Conundrums in the Conscientious Use of Current Best Evidence.
PMID: 30824507 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Munro CL, Hope AA Tags: Am J Crit Care Source Type: research

Treatment of Alcohol Withdrawal Syndrome.
PMID: 30824508 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Harmouche E, Steger C, Mikhaeil M, Hoffman RS Tags: Am J Crit Care Source Type: research

Response.
PMID: 30824509 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Tidwell WP, Thomas TL, Pouliot JD, Canonico AE, Webber AJ Tags: Am J Crit Care Source Type: research

In Reply to "Treatment of Alcohol Withdrawal Syndrome: Phenobarbital vs CIWA-Ar Protocol".
In Reply to "Treatment of Alcohol Withdrawal Syndrome: Phenobarbital vs CIWA-Ar Protocol". Am J Crit Care. 2019 Mar;28(2):97-98 Authors: Proulx LC, Villeneuve É, Genest M, Francoeur I, Brisson M, Gosselin S PMID: 30824510 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Proulx LC, Villeneuve É, Genest M, Francoeur I, Brisson M, Gosselin S Tags: Am J Crit Care Source Type: research

Response.
PMID: 30824511 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Tidwell WP, Thomas TL, Pouliot JD, Canonico AE, Webber AJ Tags: Am J Crit Care Source Type: research

Clinical Pearls.
PMID: 30824512 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Board R Tags: Am J Crit Care Source Type: research

Safety and Patients' Response to Ambulation With a Pulmonary Artery Catheter in the Cardiac Intensive Care Unit.
Abstract BACKGROUND: Early mobilization of patients in the intensive care unit can be beneficial, but evidence is insufficient to indicate whether allowing patients with an indwelling pulmonary artery catheter to walk is safe. OBJECTIVE: To describe the physiological and emotional responses to ambulation in patients with heart failure and a pulmonary artery catheter. METHODS: This prospective, descriptive study included 19 patients with heart failure monitored with a pulmonary artery catheter in a cardiac intensive care unit. Each patient, accompanied by a nurse, walked with continuous observation of hea...
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Mattioli E, Tabuzo B, Sangkachand P, Parkosewich J, Reyes L, Funk M Tags: Am J Crit Care Source Type: research

Implementing Practice Standards for Inpatient Electrocardiographic Monitoring.
CONCLUSIONS: Implementation of the practice standards via an electronic order set was associated with a statistically significant increase in appropriate monitoring, with no increase in adverse events. Use of electronic order sets is an effective and safe way to enhance appropriate electrocardiographic monitoring. PMID: 30824514 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Sendelbach S, Sandau KE, Smith L, Kreiger R, Hanovich S, Funk M Tags: Am J Crit Care Source Type: research

Surrogates' and Researchers' Assessments of Prehospital Frailty in Critically Ill Older Adults.
Abstract BACKGROUND: Prehospital frailty has been associated with adverse hospital outcomes in critically ill adults. Although frailty assessment in intensive care units depends on patients' surrogates, frailty assessments by surrogates and researchers have not been compared. OBJECTIVES: To compare agreement and validity between surrogates' and researchers' assessments of frailty in critically ill older adults. METHODS: An observational cohort study of adults (aged ≥ 50 years) admitted to a medical/surgical intensive care unit was conducted. On admission, patients' surrogates quantified prehospital fr...
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Hope AA, Munoz M, Hsieh SJ, Gong MN Tags: Am J Crit Care Source Type: research

Different Perspectives on the Baseline Status of Critically Ill Patients.
PMID: 30824516 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Delgado SA Tags: Am J Crit Care Source Type: research

