VA: Defense Technical Information Center, January 1995. http://dx.doi.org/10.21236/ada293748.

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Mavrovounis, Georgios, Maria Mermiri, and Ioannis Pantazopoulos. Peripherally inserted central catheter lines for Intensive Care Unit and onco-hematologic patients: a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2020. http://dx.doi.org/10.37766/inplasy2020.5.0043.

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Abedinov, Filip, Neda Bakalova, Plamen Krastev, Iliyan Petrov, Ralitza Marinova, and Georgy Tsaryanski. Survival and Quality of Life of Patients with a Prolonged Stay in the Intensive Care Unit after Cardiac Surgeries – Remote Results. "Prof. Marin Drinov" Publishing House of Bulgarian Academy of Sciences, August 2019. http://dx.doi.org/10.7546/crabs.2019.08.16.

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Zhang, Kai. Performance of the National Early Warning Score in predicting mortality among patients with infection outside the intensive care unit: a meta-analysis. INPLASY - International Platform of Registered Systematic Review Protocols, April 2020. http://dx.doi.org/10.37766/inplasy2020.4.0046.

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Abedinov, Filip, Violeta Groudeva, Iliyan Petrov, Hristo Angelov, Georgy Tsaryanski, and Plamen Krastev. Analysis of Functional Capacity and Risk Factors in Patients with Prolonged Treatment in Intensive Care Unit after Cardiac Surgery - Long-term Results. "Prof. Marin Drinov" Publishing House of Bulgarian Academy of Sciences, January 2021. http://dx.doi.org/10.7546/crabs.2021.01.16.

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