Journal of critical care
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Journal of critical care · Oct 2017
Clinical TrialThe haemodynamic effects of bolus versus slower infusion of intravenous crystalloid in healthy volunteers.
This pilot study aimed to characterise the haemodynamic effect of 1L of IV normal saline (NS) administered as a rapid versus slow infusion on cardiac output (CO), heart rate (HR), systemic blood pressures, and carotid blood flow in six healthy volunteers. ⋯ Slower infusion of 1L NS in healthy male volunteers produced a greater increase in CO, HR and BP than rapid infusion.
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Journal of critical care · Oct 2017
Review Meta AnalysisIntubation using apnoeic oxygenation to prevent desaturation: A systematic review and meta-analysis.
To determine whether or not apnoeic oxygenation reduces the incidence of hypoxaemia during endotracheal intubation. ⋯ In patients whom are being intubated for any indication other than respiratory failure, apnoeic oxygenation at any flow rate 15L or greater is likely to reduce their incidence of desaturation (<90%) and critical desaturation (<80%). However, further high quality RCTs are required given the high degree of heterogeneity in many of the outcomes and subgroup analyses.
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Journal of critical care · Oct 2017
Review Meta AnalysisRespiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analysis.
To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. ⋯ ApOx was significantly associated with higher minimum SpO2 registered during the intubation procedure. Further studies are needed to increase the number of included patients and demonstrate the benefit of ApOx and of other respiratory support methods (e.g. NIV, HFNC).
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Journal of critical care · Oct 2017
Multicenter StudyPediatric intermediate care and pediatric intensive care units: PICU metrics and an analysis of patients that use both.
To examine how intermediate care units (IMCUs) are used in relation to pediatric intensive care units (PICUs), characterize PICU patients that utilize IMCUs, and estimate the impact of IMCUs on PICU metrics. ⋯ There was no association between having an IMCU and most measures of PICU efficiency. At hospitals with an IMCU, patients spent more time in the PICU once they were cleared for discharge. Other ways that IMCUs might affect PICU efficiency or particular patient populations should be investigated.
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Journal of critical care · Oct 2017
Multicenter Study Observational StudyNon-survivor septic patients have persistently higher serum sCD40L levels than survivors.
Soluble CD40 ligand (sCD40L) is a protein with proinflammatory and prothrombotic effects. Previously we found higher circulating sCD40L levels in non-survivor than in survivor patients at sepsis diagnosis. Now some questions arise such as how are serum sCD40L levels during the first week of severe sepsis?, is there an association between serum sCD40L levels during the first week and mortality?, and serum sCD40L levels during the first week could be used as sepsis mortality biomarker?. This study was developed to answer these asks. ⋯ The novel findings of our study were that there were higher serum sCD40L levels persistently during the first week in non-survivor than in survivor patients, that there is an association between serum sCD40L levels during the first week and sepsis mortality, and that serum sCD40L levels during the first week could be used as sepsis mortality biomarker.