Journal of critical care
-
Journal of critical care · Aug 2012
ReviewLiberation of neurosurgical patients from mechanical ventilation and tracheostomy in neurocritical care.
Neurosurgical patients commonly require mechanical ventilation and monitoring in a neurocritical care unit. There are only few studies that specifically address the process of liberation from mechanical ventilation in this population. Patients who remain ventilator or artificial airway dependent receive a tracheostomy. ⋯ In this article, we review the general principles of liberation and the current literature as it pertains to neurosurgical patients with primary brain injury. The criteria for "readiness of extubation" include a combination of neurologic assessment, hemodynamic, and respiratory parameters. Future studies are required to better assess indicators for extubation readiness, evaluate the predictors of extubation failure in brain-injured patients, and define the most appropriate timing for a tracheostomy.
-
Journal of critical care · Aug 2012
The early phase of human sepsis is characterized by a combination of apoptosis and proliferation of T cells.
T cell activation as well as unresponsiveness has been described in separate studies in sepsis. Our aim was to establish the coexistence of both T cell fate in human sepsis. ⋯ Concomitant T cell proliferation and T cell apoptosis are observed in human sepsis, being related to a different pathway.
-
Journal of critical care · Aug 2012
The frequency and significance of postintubation hypotension during emergency airway management.
Arterial hypotension is a recognized complication of emergency intubation, but the consequence of this event is poorly described. Our aim was to identify the incidence of postintubation hypotension (PIH) after emergency intubation and to determine its association with inhospital mortality. ⋯ Postintubation hypotension occurs in almost one quarter of normotensive patients undergoing emergency intubation. Postintubation hypotension is independently associated with higher inhospital mortality and longer intensive care unit and hospital LOS.
-
Journal of critical care · Aug 2012
Review Meta AnalysisEfficacy of information interventions in reducing transfer anxiety from a critical care setting to a general ward: a systematic review and meta-analysis.
Our aim was to undertake a comprehensive systematic review on the efficacy of information interventions on reducing anxiety in patients and family members on transfer from a critical care setting to a general ward. ⋯ Providing information to understand a future ward environment can significantly reduce patients' and family members' transfer anxiety from the critical care setting when compared with standard care.