Journal of critical care
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Journal of critical care · Apr 2020
Multicenter StudyThe effects of an enteral nutrition feeding protocol on critically ill patients: A prospective multi-center, before-after study.
The aim of this study was to explore the effects of an enteral nutrition (EN) feeding protocol in critically ill patients. ⋯ The implementation of the enteral feeding protocol is associated with improved energy intake and a decreased incidence of enteral nutrition related adverse events for critically ill patients, but it had no statistically beneficial effects on reducing the hospital mortality rate. Trial registration ClinicalTrials.gov, NCT02976155. Registered November 29, 2016- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02976155.
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Journal of critical care · Apr 2020
Comparative StudyLongitudinal comparative trial of antibiotic cycling and mixing on emergence of gram negative bacterial resistance in a pediatric medical intensive care unit.
To compare antibiotic mixing vs. cycling with respect to acquisition of resistance and PICU mortality. ⋯ Acquisition of resistance was significantly lower in both mixing and cycling as compared to baseline phase. Both were similar with respect to risk of antibiotic resistance as well as incidence of HCAI and PICU mortality.
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Journal of critical care · Apr 2020
Randomized Controlled TrialLow dose Iloprost effect on platelet aggregation in comatose out-of-hospital cardiac arrest patients: A predefined sub-study of the ENDO-RCA randomized -phase 2- trial.
This is a predefined sub-study of the Endothelial Dysfunction in Resuscitated Cardiac Arrest (ENDO-RCA) trial. We aim to investigate Iloprost, a prostacyclin analogue, safety by evaluating change in whole blood platelet aggregometry (Multiplate) in out of hospital cardiac arrest (OHCA) patients from baseline to 96-h post randomization. ⋯ In conclusion, the iloprost infusion did not influence platelet aggregation as evaluated by the ASPI, TRAP, RISTO and ADP assays. There was no increased risk of bleeding or transfusion therapy. A decline in platelet aggregation was observed for the ASPI and ADP assays during the initial 96 h after OHCA.
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Journal of critical care · Apr 2020
Randomized Controlled TrialNoninvasive ventilation support during fiberoptic bronchoscopy-guided nasotracheal intubation effectively prevents severe hypoxemia.
This study investigated the feasibility and efficacy of continuous noninvasive ventilation (NIV) support with 100% oxygen using a specially designed face mask, for reducing desaturation during fiberoptic bronchoscopy (FOB)-guided intubation in critically ill patients with respiratory failure. ⋯ Continuous NIV support during FOB-guided nasal intubation can prevent severe desaturation during intubation in critically ill patients with respiratory failure.
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Journal of critical care · Apr 2020
ReviewPrevention and early treatment of driveline infections in ventricular assist device patients - The DESTINE staging proposal and the first standard of care protocol.
Mechanical circulatory support (MCS) using left ventricular assist devices (LVAD) have considerably improved the quality of life and survival rate of patients with end-stage heart failure. Despite substantial technological progress, major challenges with regard to VAD-specific and VAD-related infections have hitherto hindered the broader application of this promising therapy approach. Driveline infections (DLI) range among the main adverse events experienced in LVAD patients. ⋯ An advanced wound staging approach was defined with recommended actions for prevention, early detection and stage-related management of DLI. Broad consensus was reached on the fact that an interdisciplinary approach both in DLES care and DLES healing disorder awareness is required to prolong infect-free survival times on MCS as well as to ensure high patient compliance and quality of life. In conclusion, a new detailed SOP for appropriate DLES care and an advanced wound staging approach for prevention and management of DLI were defined on an expert level applicable for VAD clinicians, practitioners and care givers in Central Europe.