Journal of critical care
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Journal of critical care · Dec 2018
Obesity survival paradox in pneumonia supported with extracorporeal membrane oxygenation: Analysis of the national registry.
To investigate whether the obesity survival paradox, where obesity is associated with improved survival, exists for pneumonia supported with extracorporeal membrane oxygenation (ECMO). ⋯ An obesity survival paradox exists in pneumonia supported with ECMO.
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Journal of critical care · Dec 2018
Ultrasound-guided percutaneous dilatational tracheostomy using a saline-filled endotracheal tube cuff as an ultrasonographic puncture target: A feasibility study.
The saline-filled endotracheal tube (ETT) cuff can be easily identified under cervical ultrasound and can serve as an ideal puncture target during percutaneous dilatational tracheostomy (PDT). The authors present their initial experience with this novel technique. ⋯ PDT performed using a saline-filled cuff as the ultrasound-guided puncture target and an endotracheal tube exchanger is feasible, and appeared to be easier to perform than standard PDT. Larger studies are required to confirm the safety and benefits of this technique.
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Journal of critical care · Dec 2018
Case ReportsThe role of electrical impedance tomography for monitoring during bronchoscopy: A case report.
Continuous monitoring of lung ventilation can be useful in treating patients admitted to the intensive care unit (ICU). Electrical impedance tomography (EIT) has been used as a relatively new imaging technique for this purpose. ⋯ A drainage procedure and subsequent improvement in pulmonary function were monitored using EIT contributed to the treatment process. The patient has been discharged from the hospital with an improved general condition.
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Journal of critical care · Dec 2018
Tolerability and effectiveness of 4-factor prothrombin complex concentrate (4F-PCC) for warfarin and non-warfarin reversals.
Current guidelines favor 4F-PCC over plasma for warfarin reversal. Uncertainty remains on its thrombotic risk and hemostatic effectiveness when used for direct-acting oral anticoagulants (DOACs), transplants, massive transfusion protocols (MTP), and non-anticoagulated patients. This study sought to evaluate the tolerability and effectiveness of 4F-PCC in a real-world setting. ⋯ Use of 4F-PCC in this real-world setting was associated with variable thromboembolic and hemostatic effectiveness rates based on the indication for reversal.
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Journal of critical care · Dec 2018
Low-flow time is associated with a favorable neurological outcome in out-of-hospital cardiac arrest patients resuscitated with extracorporeal cardiopulmonary resuscitation.
The aim of this retrospective study was to investigate the prognostic factors in extracorporeal cardiopulmonary resuscitation (ECPR) patients and to assess their accuracy as predictors of a favorable neurological outcome. ⋯ In ECPR patients, low-flow time was significantly associated with a favorable neurological outcome, and ECPR should be performed within 58 min of the low-flow time.