Journal of critical care
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Journal of critical care · Sep 2009
Evaluation of maximal inspiratory pressure, tracheal airway occlusion pressure, and its ratio in the weaning outcome.
The objective of this study is to evaluate the predictive performance of maximal inspiratory pressure (Pimax), airway occlusion pressure (P 0.1), and its ratio (P 0.1/Pimax) in the weaning outcome. ⋯ In our study, P 0.1 and P 0.1/Pimax ratio were moderately accurate, whereas Pimax was less accurate in predicting the weaning outcome.
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Journal of critical care · Sep 2009
Hand-carried echocardiography for assessment of left ventricular filling and ejection fraction in the surgical intensive care unit.
To better define the reliability of left ventricular ejection fraction (LVEF) and left ventricular filling, as determined by either hand-carried ultrasound (HCU) or formal transthoracic echocardiography (TTE), in the critically ill surgical patient. ⋯ Formal TTE offers no advantage over HCU for determination of LVEF in critically ill surgical patients, even though the former allows for a more complete examination. However, estimations of left ventricular filling only demonstrate fair to moderate interrater agreement and thus should be interpreted with care when used as markers of volume responsiveness.
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The aim of this study was to evaluate the factors related to outcome regarding in-intensive care unit (ICU) cardiac arrest (IICA) in a university hospital. ⋯ Shorter resuscitation duration and initial VT/VF are predictors for both ROSC and hospital survival, whereas lower Acute Physiology and Chronic Health Evaluation II scores predict the latter.
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Journal of critical care · Sep 2009
Predictors of seizure onset after intracerebral hemorrhage and the role of long-term antiepileptic therapy.
Seizures are a common complication after hemorrhagic stroke that may slow recovery and decrease quality of life. Recent evidence suggests that early- and late-onset seizures have distinct etiologies, rendering the role of prophylactic long-term antiepileptic drugs controversial. We investigated predictors of early- and late-onset seizures after evacuation of intracerebral hemorrhage (ICH) in an attempt to guide antiepileptic drug management in this patient population. ⋯ The presence of subdural hematoma and increased INR is predictive of late-onset seizures in patients undergoing clot evacuation after ICH. The use of long-term antiepileptic therapy should be further studied in patients with these radiographic and clinical characteristics.
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Journal of critical care · Sep 2009
Outcomes of critically ill children requiring continuous renal replacement therapy.
Acute kidney injury in the pediatric intensive care unit (PICU) is associated with significant morbidity, with continued mortality greater than 50%. Previous studies have described an association between percentage of fluid overload (%FO) less than 20% and improved survival. We reviewed our continuous renal replacement therapy (CRRT) experience to evaluate for factors associated with mortality as well as secondary outcomes. ⋯ For patients with acute kidney injury who require CRRT, the presence of sepsis, MODS, and FO greater than 20% at the time of CRRT initiation are significantly associated with higher mortality. In addition, we report that duration of mechanical ventilation, PICU stay, hospitalization, and time to renal recovery were all significantly prolonged for survivors who had FO greater than 20%.