Journal of critical care
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Journal of critical care · Jun 2016
Computed tomography confirms a reduction in diaphragm thickness in mechanically ventilated patients.
Patients who require mechanical ventilation (MV) may experience diaphragm atrophy, which may delay the discontinuation of MV. Here, we used computed tomographic (CT) scans to confirm this phenomenon. ⋯ Computed tomography confirmed that diaphragm thickness was reduced in critically ill patients who underwent MV.
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Journal of critical care · Jun 2016
Serial measurements of troponin and echocardiography in patients with moderate-to-severe acute respiratory distress syndrome.
To assess the clinical significance of serial troponin I levels (measured in the first 72 hours from admission) in 42 consecutive patients with moderate-to-severe acute respiratory distress syndrome (ARDS). Echocardiography and electrocardiogram testings were serially performed in the time window. ⋯ In moderate-to-severe ARDS, serial troponin I assessment together with echocardiography evaluation helped to identify a subgroup at higher risk for in-ICU death. Moreover, troponin release can be related to right ventricular dysfunction, thus highlighting the clinical role of echocardiography in ARDS patients.
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Journal of critical care · Jun 2016
Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation.
To explore whether extravascular lung water (EVLW) provides a valuable prognostic tool guiding fluid therapy in septic shock patients after initial resuscitation. ⋯ A higher EVLW in septic shock patients after initial resuscitation was associated with a more positive fluid balance and increased mortality, which is an independent predictor of the 28-day mortality in septic shock patients after initial resuscitation.
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Journal of critical care · Jun 2016
A single BNP measurement in acute heart failure does not reflect the degree of congestion.
Multiple studies found a significant correlation between B-type natriuretic peptide (BNP) level and clinical severity of heart failure (HF). We aim to study the ability of a single BNP measurement to predict the degree of congestion in acute systolic HF. ⋯ Although longitudinal BNP follow-up may be valuable in reflecting the degree of congestion, looking at a single BNP measurement alone is not a good marker to predict the level of congestion and should not be used as a "stand-alone" test for determining aggressiveness of diuresis. Management should be guided by the entirety of physical examination, laboratory values, and hemodynamic parameters when available.