Critical Care Medicine (CRIT CARE MED )

Publisher: Society of Critical Care Medicine, Lippincott, Williams & Wilkins

Description

Critical Care Medicine publishes promising research and reports on clinical breakthroughs that lead to better care of patients in life-threatening situations. Each issue presents critical care practitioners with clinical breakthroughs that lead to better patient care, the latest news on promising research and advances in equipment and techniques.

  • Impact factor
    6.12
    Hide impact factor history
     
    Impact factor
  • 5-year impact
    6.40
  • Cited half-life
    7.20
  • Immediacy index
    2.61
  • Eigenfactor
    0.07
  • Article influence
    2.04
  • Website
    Critical Care Medicine website
  • Other titles
    Critical care medicine
  • ISSN
    0090-3493
  • OCLC
    1789720
  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publisher details

Lippincott, Williams & Wilkins

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • Pre-print must be removed upon acceptance for publication
    • Post-print may be deposited in personal website or institutional repository
    • Publisher's version/PDF cannot be used
    • Must include statement that it is not the final published version
    • Published source must be acknowledged with full citation
    • Set statement to accompany deposit
    • Must link to publisher version
    • NIH authors will have their accepted manuscripts transmitted to PubMed Central on their behalf after a 12 months embargo (see policy for details)
    • Wellcome Trust and HHMI authors will have their accepted manuscripts transmitted to PubMed Central on their behalf after a 6 months embargo (see policy for details)
    • If the hybrid open access option is not available, RCUK authors articles will be released as Creative Commons Attirbution Non-Commercial No Derivatives after a 6 months
    • Publisher last reviewed on 10/04/2014
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The objective of the review was to evaluate and synthesise the prevalence, risk factors and trajectory of psychosocial morbidity in informal caregivers of critical care survivors. Data Sources: A systematic search of MEDLINE, PsychInfo, Pubmed, CINAHL, Cochrane Library, Scopus, PILOTS, EMBASE and PEDro was undertaken between January and February 2014. Study Selection: Citations were screened independently by two reviewers for studies that investigated psychosocial outcomes (depression, anxiety, stress, post-traumatic stress disorder, burden, activity restriction and health-related quality of life) for informal caregivers of critical care survivors (mechanically ventilated for 48 hours or more). Data Extraction: Data on study outcomes were extracted into a standardised form and quality assessed by two independent reviewers using the Newcastle-Ottawa Scale, the Physiotherapy Evidence Database and the National Health and Medical Research Council Hierarchy of Evidence guide. Preferred Reporting Items for Systematic Reviews guidelines were followed. Data Synthesis: Fourteen studies of 1491 caregivers were included. Depressive symptoms were the most commonly reported outcome with a prevalence of 75.5% during critical care and 22.8-29% at one-year follow-up. Risk factors for depressive symptoms in caregivers included female gender and younger age. The greatest period of risk for all outcomes was during the patient’s critical care admission although psychological symptoms improved over time. The overall quality of the studies was low. Conclusions: Depressive symptoms were the most prevalent in informal caregivers of survivors of intensive care who were ventilated for more than 48 hours and persist at one year with a prevalence of 22.8-29.0%, which is comparable with caregivers of patients with dementia. Screening for caregiver risks could be performed during the ICU admission where intervention can be implemented and then evaluated. Further high-quality studies are needed to quantify anxiety, stress, caregiver burden and PTSD outcomes in informal caregivers of long-stay patients surviving ICU.
