Journal of critical care
-
Journal of critical care · Aug 2014
Verifying a medical protocol with temporal graphs: The case of a nosocomial disease.
Our contribution focuses on the implementation of a formal verification approach for medical protocols with graphical temporal reasoning paths to facilitate the understanding of verification steps. ⋯ The proposed approach allows for the visual modeling of temporal reasoning and a formalization of knowledge that can assist in the diagnosis and treatment of nosocomial infections and some clinical problems. This is the first time that one emphasizes the temporal situation modeling in conceptual graphs. It will also deliver a formal verification method for clinical guideline analyses.
-
Journal of critical care · Aug 2014
Case ReportsA practical approach to neurologic evaluation in the intensive care unit.
Delirium and neurologic impairment are extremely common in the intensive care setting, and their delayed identification is an important contributor to patient morbidity. Even in comatose patients, the clinical neurologic examination remains the most accurate and effective tool in assessing nervous system function. ⋯ The purpose of this tutorial is to discuss techniques of neurologic examination and localization with an emphasis on comatose patients. Commonly encountered cases of encephalopathy and coma along with clinical pearls are presented.
-
Journal of critical care · Aug 2014
Usefulness of interleukin 6 levels in the cerebrospinal fluid for the diagnosis of bacterial meningitis.
Interleukin 6 (IL-6) is a proinflammatory cytokine produced during infections. We hypothesized that IL-6 levels in the cerebrospinal fluid (CSF) would be elevated in bacterial meningitis and useful for diagnosing and predicting neurologic outcomes. ⋯ Measurement of the CSF IL-6 level is useful for diagnosing bacterial meningitis.
-
Journal of critical care · Aug 2014
Successful weaning and decannulation after interventional bronchoscopic recanalization of tracheal stenosis.
Early posttracheostomy tracheal stenosis (PTTS) may cause weaning and decannulation failure. Although bronchoscopic recanalization offers an effective treatment, it is not known how successfully patients can be weaned and decannulated after recanalization. The aims of this study were to determine the incidence of PTTS in a modern weaning center and to elucidate the benefit of interventional recanalization in terms of weaning and decannulation success. ⋯ Posttracheostomy tracheal stenosis remains a relevant cause of weaning and decannulation failure. Bronchoscopic recanalization is safe and facilitates weaning and successful decannulation in about half of the cases.
-
Journal of critical care · Aug 2014
Clinical results of early stabilization of spine fractures in polytrauma patients.
The purpose of study was to evaluate the clinical results of early stabilization of spine fractures in polytrauma patients. ⋯ Polytrauma patients whose spine fractures were stabilized within 72 hours had better clinical outcomes than those with late stabilization. In addition, more severely injured patients (ISS, ≥26) benefited more from early stabilization.