Journal of critical care
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Journal of critical care · Dec 2018
A feasibility study to assess pre-admission status and six month outcomes of major trauma patients admitted to an intensive care unit, using the WHO DAS 2.0.
To report the feasibility of assessing pre-admission functional status of ICU trauma patients, with repeat assessment at six months post ICU discharge using a standardised measure. ⋯ Standardised assessment of pre-admission function was feasible. Future research should investigate the clinical relevance of scores and the validity of the measure in trauma patients.
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Journal of critical care · Dec 2018
Positive end-expiratory pressure titrated according to respiratory system mechanics or to ARDSNetwork table did not guarantee positive end-expiratory transpulmonary pressure in acute respiratory distress syndrome.
Pulmonary recruitment and positive end-expiratory pressure (PEEP) titrated according to minimal static elastance of the respiratory system (PEEPEstat,RS) compared to PEEP set according to the ARDSNetwork table (PEEPARDSNetwork) as a strategy to prevent ventilator-associated lung injury (VALI) in patients with acute respiratory distress syndrome (ARDS) increases mortality. Alternatively, avoiding negative end-expiratory transpulmonary pressure has been discussed as superior PEEP titration strategy. Therefore, we tested whether PEEPEstat,RS or PEEPARDSNetwork prevent negative end-expiratory transpulmonary pressure in ARDS patients. ⋯ In patients with moderate-to-severe ARDS, PEEP titrated according to the minimal static elastance of the respiratory system or according to the ARDSNetwork table did not prevent negative end-expiratory transpulmonary pressure.
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Journal of critical care · Dec 2018
Acute skeletal muscle wasting and relation to physical function in patients requiring extracorporeal membrane oxygenation (ECMO).
Muscle weakness is common in patients requiring extracorporeal membrane oxygenation (ECMO), but early identification is challenging. This study aimed to 1) quantify the change in quadriceps size and quality (echogenicity) from baseline to day 10 using ultrasound in patients requiring ECMO, 2) determine the relationship between ultrasound measures, muscle strength and highest mobility level. ⋯ In patients requiring ECMO there was marked wasting of the quadriceps over the first 10 days. Ultrasound measures were related to muscle strength and highest mobility level.
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Journal of critical care · Dec 2018
An automated computerized critical illness severity scoring system derived from APACHE III: modified APACHE.
To evaluate the performance of an automated computerized ICU severity scoring derived from the APACHE III. ⋯ mAPACHE has adequate performance to predict mortality.
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Journal of critical care · Dec 2018
Long-term recovery profile of patients with severe disability or in vegetative states following severe primary intracerebral hemorrhage.
We conducted a single-center retrospective review to investigate the long-term recovery of patients who were severely disabled or vegetative secondary to primary intracerebral hemorrhage upon discharge from hospital from January 2009 to November 2013. ⋯ Neurological status at discharge from hospital was not truly indicative of long-term prognosis for patients who were severely disabled or vegetative. Patients in both groups can potentially improve in the long term and may benefit from prolonged rehabilitation programmes to maximize their recovery potential.