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Predictive value and optimal cut-off level of high-sensitivity troponin T in patients with acute pulmonary embolism.
Korean J Intern Med
January 2025
Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Background/aims: Elevated troponin levels predict in-hospital mortality and influence decisions regarding thrombolytic therapy in patients with acute pulmonary embolism (PE). However, the usefulness of high-sensitivity troponin T (hsTnT) regarding PE remains uncertain. We aimed to establish the optimal cut-off level and compare its performance for precise risk stratification.
View Article and Find Full Text PDFRelationship Between Clinical Decision-Making and Moral Distress in Neonatal Intensive Care Unit Nurses: A Multicenter Cross-Sectional Correlational Descriptive Study.
Adv Neonatal Care
January 2025
Author Affiliations: Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran(Professor Nobahar); Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran(Professor Nobahar); Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran (Professor Ghorbani); Social Medicine Department, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran(Professor Ghorbani); and Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran(Mss Alipour, and Jahan).
Background: In the neonatal intensive care unit (NICU), nurses care for premature and critically ill neonates, interact with parents, and make clinical decisions regarding the treatment of neonates in life-threatening conditions. The challenges of managing unstable conditions and resuscitation decisions can cause moral distress in nurses.
Purpose: This study aims to determine the relationship between clinical decision-making and moral distress in NICU nurses.
Peak serum lactate as a robust predictor of imminent death in life-sustaining treatment decisions: A study of 73,927 patients.
Sci Prog
January 2025
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Objective: The physician order for life-sustaining treatment has been implemented in clinical practice for several years. However, the determination that a patient is in the terminal phase of life, a prerequisite for the withdrawal of life-sustaining treatment, lacks objective criteria. This study aimed to evaluate whether hyperlactatemia could serve as a reliable objective indicator for determining the terminal phase.
View Article and Find Full Text PDFUntil the beginning of the century, bleeding management was similar in elective surgeries or exsanguination scenarios: clotting tests were used to guide blood product orders and, while awaiting these results, an aggressive resuscitation with crystalloids was recommended. The high mortality rate in severe hemorrhages managed with this strategy endorsed the need for a special resuscitation plan. As a result, modifications were recommended to develop a new clinical approach to these patients, called "Damage Control Resuscitation".
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