Journal of critical care
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Journal of critical care · Apr 2016
Early central diabetes insipidus: An ominous sign in post-cardiac arrest patients.
Central diabetes insipidus (CDI) after cardiac arrest is not well described. Thus, we aim to study the occurrences, outcomes, and risk factors of CDI of survivors after out-of-hospital cardiac arrest (OHCA). ⋯ All patients diagnosed with CDI had poor neurologic outcomes, and occurrence of CDI was associated with mortality. Central diabetes insipidus patients with death or brain death had earlier occurrence of CDI and more maximum urine output.
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Journal of critical care · Apr 2016
ReviewBarbiturates for the treatment of alcohol withdrawal syndrome: A systematic review of clinical trials.
To perform a systematic review of the clinical trials concerning the use of barbiturates for the treatment of acute alcohol withdrawal syndrome (AWS). ⋯ Although the evidence is limited, based on our findings, adding phenobarbital to a BZD-based regimen is a reasonable option, particularly in patients with BZD-refractory AWS.
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Journal of critical care · Apr 2016
Exposure to reprocessed single-use tracheal suction catheter and ventilator-associated pneumonia risk: A preliminary, single unit-based, matched case-control study.
The reuse of reprocessed single-use suction catheter for suctioning an amount of tracheal secretion among orally intubated, mechanically ventilated patients, who are at risk of acquiring ventilator-associated pneumonia (VAP), has not been thoroughly investigated. This study aimed to examine the association between the repetitive use of reprocessed single-use suction catheter and VAP development. ⋯ The estimated VAP risk of this traditional-based practice is essential to provide strong basis for infection control measures to reduce, if not totally eliminate, VAP.
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Journal of critical care · Apr 2016
Myocarditis in patients with subarachnoid hemorrhage: A histopathologic study.
Cardiac abnormalities after subarachnoid hemorrhage (SAH) such as electrocardiographic changes, echocardiographic wall motion abnormalities, and elevated troponin levels are independently associated with a poor prognosis. They are caused by catecholaminergic stress coinciding with influx of inflammatory cells into the heart. These abnormalities could be a sign of a myocarditis, potentially giving insight in pathophysiology and treatment options. ⋯ Myocytolysis was found in 6 SAH patients but not in controls. Myocarditis, consisting of an influx of neutrophil granulocytes, lymphocytes, and macrophages, coinciding with myocytolysis and thrombi in intramyocardial arteries, occurs in patients with SAH but not in controls. These findings might explain the cardiac abnormalities after SAH and may have implications for treatment.
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Journal of critical care · Apr 2016
Incidence and predictors of ischemic cerebrovascular stroke among patients on extracorporeal membrane oxygenation support.
There are scant data on the predictors of ischemic cerebrovascular stroke occurring during extracorporeal membrane oxygenation (ECMO). We investigated the incidence and predictors of ischemic stroke in subjects receiving ECMO support. ⋯ Ischemic stroke is not uncommon in subjects receiving ECMO support with independent risk factor being a pre-ECMO lactic acid greater than 10 mmol/L.