Journal of critical care
-
Journal of critical care · Dec 2014
Multicenter StudyExperiences with capnography in acute care settings: A mixed-methods analysis of clinical staff.
Although capnography is being incorporated into clinical guidelines, it is not used to its full potential. We investigated reasons for limited implementation of capnography in acute care areas and explored facilitators and barriers to its implementation. ⋯ We observed varied responsiveness to capnography and identified factors that work to foster or discourage its use. These data can guide future implementation strategies. A deliberate strategy to foster utilization, mitigate barriers, and broadly accelerate implementation has the potential to profoundly impact use of capnography in acute care areas with the goal of improving patient care.
-
Journal of critical care · Dec 2014
Clinical TrialPulse pressure variation-guided fluid therapy after cardiac surgery: A pilot before-and-after trial.
The aim of this study is to study the feasibility, safety, and physiological effects of pulse pressure variation (PPV)-guided fluid therapy in patients after cardiac surgery. ⋯ Pulse pressure variation-guided fluid management was feasible and safe during mandatory ventilation after cardiac surgery. However, its advantages may be clinically small.
-
Journal of critical care · Dec 2014
Maternal organ donation and acute injuries in surviving children.
The purpose of this study is to test whether maternal deceased organ donation is associated with rates of subsequent acute injuries among surviving children after their mother's death. ⋯ Deceased organ donation was associated with a reduction in excess acute injuries among surviving children after their mother's death. An awareness of this positive association provides some reassurance about deceased organ donation programs.
-
Bronchoscopy and bronchoalveolar lavage (BAL) are common procedures in intensive care units; however, no contemporaneous safety and outcomes data have been reported, particularly for critically ill patients. ⋯ Bronchoscopy with BAL in critically ill patients with sepsis and ALI is well tolerated with low risk of complications, primarily related to manageable hypoxemia.
-
Journal of critical care · Dec 2014
Pulse pressure variation is not a valid predictor of fluid responsiveness in patients with elevated left ventricular filling pressure.
The purpose of this study was to test the hypothesis that the predictive ability of pulse pressure variation (PPV) for fluid responsiveness would be altered in patients with elevated left ventricular (LV) filling pressure. ⋯ None of the assessed preload indices including PPV were able to predict fluid responsiveness in patients with elevated LV filling pressure.