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What Exactly Is Recommended for Patient Physical Activity During an ICU Stay? 重症监护室住院期间建议患者进行哪些体育锻炼?
Pub Date : 2024-04-15 DOI: 10.1097/CCM.0000000000006233
Heidi J Engel, Nathan E Brummel
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引用次数: 0
The Promise and Opportunity Costs of New Rehabilitation Technology in the ICU. 重症监护病房康复新技术的前景与机会成本。
Pub Date : 2024-04-15 DOI: 10.1097/CCM.0000000000006217
H. O’Grady, Michelle E. Kho
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引用次数: 0
Innovation in Enrichment: Is Persistence Enough? 充实创新:坚持就够了吗?
Pub Date : 2024-04-15 DOI: 10.1097/CCM.0000000000006239
E. Schenck, Ilias I. Siempos
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引用次数: 0
Clinical diagnoses and autopsy findings: discrepancies in critically ill patients*. 临床诊断和尸检结果:危重病人的差异*。
IF 8.8 Pub Date : 2012-03-01 DOI: 10.1097/CCM.0b013e318236f64f
Eva Tejerina, Andrés Esteban, Pilar Fernández-Segoviano, José María Rodríguez-Barbero, Federico Gordo, Fernando Frutos-Vivar, José Aramburu, Angela Algaba, Oscar Gonzalo Salcedo García, José A Lorente

Objectives: To determine the proportion of clinical errors by comparing clinical and pathological diagnoses, and to evaluate changes of errors over time.

Design: We conducted a prospective study of all consecutive autopsies performed on patients who died in the intensive care unit of the Hospital Universitario de Getafe, Madrid, Spain, between January 1982 and December 2007. The diagnostic errors were classified in two categories: class I errors that were major misdiagnoses with direct impact on therapy, and class II diagnostic errors which comprised major unexpected findings that probably would not have changed therapy.

Main results: Of 2,857 deaths during the study period, autopsies were performed in 866 patients (30.3%). Autopsy reports were available in 834 patients, of whom 63 (7.5%) had class I errors and 95 (11.4%) had type II errors. The most frequently missed diagnoses were pulmonary embolism, pneumonia, secondary peritonitis, invasive aspergillosis, endocarditis and myocardial infarction. The autopsy did not determine the cause of death in 22 patients (2.6%). Our rate of diagnostic discrepancy remained relatively constant over time, and the conditions leading to discrepancies have slightly changed, with pneumonia showing a decline in diagnostic accuracy in the last years.

Conclusions: This study found significant discrepancies in 18.5% of patients who underwent autopsy, 7.5% of them were diagnoses with impact on therapy and outcome. This reinforces the importance of the postmortem examination in confirming diagnostic accuracy and improving the quality of care of critically ill patients.

目的:通过比较临床和病理诊断,确定临床错误的比例,并评价错误随时间的变化。设计:我们对1982年1月至2007年12月期间在西班牙马德里赫塔菲大学医院重症监护室死亡的所有连续尸检患者进行了前瞻性研究。诊断错误分为两类:I类错误是直接影响治疗的重大误诊,II类错误是包括可能不会改变治疗的重大意外发现。主要结果:在研究期间的2857例死亡中,有866例(30.3%)进行了尸检。834例患者有尸检报告,其中63例(7.5%)有I类错误,95例(11.4%)有II类错误。漏诊最多的是肺栓塞、肺炎、继发性腹膜炎、侵袭性曲霉病、心内膜炎和心肌梗死。尸检未确定22例(2.6%)患者的死因。随着时间的推移,我们的诊断差异率保持相对恒定,导致差异的条件略有变化,在过去几年中,肺炎的诊断准确性有所下降。结论:本研究发现18.5%的尸检患者存在显著差异,其中7.5%的诊断对治疗和预后有影响。这加强了死后检查在确认诊断准确性和提高危重病人护理质量方面的重要性。
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引用次数: 76
A better biomarker for cerebral malaria: in the eye of the beheld?*. 一种更好的脑型疟疾生物标志物:在人们的眼中。
Pub Date : 2012-03-01 DOI: 10.1097/CCM.0b013e31823d7810
Hans C Ackerman, Ryan W Carroll, Climent Casals-Pascual
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引用次数: 0
期刊
Critical Care Medicine
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