Journal of critical care
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Journal of critical care · Sep 2010
Randomized Controlled Trial Comparative StudyHigh-flow nasal oxygen vs high-flow face mask: a randomized crossover trial in extubated patients.
Oxygen delivery after extubation is critical to maintain adequate oxygenation and to avoid reintubation. The delivery of oxygen in such situations is usually by high-flow face mask (HFFM). Yet, this may be uncomfortable for some patients. A recent advance in oxygen delivery technology is high-flow nasal prongs (HFNP). There are no randomized trials comparing these 2 modes. ⋯ High-flow nasal prongs are as effective as HFFM in delivering oxygen to extubated patients who require high-flow oxygen. The tolerance of HFNP was significantly better than in HFFM.
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Journal of critical care · Sep 2010
Randomized Controlled TrialIntravenous paracetamol reduced the use of opioids, extubation time, and opioid-related adverse effects after major surgery in intensive care unit.
This study assessed the analgesic efficacy, side effects, and time to extubation of intravenous paracetamol when administered as an adjuvant to intravenous meperidine after major surgery in intensive care unit (ICU). ⋯ We have demonstrated important clinical benefits by the addition of 4 g/d of paracetamol to meperidine after major surgery. This benefit has been shown in a range of patients under routine clinical conditions and therefore has important practical consequences in ICU. These data suggest that intravenous paracetamol is a useful component of the multimodal analgesia model, especially after major surgery.
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Journal of critical care · Jun 2010
Randomized Controlled Trial Comparative StudyReduced expression of systemic proinflammatory and myocardial biomarkers after off-pump versus on-pump coronary artery bypass surgery: a prospective randomized study.
The effects of off-pump (OffPCABG) and on-pump (OnPCABG) coronary artery bypass grafting (CABG) on myocardium and inflammation are unclear. ⋯ Thus, the absence of CPB during CABG preserves better the myocardium and attenuates inflammation-however, without improving survival.
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Journal of critical care · Jun 2010
Randomized Controlled Trial Multicenter StudyTriggers for emergency team activation: a multicenter assessment.
The purpose of the study was to examine triggers for emergency team activation in hospitals with or without a medical emergency team (MET) system. ⋯ In MET hospitals, more emergency team calls are triggered because staff members are worried about the patient; and fewer calls have multiple triggers. Type of hospital, type of ward, and time of day also affect the nature and frequency of triggers for emergency team activation.
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Journal of critical care · Jun 2010
Randomized Controlled TrialEffects of polygeline and hydroxyethyl starch solutions on liver functions assessed with LIMON in hypovolemic patients.
Hypovolemia is a common clinical entity in critical patients, and adequate volume replacement therapy seems to be essential for maintaining tissue perfusion. However, it is still uncertain which solution is most appropriate for fluid resuscitation. ⋯ Increasing intrathoracic blood volume index and hemodynamic variables by fluid loading is not associated with a significant change in ICG-PDR.