    Critical Care Medicine 11/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: The association between obesity and mortality in critically ill patients is unclear based on the current literature. To clarify this relationship, we analyzed the association between obesity and mortality in a large population of critically ill patients and hypothesized that mortality would be impacted by nutritional status. Methods: We performed a single-center observational study of 6,518 adult patients treated in medical and surgical ICUs between 2004 and 2011. All patients received a formal, in-person, and standardized evaluation by a registered dietitian. Body mass index was determined at the time of dietitian consultation from the estimated dry weight or hospital admission weight and categorized a priori as less than 18.5 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal/referent), 25-29.9 kg/m2 (overweight), 30-39.9 kg/m2 (obesity class I and II), and more than or equal to 40.0 kg/m2 (obesity class III). Malnutrition diagnoses were categorized as nonspecific malnutrition, protein-energy malnutrition, or well nourished. The primary outcome was all-cause 30-day mortality determined by the Social Security Death Master File. Associations between body mass index groups and mortality were estimated by bivariable and multivariable logistic regression models. Adjusted odds ratios were estimated with inclusion of covariate terms thought to plausibly interact with both body mass index and mortality. We utilized propensity score matching on baseline characteristics and nutrition status to reduce residual confounding of the body mass index category assignment. Results: In the cohort, 5% were underweight, 36% were normal weight, 31% were overweight, 23% had class I/II obesity, and 5% had class III obesity. Nonspecific malnutrition was present in 56%, protein-energy malnutrition was present in 12%, and 32% were well nourished. The 30-day and 90-day mortality rate for the cohort was 19.1 and 26.6%, respectively. Obesity is a significant predictor of improved 30-day mortality following adjustment for age, gender, race, medical versus surgical patient type, Deyo-Charlson index, acute organ failure, vasopressor use, and sepsis: underweight odds ratio 30-day mortality is 1.09 (95% CI, 0.80-1.48), overweight 30-day mortality odds ratio is 0.93 (95% CI, 0.80-1.09), class I/II obesity 30-day mortality odds ratio is 0.80 (95% CI, 0.67-0.96), and class III obesity 30-day mortality odds ratio is 0.69 (95% CI, 0.49-0.97), all relative to patients with body mass index 18.5-24.9 kg/m2. Importantly, there is confounding of the obesity-mortality association on the basis of malnutrition. Adjustment for only nutrition status attenuates the obesity-30-day mortality association: underweight odds ratio is 0.74 (95% CI, 0.54-1.00), overweight odds ratio is 1.05 (95% CI, 0.90-1.23), class I/II obesity odds ratio is 0.96 (95% CI, 0.81-1.15), and class III obesity odds ratio is 0.81 (95% CI, 0.59-1.12), all relative to patients with body mass index 18.5-24.9 kg/m2. In a subset of patients with body mass index more than or equal to 30.0 kg/m2 (n = 1,799), those with either nonspecific or protein-energy malnutrition have increased mortality relative to well-nourished patients with body mass index more than or equal to 30.0 kg/m2: odds ratio of 90-day mortality is 1.67 (95% CI, 1.29-2.15; p < 0.0001), fully adjusted. In a cohort of propensity score matched patients (n = 3,554), the body mass index-mortality association was not statistically significant, likely from matching on nutrition status. Conclusions: In a large population of critically ill adults, the association between improved mortality and obesity is confounded by malnutrition status. Critically ill obese patients with malnutrition have worse outcomes than obese patients without malnutrition.
    Critical Care Medicine 10/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mortality from septic shock is highly heritable. The identification of causal genetic factors is insufficient. To discover key contributors, we first identified nonsynonymous single-nucleotide polymorphisms in conserved genomic regions that are predicted to have significant effects on protein function. We then test the hypothesis that these nonsynonymous single-nucleotide polymorphisms across the genome alter clinical outcome of septic shock.
    Critical Care Medicine 09/2014;
  • Critical Care Medicine 09/2014; 42(9):2133-4.
  • Critical Care Medicine 09/2014; 42(9):e635.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To determine the relationship between implementation of rapid response teams and improved mortality rate using a large, uniform dataset from one state in the United States. Design: This observational cohort study included 471,062 adult patients hospitalized between 2001 and 2009. Setting: Ten acute tertiary care hospitals in Washington State. Patients or Other Participants: Hospital abstract records on adult patients (18 years old or older) were examined (n = 471,062). Patients most likely to benefit from rapid response team interventions were included and other prognostic factors of severity of illness and comorbidities were controlled. Each participating hospital provided the implementation date of their rapid response team intervention. Mortality rates in 31 months before rapid response team implementation (pre–rapid response team time period) were compared with mortality rates in 31 