Journal of critical care
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Journal of critical care · Apr 2017
Review Meta AnalysisImpact of transfusion on stroke after cardiovascular interventions: Meta-analysis of comparative studies.
To evaluate the impact of transfusion on the development of stroke after cardiovascular interventions. ⋯ The present meta-analysis is registered in PROSPERO, code CRD42016046426.
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Journal of critical care · Apr 2017
Review Meta AnalysisHigh-flow nasal cannula oxygen therapy vs conventional oxygen therapy in cardiac surgical patients: A meta-analysis.
The use of high-flow nasal cannula (HFNC) for the treatment of many diseases has gained increasing popularity. In the present meta-analysis, we aimed to assess the efficacy and safety of HFNCs compared with conventional oxygen therapy (COT) in adult postextubation cardiac surgical patients. ⋯ The HFNC could reduce the need for escalation of respiratory support compared with COT, and it could be safely administered in adult postextubation cardiac surgical patients.
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Journal of critical care · Apr 2017
Randomized Controlled Trial Multicenter StudyEffects of low-dose atrial natriuretic peptide infusion on cardiac surgery-associated acute kidney injury: A multicenter randomized controlled trial.
To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. ⋯ Atrial natriuretic peptide infusion did not show a renoprotective effect or cost-saving effect in the treatment of cardiac surgery-associated AKI.
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Journal of critical care · Apr 2017
ReviewNeurogenic stunned myocardium in subarachnoid hemorrhage.
"Stunned myocardium," characterized by reversible left ventricular dysfunction, was first described via animal models using transient coronary artery occlusion. However, this phenomenon has also been noted with neurologic pathologies and collectively been labeled "neurogenic stunned myocardium" (NSM). Neurogenic stunned myocardium resulting from subarachnoid hemorrhage (SAH) is a challenging pathology due to its diagnostic uncertainty. ⋯ Management remains largely supportive with case reports acknowledging the utility of inotropes such as dobutamine and milrinone and intra-aortic balloon pump when NSM is accompanied by cardiogenic shock. Neurogenic stunned myocardium that follows SAH can result in many complications such as arrhythmias, pulmonary edema, and prolonged intubation, which can negatively impact long-term recovery from SAH and increase morbidity and mortality. This necessitates the need to accurately diagnose and treat NSM.
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Journal of critical care · Apr 2017
Observational StudyReasons for death in patients with sepsis and septic shock.
Understanding the underlying cause of mortality in sepsis has broad implications for both clinical care and interventional trial design. However, reasons for death in sepsis remain poorly understood. We sought to characterize reasons for in-hospital mortality in a population of patients with sepsis or septic shock. ⋯ In this retrospective cohort, refractory shock and comorbid withdrawal of care were the most common reasons for death. Following prospective validation, the classification methodology presented here may be useful in the design/interpretation of trials in sepsis.