Journal of critical care
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Journal of critical care · Oct 2014
Polymyxin B-immobilized fiber column hemoperfusion removes endotoxin throughout a 24-hour treatment period.
The purpose of this study was to evaluate the extent of endotoxin adsorption by polymyxin B-immobilized fiber column hemoperfusion (PMX) performed for a 24-hour treatment period in patients with septic shock. ⋯ These findings suggest that 24-hour PMX treatment was effective in removing endotoxin continuously throughout the entire treatment period.
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Journal of critical care · Oct 2014
Observational StudyDiagnostic accuracy of central venous saturation in estimating mixed venous saturation is proportional to cardiac performance among cardiac surgical patients.
Advanced hemodynamic monitoring in cardiac surgery translates into improvement in outcomes. We evaluated the relationship between central venous (ScvO2) and mixed venous (SvO2) saturations over the early postoperative period. The adequacy of their interchangeability was tested in patients with varying degrees of cardiac performance. ⋯ The diagnostic accuracy of ScvO2 for estimating SvO2 is proportional to cardiac performance. A negative SvO2-ScvO2 gradient at T2 correlated with inotropic support requirement, higher operative risk score, age, lactate level, and duration of cardiopulmonary bypass.
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Journal of critical care · Oct 2014
Comparative StudyLimited echocardiography-guided therapy in subacute shock is associated with change in management and improved outcomes.
The purpose of the study was to compare the effect of limited echocardiography (LE)-guided therapy to standard management on 28-day mortality, intravenous fluid prescription, and inotropic dosing following early resuscitation for shock. ⋯ Limited echocardiography-guided management following early resuscitation is associated with improved survival, less fluid, and increased inotropic prescription. A prospective randomized control trial is required to verify these results.