Journal of critical care
-
Journal of critical care · Feb 2017
Value of the oxygenation index during 1-lung ventilation for predicting respiratory complications after thoracic surgery.
Thoracic surgery requiring 1-lung ventilation (OLV) is associated with significant postoperative pulmonary complications (PPCs) due to patient- and surgery-specific risk factors. The aim of this study is to determine whether the oxygenation index (OI) (fraction of inspired oxygen × mean airway pressure/partial pressure of oxygen) during OLV predicts the development of PPC. ⋯ The calculated OI during OLV is not predictive of PPC in our sample. Additional studies in a larger cohort of patients are needed to identify intraoperative ventilation parameters during OLV that can predict the risk of PPC.
-
Journal of critical care · Feb 2017
Guillain-Barré syndrome in patients with a recent history of Zika in Cúcuta, Colombia: A descriptive case series of 19 patients from December 2015 to March 2016.
Zika virus (ZIKV) infection is an emerging global threat and a public health problem in the Americas. Guillain-Barré syndrome (GBS) has been recently associated to ZIKV. This report presents a case series of GBS possibly associated to ZIKV. ⋯ All cases of this GBS outbreak had a recent history ZIKV infection, reinforcing existing evidence for the association between GBS and ZIKV. Future genetic and immunologic studies are warranted to further investigate the cause of the outbreak in detail.
-
Journal of critical care · Feb 2017
Respiratory pathogen colonization of dental plaque, the lower airways, and endotracheal tube biofilms during mechanical ventilation.
In mechanically ventilated patients, the endotracheal tube is an essential interface between the patient and ventilator, but inadvertently, it also facilitates the development of ventilator-associated pneumonia (VAP) by subverting pulmonary host defenses. A number of investigations suggest that bacteria colonizing the oral cavity may be important in the etiology of VAP. The present study evaluated microbial changes that occurred in dental plaque and lower airways of 107 critically ill mechanically ventilated patients. ⋯ To the best of our knowledge, this is the largest study to date exploring oral microbial changes during both mechanical ventilation and after recovery from critical illness. Based on these findings, it was apparent that during mechanical ventilation, dental plaque represents a source of potential VAP pathogens.
-
Journal of critical care · Feb 2017
Precision and improving outcomes in acute kidney injury: Personalizing the approach.
It is now well over a decade since attempts at harmonization of acute renal failure into a definable entity termed acute kidney injury. This has led to several landmark studies outlining the epidemiology of acute kidney injury, particularly in the critically ill, as well as providing insights into the long-term effects of the syndrome. ⋯ The introduction of novel biomarkers associated with renal damage was primarily aimed at aiding early recognition of acute kidney injury. We argue that, in the future, using biomarkers may not only alert to acute kidney injury but may direct therapy in a personalized fashion rather than a one-size-fits-all approach.
-
Journal of critical care · Feb 2017
Clinical significance of palliative care assessment in patients referred for urgent intensive care unit admission: A cohort study.
To evaluate clinical characteristics of patients with palliative care (PC) and urgent intensive care unit (ICU) referrals in the same hospital admission. ⋯ In this cohort of patients with urgent ICU referral, clinical characteristics at the moment of ICU referral were associated with co-occurrence of PC assessment in the same hospital admission. These characteristics might guide the development of instruments to enhance early referral of high-risk patients to PC services.