Journal of critical care
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Journal of critical care · Dec 2012
Prediction of extubation failure in medical intensive care unit patients.
The purpose of this study was to evaluate prediction factors for extubation failure (need for reintubation within 48 hours) in medical intensive care unit patients. ⋯ Low preextubation serum anion gap values and low preextubation Pao(2)/Fio(2) ratio might help to predict extubation failure in medical intensive care unit patients.
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Journal of critical care · Dec 2012
The impact of body mass index on the physiology of patients with polytrauma.
Obesity is a growing problem in industrial nations. The aim was to test the hypothesis that overweight patients face early physiologic impairment. ⋯ Anticipating BMI-specific critical trauma problems will become mandatory for effective polytrauma treatment in industrialized nations given their increasing prevalence of obesity.
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Journal of critical care · Dec 2012
Randomized Controlled TrialEnd-expiratory lung volume recovers more slowly after closed endotracheal suctioning than after open suctioning: a randomized crossover study.
Endotracheal suctioning causes significant lung derecruitment. Closed suction (CS) minimizes lung volume loss during suction, and therefore, volumes are presumed to recover more quickly postsuctioning. Conflicting evidence exists regarding this. We examined the effects of open suction (OS) and CS on lung volume loss during suctioning, and recovery of end-expiratory lung volume (EELV) up to 30 minutes postsuction. ⋯ Closed suctioning minimized lung volume loss during suctioning but, counterintuitively, resulted in slower recovery of EELV postsuction compared with OS. Therefore, the use of CS cannot be assumed to be protective of lung volumes postsuctioning. Consideration should be given to restoring EELV after either suction method via a recruitment maneuver.
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Journal of critical care · Dec 2012
Multicenter StudyBarriers to feeding critically ill patients: a multicenter survey of critical care nurses.
The aims of this study were to describe the barriers to enterally feeding critically ill patients from a nursing perspective and to examine whether these barriers differ across centers. ⋯ Nurses in our multicenter survey identified important barriers to providing adequate enteral nutrition to their critically ill patients. The importance of these barriers does not appear to differ significantly across different clinical settings. Future research is required to evaluate if tailoring interventions to overcome these identified barriers is an effective strategy of improving nutrition practice.