Patient- and family-centered care in adult ICU (FAM-ICU): A protocol for a feasibility study.

Background: In the intensive care unit (ICU), delirium in patients and long-term mental health challenges in both patients and their family members are highly prevalent. To address these issues, patient- and family-centered care has been recommended to alleviate the burdens associated with critical illness and ICU admission. We have developed the patient- and FAMily-centered care in the adult ICU intervention (FAM-ICU intervention).

Establishing consensus on patient- and family-centered care in adult intensive care units: A Delphi survey.

Purpose: To establish consensus between intensive care unit (ICU) experts on concrete patient- and family-centered care statements for adult patients and relatives in the ICU.

Materials And Methods: We did a three-round Delphi survey with a panel of ICU health care professionals from 23 ICUs in Denmark. In round 1, participants answered 20 open-ended questions, based on existing evidence.

Perspectives and wishes for patient and family centred care as expressed by adult intensive care survivors and family-members: A qualitative interview study.

Objectives: To explore perspectives and wishes for patient and family centred care among adult patients and family-members with recent experience of admission to an adult intensive care unit.

Research Design: An explorative descriptive study using an inductive thematic analysis. Semi-structured interviews with adults (≥18 years) who had experienced admission ≥48 hours to an adult intensive care unit as a patient or family-member within the previous three months.

Effect of Patient and Family Centred Care interventions for adult intensive care unit patients and their families: A systematic review and meta-analysis.

Objectives: To assess the evidence for the feasibility and effect of patient and familycentred care interventions provided in the intensive care unit, single or multicomponent, versus usual care, for reducing delirium, anxiety, depression and post-traumatic stress disorder in patients and family-members.

Design: A systematic review and meta-analysis following the PRISMA guidelines and GRADE approach. A systematic literature search of relevant databases, screening and inclusion of studies, data extraction and assessment of risk of bias according to Cochrane methodology.

Long-term mortality in the Intermediate care after emergency abdominal surgery (InCare) trial-A post-hoc follow-up study.

Background: Patients undergoing emergency abdominal surgery are at high risk of post-operative complications. Although post-operative treatment at an intermediate care unit may improve early outcome, there is a lack of studies on the long-term effects of such therapy. The aim of this study was to assess the long-term effect of intermediate care versus standard surgical ward care on mortality in the Intermediate Care After Emergency Abdominal Surgery (InCare) trial.

Intensive care doctors' preferences for arterial oxygen tension levels in mechanically ventilated patients.

Background: Oxygen is liberally administered in intensive care units (ICUs). Nevertheless, ICU doctors' preferences for supplementing oxygen are inadequately described. The aim was to identify ICU doctors' preferences for arterial oxygenation levels in mechanically ventilated adult ICU patients.

[Track and trigger systems in Denmark - small country, great variations].

A track and trigger (TAT) system and mobile emergency team (MET) can aid observation and care for admitted patients in the hospital ward. We have examined the literature and find evidence, though not strong, that the introduction of TAT and MET systems reduce hospital mortality. However, in Denmark, many different TAT systems are used, and several hospitals do not have MET.

Induced hypothermia in patients with septic shock and respiratory failure (CASS): a randomised, controlled, open-label trial.

Background: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock.

Methods: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America.

Randomized multicentre feasibility trial of intermediate care versus standard ward care after emergency abdominal surgery (InCare trial).

Background: Emergency abdominal surgery carries a considerable risk of death and postoperative complications. Early detection and timely management of complications may reduce mortality. The aim was to evaluate the effect and feasibility of intermediate care compared with standard ward care in patients who had emergency abdominal surgery.

Patients' experiences of postoperative intermediate care and standard surgical ward care after emergency abdominal surgery: a qualitative sub-study of the Incare trial.

Aims And Objectives: To elicit knowledge of patient experiences of postoperative intermediate care in an intensive care unit and standard postoperative care in a surgical ward after emergency abdominal surgery.

Background: Emergency abdominal surgery is common, but little is known about how patients experience postoperative care. The patient population is generally older with multiple comorbidities, and the short-term postoperative mortality rate is 15-20%.

Preadmission quality of life can predict mortality in intensive care unit--a prospective cohort study.

Purpose: We sought to investigate whether preadmission quality of life could act as a predictor of mortality among patients admitted to the intensive care unit (ICU).

Materials And Methods: This is a prospective observational study of all patients above the age of 18 years admitted to the ICU with a length of stay longer than 24 hours. Short form 36 (SF-36) and Acute Physiology and Chronic Health Evaluation II (APACHE II) were used.

Mortality and postoperative care pathways after emergency gastrointestinal surgery in 2904 patients: a population-based cohort study.

Background: Emergency major gastrointestinal (GI) surgery carries a considerable risk of mortality and postoperative complications. Effective management of complications and appropriate organization of postoperative care may improve outcome. The importance of the latter is poorly described in emergency GI surgical patients.

