Journal of critical care
-
Journal of critical care · Apr 2016
Observational StudyEfficacy of noninvasive mechanical ventilation in prevention of intubation and reintubation in the pediatric intensive care unit.
To determine the efficiency of noninvasive mechanical ventilation (NIV) both in protection from intubation and in preventing reintubation of postextubation in patients in the pediatric intensive care unit (PICU). ⋯ Noninvasive mechanical ventilation effectively and reliably reduced endotracheal intubation in the treatment of respiratory failure due to different clinical situations. Our results suggest that NIV can play an important role in PICUs in helping to avoid intubation and prevent reintubation. Although there were serious underlying diseases in most of our patients, such as immunosuppression, 70% avoided intubation with use of NIV.
-
Journal of critical care · Apr 2016
Observational StudyCan 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.
Circulatory failure (CF) influences management of out-of-hospital cardiac arrest (OHCA) patients and the decision of circulatory assistance. We performed a study to identify on hospital admission patients at risk for CF-related death. ⋯ A logistic score based on arterial pH and shock requiring catecholamines on admission can predict CF-related death in OHCA patients.
-
Journal of critical care · Apr 2016
Decision conflict and regret among surrogate decision makers in the medical intensive care unit.
Family members of critically ill patients in the intensive care unit face significant morbidity. It may be the decision-making process that plays a significant role in the psychological morbidity associated with being a surrogate in the ICU. We hypothesize that family members facing end-of-life decisions will have more decisional conflict and decisional regret than those facing non-end-of-life decisions. ⋯ Nearly all surrogates enrolled were faced with decision-making responsibilities on behalf of his or her critically ill family member. In our small pilot study, we found more decisional conflict in those surrogates facing end-of-life decisions, specifically on the subset of questions dealing with uncertainty. Surrogates report low levels of decisional regret.
-
Journal of critical care · Apr 2016
Duration of extracorporeal membrane oxygenation is a poor predictor of hospital survival.
Venovenous extracorporeal membrane oxygenation (ECMO) is increasingly used in patients with respiratory failure. In patients without the option of lung transplantation, prognostication is challenging. We hypothesized that duration of ECMO therapy is inversely correlated with the chance of recovery and therefore hospital survival. ⋯ According to our registry data, duration of ECMO therapy by itself could not predict hospital survival. Prospective studies are needed to confirm this finding.
-
Journal of critical care · Apr 2016
Observational StudyThrombocytopenia in critically ill patients with severe sepsis/septic shock: Prognostic value and association with a distinct serum cytokine profile.
The purpose of the study is to evaluate the incidence, association with serum cytokine profile, and prognostic value of thrombocytopenia, in critically ill patients with severe sepsis/septic shock. ⋯ Thrombocytopenia is associated with poor prognosis and a distinct serum cytokine profile.