Journal of critical care
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Journal of critical care · Apr 2017
The diagnostic utility of sonographic carotid flow time in determining volume responsiveness.
We aimed to predict volume responsiveness and to assess the diagnostic accuracy of carotid flow time (FTc) with the change in hydration status before and after a passive leg raise (PLR) maneuver. ⋯ The use of point-of-care ultrasound to measure FTc may provide a noninvasive alternative to determine fluid status. Percentage change in FTc of ≥5% provides a reliable diagnostic accuracy for predicting fluid status.
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Journal of critical care · Apr 2017
Bronchoscopic intubation is an effective airway strategy in critically ill patients.
American Society of Anesthesiologists guidelines recommend the use of bronchoscopic intubation as a rescue technique in critically ill patients. We sought to assess the safety and efficacy of bronchoscopic intubation as an initial approach in critically ill patients. ⋯ Bronchoscopic intubation as an initial strategy in critically ill patients is associated with a higher first-pass success rate than laryngoscopic intubation, and is not associated with an increase in complications.
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Journal of critical care · Apr 2017
Noninvasive ventilation during acute respiratory distress syndrome in patients with cancer: Trends in use and outcome.
The objectives of our study were to describe the outcome of patients with malignancies treated for acute respiratory distress syndrome (ARDS) with noninvasive ventilation (NIV) and to evaluate factors associated with NIV failure. ⋯ Noninvasive ventilation failure in ARDS patients with malignancies is frequent and related to ARDS severity, SOFA score, and pulmonary infection-related ARDS. Noninvasive ventilation failure is associated with in-hospital mortality.
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Journal of critical care · Apr 2017
Randomized Controlled TrialActivation of respiratory muscles during weaning from mechanical ventilation.
Respiratory muscle dysfunction is a key component of weaning failure. Balancing respiratory muscle loading and unloading by applying different ventilation modes along with spontaneous breathing episodes are established weaning strategies. However, the effects of body positioning on the respiratory muscles during weaning remains unclear. ⋯ This is the first study to show that body positioning influences respiratory drive to the diaphragm in tracheotomized patients with prolonged weaning from mechanical ventilation during unassisted breathing. Sitting position reduces respiratory drive compared with semirecumbent and supine positioning and might therefore be favored during spontaneous breathing trials.