Journal of critical care
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Journal of critical care · Feb 2017
Value of the oxygenation index during 1-lung ventilation for predicting respiratory complications after thoracic surgery.
Thoracic surgery requiring 1-lung ventilation (OLV) is associated with significant postoperative pulmonary complications (PPCs) due to patient- and surgery-specific risk factors. The aim of this study is to determine whether the oxygenation index (OI) (fraction of inspired oxygen × mean airway pressure/partial pressure of oxygen) during OLV predicts the development of PPC. ⋯ The calculated OI during OLV is not predictive of PPC in our sample. Additional studies in a larger cohort of patients are needed to identify intraoperative ventilation parameters during OLV that can predict the risk of PPC.
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Journal of critical care · Feb 2017
Clinical significance of palliative care assessment in patients referred for urgent intensive care unit admission: A cohort study.
To evaluate clinical characteristics of patients with palliative care (PC) and urgent intensive care unit (ICU) referrals in the same hospital admission. ⋯ In this cohort of patients with urgent ICU referral, clinical characteristics at the moment of ICU referral were associated with co-occurrence of PC assessment in the same hospital admission. These characteristics might guide the development of instruments to enhance early referral of high-risk patients to PC services.
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Journal of critical care · Feb 2017
Cerebral oxidative metabolism failure in traumatic brain injury: "Brain shock".
Shock is a systemic form of acute circulatory failure leading to cellular dysoxia and death. Such a state of aerobic metabolism failure also underlies neuronal cell death in severe traumatic brain injury. ⋯ These different mechanisms can be usefully understood via analysis of the classic subdivisions of tissue hypoxia. This approach could lead to an alternative treatment paradigm toward cerebral oxygen metabolic rate targeting instead of the traditional targets of intracranial and perfusion pressures.