Journal of critical care
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Journal of critical care · Jun 2009
Comparative Study Clinical TrialColorimetric capnography to ensure correct nasogastric tube position.
We evaluate a procedure, combining colorimetric capnography with epigastric auscultation, to ensure nasogastric (NG) feeding tube correct position without any radiograph. ⋯ Colorimetric capnography combined with epigastric auscultation is safe and accurate in ensuring correct gastric tube insertion.
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Journal of critical care · Jun 2009
Clinical TrialEffect of intrapulmonary percussive ventilation on expiratory flow limitation in chronic obstructive pulmonary disease patients.
The aims of this prospective study were (1) to select, after weaning and extubation, chronic obstructive pulmonary disease (COPD) patients with expiratory flow limitation (EFL) measured by the negative expiratory pressure method and (2) to assess, in these patients, the short-term (30 minutes) physiologic effect of a session of intrapulmonary percussive ventilation (IPV). ⋯ In COPD patients, a session of IPV allowed a significant reduction of EFL and of P01 and a significant improvement of gas exchange.
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Journal of critical care · Jun 2009
Construction of a parent satisfaction instrument: perceptions of pediatric intensive care nurses and physicians.
The aims of the study were (1) to identify parental satisfaction items through the opinions of pediatric intensive care unit (PICU) nurses and physicians, (2) to reach consensus on the identified items, and (3) to apply factor analysis to evaluate the items and domains toward a PICU parental satisfaction instrument. ⋯ Priorities in parental satisfaction measures are identified. The findings are fundamental in the development of a PICU parental satisfaction instrument.
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Journal of critical care · Jun 2009
Prophylaxis against venous thromboembolism in neurointensive care patients: survey of Canadian practice.
Although anticoagulant thromboprophylaxis reduces the incidence of venous thromboembolism in critically ill patients, it may increase the risk of devastating bleeding complications in neurosurgical patients. For this population, anticoagulant thromboprophylaxis remains controversial and randomized controlled studies are sparse. Our goal was to establish sufficient clinical equipoise to facilitate future research in this area. ⋯ Most Canadian physicians reported using anticoagulant thromboprophylaxis after neurosurgery, although practice patterns differed as to when and for whom. Future research should quantify the benefits and risks in relation to the time of initiation in different neurosurgical subgroups. Our results suggest there is equipoise regarding the use of anticoagulation thromboprophylaxis in neurosurgical patients. Therefore randomized controlled trials are justifiable and needed to guide clinicians.
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Journal of critical care · Jun 2009
Age differences in survival outcomes and resource use for chronically critically ill patients.
Chronically critically ill (CCI) patients use a disproportionate amount of resources, yet little research has examined outcomes for older CCI patients. The purpose of this study was to compare outcomes (mortality, disposition, posthospital resource use) between older (> or =65 years) and middle-aged (45-64 years) patients who require more than 96 hours of mechanical ventilation while in the intensive care unit. ⋯ Older subjects were at higher risk of overall mortality and used, on average, more postdischarge services per patient when compared with middle-aged subjects.