Journal of critical care
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Journal of critical care · Dec 2016
Effect and mechanism of hydrocortisone on organ function in patients with severe burns.
In patients with severe burns, resuscitation with large volumes of fluid is needed, partly because of an increase in capillary leakage. Corticosteroids might be beneficial by diminishing capillary leakage. This study aimed to assess in severely burned nonseptic patients whether hydrocortisone (HC) improved outcome and diminished capillary leakage. ⋯ Hydrocortisone treatment in severe burned patients without sepsis might improve organ dysfunction possibly because of a reduction in capillary leakage, as reflected by a decrease of proteinuria, an increase of BNP, and diminished fluid resuscitation volumes.
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Journal of critical care · Dec 2016
Observational StudyInferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis.
Currently, physicians employ pulse pressure variation (PPV) as a gold standard for predicting fluid responsiveness. However, employing ultrasonography in intensive care units is increasing, including using the ultrasonography for assessment of fluid responsiveness. Data comparing the performance of both methods are still lacking. This is the reason for the present study. ⋯ The present study demonstrated better performance of the PPV than the IVDV. A threshold value more than 10% may be used for identifying fluid responders.
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Journal of critical care · Dec 2016
Results of implementing a pain management algorithm in intensive care unit patients: The impact on pain assessment, length of stay, and duration of ventilation.
This study aimed to measure the impact of implementing a pain management algorithm in adult intensive care unit (ICU) patients able to express pain. No controlled study has previously evaluated the impact of a pain management algorithm both at rest and during procedures, including both patients able to self-report and express pain behavior, intubated and nonintubated patients, throughout their ICU stay. ⋯ Several outcome variables were significantly improved after implementation of the algorithm compared with the control group.
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Journal of critical care · Dec 2016
Ultrasound-guided laryngeal air column width difference and the cuff leak volume in predicting the effectiveness of steroid therapy on postextubation stridor in adult. Are they useful?
To evaluate the effectiveness of steroids therapy on postextubation stridor (PES) depending on the clinical response, the ultrasound guided laryngeal air column width difference (LACWD) and the cuff leak volume (CLV). ⋯ Steroids therapy improves postextubation stridor. Both LACWD and CLV are non-invasive and simple methods for monitoring of laryngeal edema regression after steroid therapy. We recommend administration of corticosteroids to patients with a lower level of leak volume and LACWD before extubation.
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Journal of critical care · Dec 2016
Comment LetterResponse to the letter by Dr Sébastien Champion regarding the study "Can mortality due to circulatory failure in comatose out-of-hospital cardiac arrest patients be predicted on admission? A study in a retrospective derivation cohort validated in a prospective cohort".