Journal of critical care
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Journal of critical care · Feb 2021
ReviewOutcomes of severe Legionella pneumonia requiring extracorporeal membrane oxygenation (ECMO).
Legionella pneumonia with acute respiratory failure may necessitate extracorporeal membrane oxygenation (ECMO). The medical literature in this area is comprised primarily of case reports and small case series. Our goal was to summarize published data and contribute our institutional experience regarding survival in severe Legionella pneumonia requiring ECMO. ⋯ Review of clinical experience with ECMO for severe Legionella pneumonia yields a survival rate of over 70%. The similarity in survival rates among all published cases (78.1%), case series reporting surviving and non-surviving patients (71.7%), our institutional experience (80%), and recently reported Extracorporeal Life Support Organization (ELSO) registry data (71%) supports the veracity of this encouraging survival rate.
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Journal of critical care · Feb 2021
The use and usefulness of ICU diaries to support family members of critically ill patients.
To analyze and describe the use and usefulness of the ICU diary to support family members of critically ill patients. ⋯ The ICU diary is useful to family members as a stress reduction, information management, and communication tool. The design of ICU diary implementations must address system factors to assure family members receive benefits from diary use. Further research is needed to expand our understanding of the optimal structure, process, and content of ICU diary implementations.
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Journal of critical care · Feb 2021
Randomized Controlled TrialEsophageal balloon calibration during Sigh: A physiologic, randomized, cross-over study.
Optimal esophageal balloon filling volume (Vbest) depends on the intrathoracic pressure. During Sigh breath delivered by the ventilator machine, esophageal balloon is surrounded by elevated intrathoracic pressure that might require higher filling volume for accurate measure of tidal changes in esophageal pressure (Pes). The primary aim of our investigation was to evaluate and compare Vbest during volume controlled and pressure support breaths vs. Sigh breath. ⋯ During Sigh breath, applying a calibrated approach for Pes assessment, a higher Vbest was required compared to VCV and PSV tidal breath.
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Journal of critical care · Feb 2021
Early alterations in heart rate are associated with poor outcome in patients with intracerebral hemorrhage.
Cardiac complications are common after spontaneous intracerebral hemorrhage (ICH). In this study we intended to investigate factors associated with higher alterations in heart rate and their impact on outcome. ⋯ The study suggests that a higher variation in heart rate in the early phase after ICH may discriminate patients with poor outcome.
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Journal of critical care · Feb 2021
Case ReportsThe clinical spectrum of pulmonary thromboembolism in patients with coronavirus disease-2019 (COVID-19) pneumonia: A European case series.
To describe the clinical characteristics and outcomes of coronavirus disease-2019 (COVID-19)-associated pulmonary thromboembolism (PTE). ⋯ PTE is a potential life-threatening complication, which occurs frequently in patients with COVID-19. Intermediate therapeutic dose of anticoagulants and extend thromboprophylaxis are necessary after meticulous risk-benefit assessment.