Journal of critical care
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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.
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Journal of critical care · Apr 2016
Observational StudyObstructive coronary artery disease in patients hospitalized for severe sepsis or septic shock with concomitant acute myocardial infarction.
It is difficult to differentiate type 1 acute myocardial infarction (AMI) with obstructive coronary artery disease (OCAD) from type 2 AMI in patients admitted for severe sepsis. The aims of this study were to assess the risk factors and prognosis of OCAD in patients admitted to the intensive care unit for severe sepsis with concomitant AMI. ⋯ Obstructive coronary artery disease is a poor prognosis factor in patients hospitalized for severe sepsis with concomitant AMI. In this setting, medical treatment should be considered for patients with peripheral vascular disease or with at least 2 cardiovascular risk factors; the need to perform coronary angiography should be considered carefully.
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Journal of critical care · Apr 2016
Balancing hope and despair at the end of life: The contribution of organ and tissue donation.
Concern for the grieving family can moderate the intentions of critical care staff to advocate deceased organ and tissue donation. Conversely, benevolent actions may provoke distress through missed opportunities to save or transform lives. This article provides insight into the perceived benefits of organ and tissue donation for grieving families who experienced end-of-life care in the intensive care unit. ⋯ Our study findings underlined the significance of donation decision making for grieving families. Organ and tissue donation has the potential to balance hope and despair at the end of life when the wishes of the dying, deceased, and bereaved are fulfilled.