Journal of critical care
-
Journal of critical care · Aug 2011
Colorimetric capnography, a new procedure to ensure correct feeding tube placement in the intensive care unit: an evaluation of a local protocol.
Radiography is the criterion standard method to ensure correct placement of a feeding tube. Recently, excellent results were reported using a combination of colorimetric capnography and epigastric auscultation, but the impact of this technique has not been studied to date. Objectives were to assess whether our local procedure, using colorimetric capnography to ensure proper feeding tube placement, improves the patient's care, satisfies nurses, and decreases costs compared with the standard procedure requiring systematic radiography. ⋯ The use of colorimetric capnography and epigastric auscultation to confirm feeding tube placement improves nurse's organization of care, saves time, and decreases costs.
-
Journal of critical care · Aug 2011
Increased myeloperoxidase enzyme activity in plasma is an indicator of inflammation and onset of sepsis.
Circulating lipopolysaccharides released from bacteria may activate both neutrophils and monocytes. The activated neutrophils release myeloperoxidase (MPO), a specific enzyme with strong oxidative activity. The aim of this study was to evaluate MPO enzyme activity in plasma of critically ill patients and to check the hypothesis that these concentrations in plasma would be higher in sepsis and systemic inflammatory conditions, as neutrophils release their contents before proliferating in response to stress. ⋯ The plasma MPO concentrations may be a marker of the neutrophil proliferation and severity of inflammation.
-
Journal of critical care · Aug 2011
Bacteremia in Staphylococcus aureus pneumonia: outcomes and epidemiology.
Staphylococcus aureus represents a major cause of pneumonia in critically ill patients. Although bacteremia may complicate S aureus pneumonia, the epidemiology of and outcomes associated with bacteremia in this syndrome are poorly described. ⋯ Bacteremia often arises in S aureus pneumonia and is associated with both increased morbidity and mortality. Several simple clinical factors to determine clinical features identify patients with S aureus pneumonia likely to have simultaneous bacteremia.
-
Journal of critical care · Aug 2011
Editorial CommentConflict of interest; disclosure; peer review.
-
Journal of critical care · Aug 2011
Randomized Controlled Trial Multicenter Study Comparative StudyThe Toronto prehospital hypertonic resuscitation--head injury and multiorgan dysfunction trial: feasibility study of a randomized controlled trial.
The aim of the study was to evaluate the feasibility of a prehospital trial comparing hypertonic saline and dextran (HSD) with normal saline (NS) in blunt head injury patients. ⋯ It is feasible to conduct a prehospital randomized controlled trial with HSD for treatment of blunt trauma patients with head injuries; however, consent for neurofunctional outcomes in this cohort is problematic and threatens the feasibility of definitive trials using these potentially meaningful end points.