Journal of critical care
-
Journal of critical care · Oct 2021
Observational StudyIs the routine use of antipseudomonal antibiotics in acutely exacerbated COPD patients indicated: A retrospective analysis in 437 ICU patients.
Chronic obstructive pulmonary disease (COPD) is a risk factor for acquiring multiple drug resistant bacteria. The main objective of this analysis was to question a beneficial outcome in the routine use of antipseudomonal antibiotics in the empiric treatment of severe AECOPD in Intensive Care Unit patients. ⋯ Empiric use of antipseudomonal antibiotics did not result in improved ICU survival in this retrospective analysis.
-
Journal of critical care · Oct 2021
Deepening of sedation with propofol has limited effect on intra-abdominal pressure - An interventional study in mechanically ventilated adult patients with intra-abdominal hypertension.
To evaluate the effect of deepening of sedation on intra-abdominal pressure (IAP). ⋯ Deepening of sedation with propofol results in a small decrease in IAP and greater simultaneous decrease in MAP and APP, requiring increased vasopressor support in some cases.
-
Journal of critical care · Oct 2021
Family participation during physical activity in the intensive care unit: A longitudinal qualitative study.
Family-centered care has been implemented in the ICU to meet relatives' needs concerning information, support, participation and shared decision making. This study explores the needs, beliefs, feelings and behaviors of relatives of patients admitted to the ICU regarding participation during physical activity. ⋯ The conceptual model shows how family participation during physical activity changes from a passive role, with negative beliefs and feelings of uselessness and powerlessness, to a more proactive participatory role. Relatives felt more useful and like they were part of the team. Providing relatives with additional information might be a viable strategy to help and stimulate participation.
-
Journal of critical care · Oct 2021
Case ReportsFixed dilated pupils in Covid-19 ARDS patients under rocuronium, reversed after discontinuation.
Neuromuscular Blockade Agents (NMBA) are used in the management of moderate and severe Acute Respiratory Distress Syndrome (ARDS) patients. They have never been reported to present Central Nervous System adverse reactions. Shortage of cis-atracurium during the pandemic, led to the use of rocuronium. ⋯ NMBA's discontinuation led to reversal of the pupillary dilation. We believe that impairment of Blood-Brain-Barrier, due to Covid-19, led rocuronium access into the Central Nervous System, leading to this adverse effect. Clinicians should be aware of this adverse reaction when managing patients with Covid-19 ARDS warranting NMBA use.