Delirium Monitoring: Yes or No? That Is The Question.
Abstract Delirium, one of the most common manifestations of acute brain dysfunction, is a serious complication in patients receiving care throughout the hospital and a strong predictor of worse outcome. Although delirium monitoring is advocated in numerous evidence-based guidelines as part of routine clinical care, it is still not widely and consistently performed at the bedside in different patient care settings. In a debate on delirium monitoring in hospitalized patients at the 7th American Delirium Society meeting in Nashville, Tennessee, June 2017, areas related to the feasibility, acceptability, and effective...
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Marra A, Kotfis K, Hosie A, MacLullich AMJ, Pandharipande PP, Ely EW, Pun BT Tags: Am J Crit Care Source Type: research

Resting Energy Expenditure and Oxygen Consumption in Critically Ill Patients With vs Without Sepsis.
CONCLUSION: In clinical practice, patients with sepsis do not seem to require an increased energy supply. Additional studies are needed to confirm this conclusion. PMID: 30824518 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Menegueti MG, de Araújo TR, Laus AM, Martins-Filho OA, Basile-Filho A, Auxiliadora-Martins M Tags: Am J Crit Care Source Type: research

Attitudes of Community Hospital Critical Care Nurses Toward Family-Witnessed Resuscitation.
CONCLUSIONS: Findings show that community hospital critical care nurses support family-witnessed resuscitation. Prior experiences and cultural beliefs should be considered when developing family-witnessed resuscitation policies. Further research is needed on the influence of these factors on nurses' attitudes toward family presence to inform practice. PMID: 30824519 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Gomes BD, Dowd OP, Sethares KA Tags: Am J Crit Care Source Type: research

Patients' Perception of Stressful Events in the Intensive Care Unit After Cardiac Surgery.
CONCLUSIONS: With pain, endotracheal intubation, and sleeplessness identified as highly distressing to patients, further research can be done to elicit interventions that could alleviate some of the stress involved with a postoperative stay in an intensive care unit. PMID: 30824520 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Carey MG, Qualls BW, Burgoyne C Tags: Am J Crit Care Source Type: research

The Influence of Appropriate Staffing and Healthy Work Environments on Patient and Nurse Outcomes.
PMID: 30824521 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Halm M Tags: Am J Crit Care Source Type: research

Importance of Evaluating Prior Electrocardiograms.
PMID: 30824522 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - March 1, 2019 Category: Nursing Authors: Pelter MM, Kozik TM, Al-Zaiti SS, Carey MG Tags: Am J Crit Care Source Type: research

Principles of Narrative Critical Care.
PMID: 30600218 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Hope AA Tags: Am J Crit Care Source Type: research

Night Shift Naps.
PMID: 30600219 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Girbo A Tags: Am J Crit Care Source Type: research

Response.
PMID: 30600220 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Halm M Tags: Am J Crit Care Source Type: research

Clinical Pearls.
PMID: 30600221 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Board R Tags: Am J Crit Care Source Type: research

Validation of a New Clinical Tool for Post-Intensive Care Syndrome.
CONCLUSION: The self-report version of the Healthy Aging Brain Care Monitor is a valid clinical tool for assessing symptoms of post-intensive care syndrome. PMID: 30600222 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Wang S, Allen D, Perkins A, Monahan P, Khan S, Lasiter S, Boustani M, Khan B Tags: Am J Crit Care Source Type: research

Post-Intensive Care Syndrome: Educational Interventions for Parents of Hospitalized Children.
CONCLUSION: Simple, low-cost education can improve caregivers' knowledge of post-intensive care syndrome and can be well supported by nursing staff. To ensure sustainable implementation, the characteristics of the unit should be considered when selecting an educational program. PMID: 30600223 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Esses SA, Small S, Rodemann A, Hartman ME Tags: Am J Crit Care Source Type: research

CORTRAK Superuser Competency Assessment and Training Recommendations.
CONCLUSIONS: At least 3 observations should be performed to assess initial competency; the number should be individualized to the operator. Interpretation of the insertion tracing is complex and requires multiple performance opportunities to gain competency and confidence for this high-risk skill. PMID: 30600224 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Bourgault AM, Gonzalez L, Aguirre L, Ibrahim JA Tags: Am J Crit Care Source Type: research

