Journal of critical care
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Journal of critical care · Feb 2014
Randomized Controlled TrialHeparin/N-acetylcysteine: An adjuvant in the management of burn inhalation injury: A study of different doses.
Nebulized heparin may reduce fibrin cast formation and reduce the degree of airway obstruction in burn inhalation injury. ⋯ Nebulized heparin 10,000 IU decreased lung injury scores and duration of mechanical ventilation but had no effect on length of ICU stay and mortality. Moreover, nebulized heparin 10,000 IU was safe and had no effect on coagulation parameters.
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Journal of critical care · Feb 2014
Review Meta AnalysisLoop diuretic strategies in patients with acute decompensated heart failure: A meta-analysis of randomized controlled trials.
The safety and efficacy of continuous infusion vs bolus injection of intravenous loop diuretics to treat acute decompensated heart failure were debated. Our aim is to compare the administration routes of diuretics in hospitalized patients with acute decompensated heart failure. ⋯ Meta-analysis of the existing limited studies did not confirm any significant differences in the safety and efficacy with continuous administration of loop diuretic, compared with bolus injection in patients with acute decompensated heart failure.
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Journal of critical care · Feb 2014
Randomized Controlled TrialMelatonin suppresses markers of inflammation and oxidative damage in a human daytime endotoxemia model.
Melatonin used as an exogenous drug has been documented to have potent antioxidant and anti-inflammatory effects in animal model. We aimed to examine the effect of melatonin in an experimental human sepsis model. ⋯ Melatonin administration before endotoxemia resulted in reduction of certain markers of inflammation and oxidative stress. Further studies are needed to clarify the role of melatonin in clinical setting.
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Journal of critical care · Feb 2014
Meta AnalysisA meta-analysis of continuous vs intermittent infusion of loop diuretics in hospitalized patients.
Several studies have examined the potential benefits of continuous vs intermittent (bolus) intravenous loop diuretic administration in hospitalized patients with conflicting results. We conducted a meta-analysis to compare the efficacy of these 2 strategies in hospitalized adults and children with extracellular fluid volume expansion. ⋯ Continuous infusion of loop diuretics preceded by a loading dose results in greater diuresis in hospitalized adults with extracellular fluid volume expansion compared with intermittent dosing regimens. Further studies are required to examine whether these benefits translate into improved clinical outcomes.