Journal of critical care
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Journal of critical care · Dec 2018
Development and feasibility of a smartphone-based test for the objective detection and monitoring of attention impairments in delirium in the ICU.
Delirium in the ICU is under-diagnosed. We evaluated feasibility and performance of a novel smartphone-based test for objectively detecting inattention in delirium. ⋯ DelApp-ICU shows promise for assessing inattention and delirium in ICU patients, including longitudinally monitoring deficits and providing a metric of delirium severity.
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Journal of critical care · Dec 2018
Randomized Controlled Trial Multicenter StudyP(v-a)CO2/C(a-v)O2-directed resuscitation does not improve prognosis compared with SvO2 in severe sepsis and septic shock: A prospective multicenter randomized controlled clinical study.
The present study examined the value of P(v-a)CO2/C(a-v)O2 compared with ScvO2 as a target for clinical resuscitation of severe sepsis/septic shock. ⋯ P(v-a)CO2/C(a-v)O2-directed resuscitation did not improve prognosis compared with ScvO2 in severe sepsis and septic shock. ClinicalTrials.gov Identifier NCT01877798.
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Journal of critical care · Dec 2018
ReviewPredictive factors of weaning from mechanical ventilation and extubation outcome: A systematic review.
To identify, describe and discuss the parameters used to predict weaning from mechanical ventilation and extubation outcomes. ⋯ There are several parameters used to predict weaning and extubation outcomes. RSBI was the most frequently studied and seems to be an important measurement tool in deciding whether to wean/extubate a patient. Furthermore, the results demonstrated that weaning and extubation should be guided by several parameters, and not only to respiratory ones.
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Journal of critical care · Dec 2018
ReviewPerceptions of medical futility in clinical practice - A qualitative systematic review.
To summarize and compare qualitative studies which explored attitudes of patients, families and healthcare providers towards medical futility. ⋯ This review describes existing opinions about medical futility and demonstrates the multifaceted understanding of medical futility by physicians, caregivers and patients. The difficulties in defining medical futility demonstrate the need for resources to help healthcare providers and patients to deal with decision-making in such situations.
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Journal of critical care · Dec 2018
Multicenter StudyC-reactive protein and procalcitonin profile in ventilator-associated lower respiratory infections.
Ventilator-associated tracheobronchitis (VAT) has been suggested as an intermediate process between tracheobronchial colonization and ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. The aim of this study was to evaluate the ability of C-reactive protein (CRP) and procalcitonin (PCT) to differentiate between VAT and VAP. ⋯ Although PCT and CRP presented lower values in VAT as compared to VAP, there was a marked overlap of both biomarkers values in both VA-LRTI not allowing adequate discrimination.