Effect of a Scheduled Nurse Intervention on Thirst and Dry Mouth in Intensive Care Patients.
CONCLUSION: Scheduled use of ice water oral swabs and lip moisturizer with menthol may lessen thirst intensity and dry mouth in critical care patients. PMID: 30600225 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: VonStein M, Buchko BL, Millen C, Lampo D, Bell T, Woods AB Tags: Am J Crit Care Source Type: research

Frequency of Oral Care to Address Thirst: A Practice in Search of Evidence.
PMID: 30600226 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Cain C Tags: Am J Crit Care Source Type: research

Impact of an Active Music Therapy Intervention on Intensive Care Patients.
Abstract BACKGROUND: Nonpharmacological interventions appear to benefit many patients and do not have the side effects commonly associated with medications. Music-based experiences may benefit critical care patients. OBJECTIVE: To examine the effect of an active music therapy intervention on physiological parameters and self-reported pain and anxiety levels of patients in the intensive care unit. METHODS: A study was conducted using a pretest-posttest, within-subject, single-group design. The study population consisted of a convenience sample of 52 patients. Study participants received a 30-minute music ...
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Golino AJ, Leone R, Gollenberg A, Christopher C, Stanger D, Davis TM, Meadows A, Zhang Z, Friesen MA Tags: Am J Crit Care Source Type: research

Intensive Care Unit Readmission in Patients With Primary Brain Injury and Tracheostomy.
CONCLUSIONS: Tracheostomy patients with primary brain injury may have central nervous system-mediated respiratory compromise associated with reduced Glasgow Coma Scale score, increased atelectasis, and shorter duration of ventilator dependency. PMID: 30600228 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Pandian V, Datta M, Nakka S, Tammineedi DS, Davidson PM, Nyquist PA Tags: Am J Crit Care Source Type: research

Telemedicine Intensive Care Unit Nursing Interventions to Prevent Failure to Rescue.
CONCLUSION: A conceptual framework extending the American Association of Critical-Care Nurses model of success for tele-ICU nursing practice is proposed to prevent failure to rescue. Tele-ICU nurses use systems thinking and integration of complex factors in their practice to prevent failure to rescue. Tele-ICU nurses' perception of their role in preventing failure to rescue and emotional intelligence competence are key to building and maintaining effective relationships with the ICU. Tele-ICU nurses' intentional use of advanced technology, rather than the technology itself, supports and enhances proactive tele-ICU practice...
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Williams LS, Nemeth LS, Johnson E, Armaignac DL, Magwood GS Tags: Am J Crit Care Source Type: research

Hospital Readmission and Subsequent Decline in Long-Term Survivors of Acute Respiratory Distress Syndrome.
Abstract Acute respiratory distress syndrome is associated with long-term physical impairments. Although readmission is common, little is known about the impact of readmissions on the physical status of this population. The purpose of this study was to evaluate the association between hospital readmission, with or without an intensive care unit stay, and physical status in survivors of acute respiratory distress syndrome. The exposure was hospital readmission, categorized as (1) no readmission, (2) readmitted 1 or more times without an intensive care unit stay, or (3) readmitted 1 or more times with an intensive c...
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Wozniak AW, Pfoh ER, Dinglas VD, Pronovost PJ, Needham DM, Colantuoni E Tags: Am J Crit Care Source Type: research

Coffee Talk: A Jolt for Night Shift Education.
CONCLUSIONS: The introduction of an informal educational series improved nurses' access to education and nurses' feelings of support from administrators and overall job satisfaction. PMID: 30600231 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Margretta M, Dennis M, McLaughlin DC Tags: Am J Crit Care Source Type: research

Electrocardiographic Changes Associated With a Life-Threatening Condition.
PMID: 30600232 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - January 1, 2019 Category: Nursing Authors: Al-Zaiti SS, Faramand Z, Kozik TM, Pelter MM, Carey MG Tags: Am J Crit Care Source Type: research

