Journal of critical care
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Journal of critical care · Jun 2017
Review Meta AnalysisEffect of ulinastatin combined with thymosin alpha1 on sepsis: A systematic review and meta-analysis of Chinese and Indian patients.
To assess the effects of urinary trypsin inhibitor (UTI) ulinastatin combined with thymosin alpha1 (Tα1) on sepsis. ⋯ Treatment of UTI+Tα1 can suppress the production of proinflammatory cytokines, decrease the APACHE II score, shorten the duration of mechanical ventilation, and improve the 28-day survival rate.
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Journal of critical care · Jun 2017
ReviewReconsidering the role of decompressive craniectomy for neurological emergencies.
There is little doubt that decompressive craniectomy can reduce mortality. However, there is concern that any reduction in mortality comes at an increase in the number of survivors with severe neurological disability. ⋯ It would appear unlikely that further randomised controlled trials will be possible given the significant reduction in mortality achieved by surgical decompression. It may be that observational cohort studies and outcome prediction models may provide data to determine those patients most likely to benefit from surgical decompression.
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Acute liver failure is a rare but potentially devastating disease. Throughout the last few decades, acute liver failure outcomes have been improving in the context of the optimized overall management. This positive trend has been associated with the earlier recognition of this condition, the improvement of the intensive care unit management, and the developments in emergent liver transplantation. Accordingly, we aimed to review the current diagnostic and therapeutic approach to this syndrome, especially in the intensive care unit setting.
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Journal of critical care · Jun 2017
ReviewEchocardiographic approach to cardiac tamponade in critically ill patients.
Cardiac tamponade should be considered in a critically ill patient in whom the cause of haemodynamic shock is unclear. When considering tamponade, transthoracic echocardiography plays an essential role and is the initial investigation of choice. ⋯ Knowledge of the pathophysiology and echocardiographic features of cardiac tamponade are essential for the practicing Intensivist. This review presents an approach to the recognition, diagnosis, and treatment of cardiac tamponade in critically ill patients.
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Journal of critical care · Jun 2017
Multicenter StudyRelatives' perception of stressors and psychological outcomes - Results from a survey study.
To identify relevant stressors or resources of relatives of critically ill patients and explore their relationship with psychological outcomes. ⋯ Our study confirmed a high prevalence of PICS-F among relatives of critically ill patients. Feeling overburdened and experiencing acute stressors may be related to negative psychological outcomes. In future, vulnerable relatives might be identified by a single-item screening tool on feeling overburdened.