Journal of critical care
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Journal of critical care · Oct 2018
Case ReportsWhen the heart gets the flu: Fulminant influenza B myocarditis: A case-series report and review of the literature.
To describe patients with refractory cardiogenic shock related to influenza B virus myocarditis rescued by venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO). ⋯ Influenza myocarditis is a rare but reversible cause of cardiogenic shock amenable to VA-ECMO rescue. Early antiviral therapy and ECMO support should be considered for patients with fulminant myocarditis during an influenza epidemic.
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Journal of critical care · Oct 2018
Evaluation of disseminated intravascular coagulation scores in critically ill pediatric patients with septic shock.
To evaluated the outcome predictability of DIC scores in critically ill children with septic shock. ⋯ Critically ill children with septic shock frequently experience DIC. Patients with DIC had worse outcomes than those without DIC. JAAM and modified JAAM DIC scores could be promising outcome predictors in these patients.
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Journal of critical care · Oct 2018
Out-of-bed mobilization of patients undergoing mechanical ventilation with orotracheal tubes: A survey study.
The aim of this study is to clarify intensive care unit (ICU)-level factors facilitating out-of-bed mobilization defined as a range of activities from sitting on edge of bed up to walking in mechanically ventilated patients with orotracheal tubes. ⋯ Based on impression of professionals, the presence of dedicated therapist in the ICU, and the high intensity physician staffing are significantly associated with an increased rate of out-of-bed mobilization for mechanically ventilated patients with orotracheal tubes.
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Journal of critical care · Oct 2018
Accidental dual humidification in intensive care units: Repeated alerts and system changes are not enough.
The inadvertent, simultaneous use of heat and moisture exchangers (HMEs) and heated humidifiers (HHs) can result in waterlogging of the filter and sudden ventilation tube occlusion, with potentially fatal consequences. Following an NHS England Safety Alert, a near miss and educational reminders in our institution, we introduced new guidelines to solely use HHs in the intensive care unit and HMEs only for patient transfers. No further incidents have occurred, however this solution is potentially fallible. Two years later, we sought to assess staff knowledge and likelihood of recognising this error should it occur. ⋯ Despite educational efforts and system changes, recognition of this error remained poor. System changes may reduce the likelihood of the error occurring, but when it does, recognition may not occur. Substantial reductions or elimination of this error may be achieved through a safety-engineered fail-safe within the equipment, which alerts staff to improve recognition and prevent the mistake.