Journal of critical care
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Journal of critical care · Aug 2017
"Pseudo-subarachnoid hemorrhage sign" on early brain computed tomography in out-of-hospital cardiac arrest survivors receiving targeted temperature management.
Newly updated guidelines suggest brain computed tomography for out-of-hospital cardiac arrest survivors to identify a neurologic cardiac arrest cause. We hypothesized that the "pseudo-subarachnoid hemorrhage" (p-SAH) sign in cardiac arrest survivors is associated with poor outcome. ⋯ Pseudo-subarachnoid hemorrhage sign might be one of the simple methods to identify poor neurologic outcome early. However, further prospective studies will be needed to clarify the clinical implication of the p-SAH sign.
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Journal of critical care · Aug 2017
Clinical TrialVentilation distribution and lung recruitment with speaking valve use in tracheostomised patient weaning from mechanical ventilation in intensive care.
Speaking valves (SV) are used infrequently in tracheostomised ICU patients due to concerns regarding their putative effect on lung recruitment. A recent study in cardio-thoracic population demonstrated increased end-expiratory lung volumes during and post SV use without examining if the increase in end-expiratory lung impedance (EELI) resulted in alveolar recruitment or potential hyperinflation in discrete loci. ⋯ These findings indicate that hyperinflation did not occur with SV use, which is supported by previously published data on respiratory parameters. These data along with obvious psychological benefits to patients are encouraging towards safe use of SVs in this critically ill cardio-thoracic patient population.
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Journal of critical care · Aug 2017
Bioelectrical impedance analysis values as markers to predict severity in critically ill patients.
We investigated bioelectrical impedance analysis (BIA)-derived parameters in critically ill patients to evaluate any differences between survivors and nonsurvivors. ⋯ PhA, impedance, and reactance determined by BIA in critically ill patients were associated with mortality outcomes and revealed stronger predictive power for mortality than severity scoring systems commonly used in an intensive care unit.
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Journal of critical care · Aug 2017
Observational StudyRelation of positive fluid balance to the severity of renal impairment and recovery among ST elevation myocardial infarction complicated by cardiogenic shock.
We analyzed the relationship between a positive fluid balance and its persistence over time on acute kidney injury (AKI) development, severity and resolution among ST elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock. ⋯ A positive fluid balance was strongly associated with higher stage AKI and lower rate of AKI recovery in STEMI complicated by cardiogenic shock.
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Journal of critical care · Aug 2017
Observational StudyThe correlation between CVP-derived parameters and the prognosis of critically ill patients.
To investigate the effect of central venous pressure on the organ dysfunction and prognosis of critically ill patients. ⋯ Exposure to higher levels of central venous pressure in critically ill patients is associated with a poorer prognosis and worse organ function. Therefore, central venous pressure should be kept as low as possible during hemodynamic therapy in critically ill patients.