For Better or Worse, We Are All Connected: Contemplating the Stark Reality of Social Media.
PMID: 30385531 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Savel RH, Munro CL Tags: Am J Crit Care Source Type: research

Blood Transfusion in Sepsis and Iatrogenic Hemodilution.
PMID: 30385532 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Perel A, Javidroozi M, Shander A Tags: Am J Crit Care Source Type: research

Response.
PMID: 30385533 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Nathanson BH, Raghunathan K Tags: Am J Crit Care Source Type: research

Clinical Pearls.
PMID: 30385534 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Board R Tags: Am J Crit Care Source Type: research

Contributors to Intensive Care Unit Clinicians' Predictions of Patient Outcomes: A Qualitative Analysis.
CONCLUSIONS: Intensive care unit clinicians use various patient factors to inform their prognoses. Clinicians use different factors when predicting survival than when predicting death. Some factors are reported more frequently for correct predictions than for incorrect predictions. PMID: 30385535 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Buehler AE, Ciuffetelli IV, Delman AM, Kent SA, Bayard DF, Cooney E, Halpern SD, Detsky ME Tags: Am J Crit Care Source Type: research

Treatment of Alcohol Withdrawal Syndrome: Phenobarbital vs CIWA-Ar Protocol.
Abstract BACKGROUND: Benzodiazepine-based therapy for alcohol withdrawal is associated with agitation and respiratory depression. Treatment can be complicated by a need for adjunctive therapy to control these symptoms and in patients requiring mechanical ventilation. Strong evidence for the effectiveness of alternative treatment modalities is lacking, despite the availability of promising pharmacological agents such as phenobarbital. OBJECTIVE: To compare the standard of care for the treatment of alcohol withdrawal-a symptom-triggered benzodiazepine protocol used in conjunction with the revised Clinical Insti...
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Tidwell WP, Thomas TL, Pouliot JD, Canonico AE, Webber AJ Tags: Am J Crit Care Source Type: research

Predicting Pressure Injury in Critical Care Patients: A Machine-Learning Model.
CONCLUSION: This machine-learning approach differs from other available models because it does not require clinicians to input information into a tool (eg, the Braden Scale). Rather, it uses information readily available in electronic health records. Next steps include testing in an independent sample and then calibration to optimize specificity. PMID: 30385537 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Alderden J, Pepper GA, Wilson A, Whitney JD, Richardson S, Butcher R, Jo Y, Cummins MR Tags: Am J Crit Care Source Type: research

Outcomes Associated With Stage 1 Pressure Injuries: A Retrospective Cohort Study.
Abstract BACKGROUND: Approximately half of hospital-acquired pressure injuries identified among critical care patients are stage 1. Although stage 1 injuries are common, outcomes associated with them among critical care patients have not been examined. OBJECTIVES: To examine the outcomes of stage 1 pressure injuries among critical care patients and to identify factors associated with worsening of pressure injuries. METHODS: Electronic health records were used to determine which surgical critical care patients at a level I trauma center and academic medical center had stage 1 pressure injuries. Competing ...
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Alderden J, Zhao YL, Zhang Y, Thomas D, Butcher R, Zhang Y, Cummins MR Tags: Am J Crit Care Source Type: research

Score for Predicting Ventilator Weaning Duration in Patients With Tracheostomies.
CONCLUSIONS: A score derived from ventilator settings may help clinicians predict the timing of ventilator liberation in patients requiring prolonged mechanical ventilation. PMID: 30385539 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Greenberg JA, Balk RA, Shah RC Tags: Am J Crit Care Source Type: research

Long-Term Effects of Saline Instilled During Endotracheal Suction in Pediatric Intensive Care: A Randomized Trial.
CONCLUSION: Using no saline was at least as effective as using either 0.225% or 0.9% saline in endotracheal suctioning. The optimal policy may be to routinely use no saline with endotracheal suctioning in children but allow the occasional use of 0.9% saline when secretions are thick. PMID: 30385540 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: McKinley DF, Kinney SB, Copnell B, Shann F Tags: Am J Crit Care Source Type: research