Effect of intermediate care on mortality following emergency abdominal surgery. The InCare trial: study protocol, rationale and feasibility of a randomised multicentre trial.

Background: Emergency abdominal surgery carries a 15% to 20% short-term mortality rate. Postoperative medical complications are strongly associated with increased mortality. Recent research suggests that timely recognition and effective management of complications may reduce mortality.

Consecutive daily measurements of luminal concentrations of lactate in the rectum in septic shock patients.

In a recent study we found no difference in the concentrations of luminal lactate in the rectum between nonsurvivors and survivors in early septic shock (<24 h). This study was initiated to investigate if there are any changes in the concentrations of luminal lactate in the rectum during the first 3 days of septic shock and possible differences between nonsurvivors and survivors. Methods.

Lactate concentrations in the rectal lumen in patients in early septic shock.

Background: Previously, we observed that rectal luminal lactate was higher in non-survivors compared with survivors of severe sepsis or septic shock persisting >24 h. The present study was initiated to further investigate this tentative association between rectal luminal lactate and mortality in a larger population of patients in early septic shock.

Methods: A prospective observational multicentre study of 130 patients with septic shock at six general ICU's of university hospitals.

[Septic shock in intensive care].

Introduction: Patients in septic shock have a 33-42% 30-day mortality, but characteristics and outcome have not been assessed in Danish intensive care units (ICUs).

Material And Methods: This is a cohort study with prospective registration over a 3-month period of all patients suffering from septic shock at six Danish ICUs. We registered admission-, disease- and treatment characteristics during the first day after the diagnosis and 30- and 90-day mortality.

[Capacity in Danish intensive care units. A national survey of capacity, cancellations and transfers of critically ill patients].

Introduction: A shortage of intensive care beds and fully-booked intensive care units has a range of undesirable consequences for patients and personnel, eg. transfer to other intensive care units, cancellation of operations, tighter visitation criteria and an increase in the work-load. The problem is illustrated in a national survey.

Terlipressin increased the concentration of L-lactate in the rectal lumen in a patient with septic shock.

Terlipressin--a long-acting analogue of vasopressin--has been described to restore blood pressure in patients with catecholamine-resistant septic shock without obvious complications. We administered low-dose terlipressin (a single i.v.

Assessment of the respiratory exchange ratio in mechanically ventilated patients by a standard anaesthetic gas analyser.

Background: The respiratory exchange ratio (R) is the CO2 production divided with O2 consumption. R is an essential factor included in several formulas during routine blood gas analysis. Instant and individual measurement of R may be of particular interest to improve the evaluation of each single patient.

Evaluation of five oxygen delivery devices in spontaneously breathing subjects by oxygraphy.

Oxygen supply systems may be divided into constant and variable performance systems. As the variable performance systems are widely used, it is relevant to investigate the variation in performance between devices and the influence of oxygen supply on the inspired oxygen fraction. Data were collected from 10 healthy volunteers during the use of one constant performance system and four variable performance systems at different gas flows and inspired oxygen fractions.

Preoperative evaluation of intubation conditions in patients scheduled for elective surgery.

Prediction of a difficult airway is a continuing problem. Several tests have been developed in order to overcome this problem. It has been proposed that using more than one test could increase the degree of predictability.

Erythrocyte 2,3-diphosphoglycerate depletion associated with hypophosphatemia detected by routine arterial blood gas analysis.

Objective: To describe a clinical case where an extremely low erythrocyte 2,3-diphosphoglycerate concentration (2,3-DPG) was discovered by routine blood gas analysis supplemented by computer calculation of derived quantities. The finding of a low 2,3-DPG revealed a severe hypophosphatemia.

Design: Open uncontrolled study of a patient case.

The effect of nasal oxygen flow and catheter position on the accuracy of end-tidal carbon dioxide measurements by a pharyngeal catheter in unintubated, spontaneously breathing subjects.

Reliable recordings of carbon dioxide concentrations during spontaneous respiration can be obtained from a catheter positioned in the hypopharynx. The present study investigated the possible influence on end-tidal carbon dioxide measurement of nasal oxygen administration, position of the sampling catheter and mouth breathing. The study demonstrated that not only can reliable capnographic tracings be obtained from a thin catheter placed in the unintubated airway, but the subject may also receive up to 6 l.

Reliability of CO2 measurements from the airway by a pharyngeal catheter in unintubated, spontaneously breathing subjects.

Although several short communications have appeared describing attempts to record the concentrations of carbon dioxide (cCO2) from the unintubated airway by a catheter placed in the nose, so far only few reports have documented the reliability of the method. To evaluate the reliability of CO2 measurements by a catheter in the open, unintubated airway during spontaneous respiration, a 12 CH PVC catheter was forwarded through the nostril to the hypopharynx and connected to a capnograph in nine healthy volunteers. Another capnograph was connected to a tightly fitting face mask and simultaneous CO2 recordings were attained from the two parts of the airway during normoventilation, hyperventilation and rebreathing.