Journal of critical care
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Journal of critical care · Feb 2016
Complication rates among peripherally inserted central venous catheters and centrally inserted central catheters in the medical intensive care unit.
There are limited contemporary data describing the rates of catheter-related deep vein thrombosis (CRDVT) and central line-associated bloodstream infection for peripherally inserted central venous catheters (PICCs) and centrally inserted central venous catheters (CICCs) in the medical intensive care unit (ICU). ⋯ Thrombotic and infectious complications were uncommon following PICC and CICC insertion, with no significant difference in complication rates observed. Half of PICC DVTs occurred on the general floor, and like all central catheters placed in the ICU, PICCs should be aggressively discontinued when no longer absolutely needed.
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Journal of critical care · Feb 2016
Low total cholesterol and high total bilirubin are associated with prognosis in patients with prolonged sepsis.
Nutritional biochemical indexes are generally used as markers for critically ill patients. However, they are easily influenced by acute phase changes after injury and are difficult to use as common and practical biomarkers. The objective of this study was to determine the most valuable prognostic markers among 15 common laboratory tests in patients with sepsis. ⋯ Total cholesterol and T-Bil could be associated with prognosis in patients with sepsis.
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Journal of critical care · Feb 2016
Ultrasound assessment of optic nerve sheath diameter in healthy volunteers.
Ultrasound assessment of optic nerve sheath diameter (ONSD) has been suggested as a non-invasive measure of intracranial pressure. Numerous small studies suggest its validity; however, discrepancy exists around normal values for ONSD. In this study we sought to define a normal value range for ONSD in a population of healthy adult volunteers. ⋯ This study has defined the range of ONSD in a healthy cohort of volunteers. The lack of relationship to age, weight and height is similar to other studies but this is the first study to find a difference depending on sex suggesting the possible need for separate reference ranges for men and women.
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Journal of critical care · Feb 2016
Prolonged postoperative respiratory support after proximal thoracic aortic surgery: Is deep hypothermic circulatory arrest a risk factor?
In addition to the pulmonary risks associated with cardiopulmonary bypass, thoracic aortic surgery using deep hypothermic circulatory arrest (DHCA) may subject the lungs to further injury. However, this topic has received little investigation to date. ⋯ Prolonged postoperative respiratory support is common after proximal aortic surgery. The use of DHCA was not associated with this complication in the overall cohort, although longer DHCA times were predictive when only the subset of patients undergoing DHCA was analyzed. Knowledge of the risk factors for PPRS after proximal aortic surgery should improve preoperative risk stratification and postoperative management of these patients.
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Journal of critical care · Feb 2016
Risk factor analysis of postoperative acute respiratory distress syndrome in valvular heart surgery.
The aim of this study is to investigate the incidence, severity, and outcome of postoperative acute respiratory distress syndrome (ARDS), according to the Berlin definition, in isolated valvular heart surgery. The preoperative and perioperative predisposing factors of this complication were also identified. ⋯ In conclusion, postoperative ARDS, according to Berlin definition, in valvular surgery, was associated with high in-hospital mortality. The severity of ARDS was associated with patient midterm mortality. In multivariate analysis, age, liver cirrhosis, massive blood transfusion, and tricuspid valve replacement were identified as independent risk factors of ARDS.