Effect of Transcutaneous Electrical Neuromuscular Stimulation on Myopathy in Intensive Care Patients.
CONCLUSION: TENMS had no significant impact on myopathy in the critically ill patients in this study. PMID: 30385541 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Koutsioumpa E, Makris D, Theochari A, Bagka D, Stathakis S, Manoulakas E, Sgantzos M, Zakynthinos E Tags: Am J Crit Care Source Type: research

Using Digestive Fluid Biomarkers to Predict Acute Gastrointestinal Injury in Critically Ill Patients: A Pilot Study.
CONCLUSIONS: Secretory immunoglobulin A was predictive of grade III acute gastrointestinal injury. Digestive fluid markers of injury (pH, interleukin 10, and secretory immunoglobulin A) were predictors of acute gastrointestinal failure. Further study is required to determine if other markers are specific or sensitive for acute gastrointestinal injury. PMID: 30385542 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Minhua C, Tao G, Fengchan X, Wenkui Y Tags: Am J Crit Care Source Type: research

Impact of Nurses Taking Daily Work Breaks in a Hospital Garden on Burnout.
Abstract BACKGROUND: Nurses working in hospital environments are at risk for burnout. Exposure to nature has psychological benefits, but the effect of hospital gardens on nurse burnout is less understood. OBJECTIVE: To compare the effect on nurse burnout of taking daily work breaks in a hospital-integrated garden with the effect of indoor-only breaks. METHODS: A prospective crossover trial was conducted of nurses assigned to either 6 weeks of a work break in an outdoor hospital garden or 6 weeks of indoor-only breaks. After a 1-week washout period, break assignments were switched for a subsequent 6 weeks...
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Cordoza M, Ulrich RS, Manulik BJ, Gardiner SK, Fitzpatrick PS, Hazen TM, Mirka A, Perkins RS Tags: Am J Crit Care Source Type: research

Acquisition and Retention of Resuscitation Knowledge and Skills: What's Practice Have to Do With It?
PMID: 30385544 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Halm M, Crespo C Tags: Am J Crit Care Source Type: research

Cardiac Dysrhythmia During Pacing in an Infant.
PMID: 30385545 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - November 1, 2018 Category: Nursing Authors: Shields A, Al-Zaiti SS, Kozik TM, Pelter MM, Carey MG Tags: Am J Crit Care Source Type: research

Our Voices, Our Strength: The Power of Positive Deviance.
PMID: 30173165 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - September 1, 2018 Category: Nursing Authors: Munro CL, Savel RH Tags: Am J Crit Care Source Type: research

Clinical Pearls.
PMID: 30173166 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - September 1, 2018 Category: Nursing Authors: Board R Tags: Am J Crit Care Source Type: research

Nonadherence to Geriatric-Focused Practices in Older Intensive Care Unit Survivors.
Abstract BACKGROUND: Older adults account for more than half of all admissions to intensive care units; most remain alive at 1 year, but with long-term sequelae. OBJECTIVE: To explore geriatric-focused practices and associated outcomes in older intensive care survivors. METHODS: In a 1-year, retrospective, cohort study of patients admitted to the medical intensive care unit and subsequently transferred to the medicine service, adherence to geriatric-focused practices and associated clinical outcomes during intensive care were determined. RESULTS: A total of 179 patients (mean age, 80.5 years) met in...
Source: American Journal of Critical Care - September 1, 2018 Category: Nursing Authors: Sinvani L, Kozikowski A, Patel V, Mulvany C, Talukder D, Akerman M, Pekmezaris R, Wolf-Klein G, Hajizadeh N Tags: Am J Crit Care Source Type: research

Caring for Older Adults: Our Adherence Makes a Difference.
PMID: 30173168 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - September 1, 2018 Category: Nursing Authors: Delgado SA Tags: Am J Crit Care Source Type: research