Journal of critical care
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Journal of critical care · Jun 2017
Cardiac output and systemic vascular resistance: Clinical assessment compared with a noninvasive objective measurement in children with shock.
To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. ⋯ There is poor agreement between physician-assessed CI and SVRI and USCOM, with significant interobserver variability among physicians. Objective measurement of CI and SVRI may reduce variability and improve diagnostic accuracy.
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Journal of critical care · Jun 2017
Review Meta AnalysisAnticoagulation practices and the prevalence of major bleeding, thromboembolic events, and mortality in venoarterial extracorporeal membrane oxygenation: A systematic review and meta-analysis.
The purpose was to evaluate the safety of anticoagulation in venoarterial extracorporeal membrane oxygenation (VA-ECMO). ⋯ The optimal targets and strategies for anticoagulation in VA-ECMO are unclear. Evaluation of major bleeding and thromboembolic events is limited by study quality and between-study heterogeneity. Clinical trials are needed to investigate the optimal anticoagulation strategy.
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Journal of critical care · Jun 2017
Randomized Controlled TrialMild induced hypothermia for patients with severe traumatic brain injury after decompressive craniectomy.
To evaluate the efficacy and safety of mild induced hypothermia for intracranial hypertension in patients with traumatic brain injury after decompressive craniectomy. ⋯ Mild induced hypothermia can reduce intracranial hypertension after decompressive craniectomy, decreasing patient mortality. Hypothermia should be considered one of the main treatments for intracranial hypertension after decompressive craniectomy in patients with traumatic brain injury.
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Journal of critical care · Jun 2017
ReviewDying in intensive care units of India: Commentaries on policies and position papers on palliative and end-of-life care.
This study critically examines the available policy guidelines on integration of palliative and end-of-life care in Indian intensive care units to appraise their congruence with Indian reality. ⋯ The article suggests the need to reexamine policies in terms of their attainability and congruence with Indian reality.