Intensive care medicine
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Intensive care medicine · Feb 2011
Comparative StudyFluid leakage across tracheal tube cuff, effect of different cuff material, shape, and positive expiratory pressure: a bench-top study.
Standard polyvinylchloride (PVC) endotracheal tube (ETT) cuffs do not protect from aspiration across the cuff, a leading cause of ventilator-associated pneumonia (VAP). In a long-lasting in vitro study we compared the effect of different cuff materials (PVC, polyurethane, and guayule latex), shapes (cylindrical, conical), and positive end expiratory pressures (PEEP) in reducing fluid leakage across the cuff. ⋯ The guayule latex cuffs always prevented fluid leakage; the polyurethane and PVC cuffs required incremental levels of PEEP to prevent fluid leakage ever-present at zero PEEP.
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Intensive care medicine · Feb 2011
The relationship between workload and medical staffing levels in a paediatric cardiac intensive care unit.
To evaluate the matching between workload in a paediatric cardiac intensive care unit (ICU) and the corresponding medical staffing levels over a 24-h period. ⋯ Workload was most intense for the in-house team at night, in terms of sicker admissions, ECMOs and cardiac arrests. Conventional roster patterns may not offer ideal matching between staffing and workload. Data analysis of variable and urgent workload may be used to inform medical rosters.
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Intensive care medicine · Feb 2011
Cerebrospinal fluid pentraxin 3 early after subarachnoid hemorrhage is associated with vasospasm.
To investigate plasma and cerebrospinal fluid (CSF) concentrations of pentraxin 3 (PTX3), a prototypic long pentraxin protein induced by proinflammatory signals, in subarachnoid hemorrhage (SAH), and its relation with SAH-associated vasospasm. ⋯ Acute increased concentrations of PTX3 in CSF but not in plasma are related to the occurrence of vasospasm, indicating that measurement of CSF PTX3 associated with the clinical evaluation can improve early diagnosis of this complication.
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Intensive care medicine · Feb 2011
Peripherally inserted central venous catheters and central venous catheters related thrombosis in post-critical patients.
Peripherally inserted central venous catheters (PICC) have been proposed as an alternative to central venous catheters (CVC). The aim of this study was to determine the thrombosis rate in relation to PICC placement in patients discharged from the intensive care unit (ICU). ⋯ In our post-critically ill population, PICCs were associated with a higher rate of DVT complications than CVCs. Routine ultrasound surveillance for the first 2 weeks after patient discharge from the ICU with a PICC and preferential use of CVC for these patients may be warranted.