Journal of critical care
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Journal of critical care · Aug 2013
Relationships between mortality, morbidity, and physical function in adults who survived a period of prolonged mechanical ventilation.
This study aimed to report mortality, morbidity, and the relationship between these outcomes with physical function in patients who survived prolonged mechanical ventilation during an intensive care unit (ICU) admission. ⋯ For survivors of prolonged mechanical ventilation, physical function during acute care was associated with hospitalization over the following 12 months.
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Journal of critical care · Aug 2013
Safety and feasibility of femoral catheters during physical rehabilitation in the intensive care unit.
Femoral catheters pose a potential barrier to early rehabilitation in the intensive care unit (ICU) due to concerns, such as catheter removal, local trauma, bleeding, and infection. We prospectively evaluated the feasibility and safety of physical therapy (PT) in ICU patients with femoral catheters. ⋯ Physical therapy interventions in MICU patients with in situ femoral catheters appear to be feasible and safe. The presence of a femoral catheter should not automatically restrict ICU patients to bed rest.
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Journal of critical care · Aug 2013
Randomized Controlled TrialEffect of intraoperative dobutamine on splanchnic tissue perfusion and outcome after Whipple surgery.
Splanchnic hypoperfusion during abdominal surgery contributes to postoperative gut sepsis and mortality. Dobutamine is an inotrope with vasodilator properties that improve hepatosplanchnic perfusion. The aim of this study was to examine the effect of intraoperative dobutamine infusion during Whipple surgery on splanchnic perfusion, hemodynamic, and overall postoperative outcome. ⋯ Intraoperative use of dobutamine improved global oxygen delivery, splanchnic perfusion, and postoperative outcome after Whipple surgery. These findings may be of clinical importance when the therapeutic goal is to improve gut perfusion.
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Journal of critical care · Aug 2013
Multicenter StudyPediatric upper airway obstruction: interobserver variability is the road to perdition.
The purposes of the study are to determine the interobserver variability in the clinical assessment of pediatric upper airway obstruction (UAO) and to explore how variability in assessment of UAO may contribute to risk factors and incidence of postextubation UAO. ⋯ Physical findings routinely used for UAO have poor interobserver reliability among bedside providers. This variability may contribute to inconsistent findings regarding incidence, risk factors, and therapies for postextubation UAO.