months following rapid response team implementation (post–rapid response team time period). Intervention(s): Implementation of a rapid response team within each acute tertiary care hospital. Measurements and Main Results: In-hospital mortality. Relative risk for in-hospital mortality improved in the post-rapid response team time period compared with the pre- rapid response team time period (relative risk = 0.76; 95% CI = 0.72–0.80; p < 0.001). Conclusions: In-hospital mortality improved in six of 10 acute tertiary care hospitals in the post-rapid response team time period when compared with the pre-rapid response team time period. Because of a long-term trend of decline in hospital mortality, these decreases could not be unambiguously attributed to rapid response team implementation. Further research should examine additional objective outcomes and optimal configuration of rapid response teams to maximize intervention effectiveness. (Crit Care Med 2014; XX:00–00)
    Critical Care Medicine 09/2014;
  • Critical Care Medicine 09/2014; 42(9):2147-8.
  • Critical Care Medicine 09/2014; 42(9):2145-6.
  • Critical Care Medicine 09/2014; 42(9):2129-31.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To determine the relationship between implementation of rapid response teams and improved mortality rate using a large, uniform dataset from one state in the United States. Design: This observational cohort study included 471,062 adult patients hospitalized between 2001 and 2009. Setting: Ten acute tertiary care hospitals in Washington State. Patients or Other Participants: Hospital abstract records on adult patients (18 years old or older) were examined (n = 471,062). Patients most likely to benefit from rapid response team interventions were included and other prognostic factors of severity of illness and comorbidities were controlled. Each participating hospital provided the implementation date of their rapid response team intervention. Mortality rates in 31 months before rapid response team implementation (pre–rapid response team time period) were compared with mortality rates in 31 months following rapid response team implementation (post–rapid response team time period). Intervention(s): Implementation of a rapid response team within each acute tertiary care hospital. Measurements and Main Results: In-hospital mortality. Relative risk for in-hospital mortality improved in the post-rapid response team time period compared with the pre-rapid response team time period (relative risk = 0.76; 95% CI = 0.72–0.80; p < 0.001). Conclusions: In-hospital mortality improved in six of 10 acute tertiary care hospitals in the post-rapid response team time period when compared with the pre-rapid response team time period. Because of a long-term trend of decline in hospital mortality, these decreases could not be unambiguously attributed to rapid response team implementation. Further research should examine additional objective outcomes and optimal configuration of rapid response teams to maximize intervention effectiveness.
    Critical Care Medicine 09/2014; 42(9):2001-2006.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patient- and organization-related factors are the most common influences affecting the ICU decision-making process. Few studies have investigated ICU physician-related factors and life-sustaining treatment use during nights and weekends, when staffing ratios are low. Here, we described patients admitted during nights/weekends and looked for physician-related determinants of life-sustaining treatment use in these patients after adjustment for patient- and center-related factors.
    Critical Care Medicine 08/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: New biomarkers are needed to better predict the severity of acute pancreatitis. CD73/ecto-5'-nucleotidase is an enzyme that generates adenosine, which dampens inflammation and improves vascular barrier function in several disease models. CD73 also circulates in a soluble form in the blood. We studied whether levels of soluble form of CD73 predict the development of organ failure in acute pancreatitis.
    Critical Care Medicine 08/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: In recent years, England has seen renewed interest in donation after circulatory death. Many national and local initiatives have been implemented to encourage and support donation after circulatory death. To assess whether practice is in line with published guidance, we conducted a national survey with regard to current donation after circulatory death practices, local guidelines, and views on the need to further develop a national standardized protocol for donation after circulatory death.
    Critical Care Medicine 08/2014;
  • Critical Care Medicine 08/2014; 42(8):1935-1936.