Journal of critical care
-
Journal of critical care · Dec 2015
ReviewImportant clinician information needs about family members in the intensive care unit.
Clinicians often lack key information regarding intensive care unit (ICU) families. Our objective was to identify (1) important information for clinicians to know about ICU families when making decisions and (2) important information for families to know about patients from clinicians. ⋯ Through qualitative and quantitative analysis, we identified important information for ICU clinicians to know about family members and for family members to know about patients. The identified information can be used to guide strategies and tools to improve assessment of and communication with families.
-
Journal of critical care · Dec 2015
ReviewMechanistic similarities between trauma, atherosclerosis, and other inflammatory processes.
Most human diseases, including trauma, atherosclerosis, and malignancy, can be characterized by either an overexuberant inflammatory response or an inadequate immunologic response. As our understanding of the mechanisms underlying these inflammatory aberrations improves, so should our approach to the patient. ⋯ Trauma surgeons are uniquely positioned to usher in a new era of patient diagnostics and patient-directed therapies based on an understanding of the immune system's response to stimuli. These improvements are likely to affect not only trauma care but all aspects of medicine.
-
Journal of critical care · Dec 2015
ReviewMagnesium status and magnesium therapy in critically ill patients: A systematic review.
Magnesium is frequently measured and administered in general intensive care unit patients. However, magnesium status, its association with outcomes, and therapeutic utility in such patients are unclear. We performed a systematic review of the relevant literature to define current knowledge in this field. ⋯ Total serum magnesium levels are generally used to estimate magnesium status in critical illness. Hypomagnesemia appears associated with greater risk of mortality, but the efficacy of magnesium administration is open to challenge.
-
Journal of critical care · Dec 2015
Observational StudyAssessment of muscle tissue oxygen saturation after out-of-hospital cardiac arrest.
Pathophysiology of cardiac arrest corresponds to an ischemia-reperfusion syndrome with deep impairment of microcirculation. Muscular tissue oxygen saturation (StO2) is a noninvasive method of evaluation of microcirculation. Our study was aimed at assessing the prognosis value of muscular StO2 in patients admitted for out-of-hospital cardiac arrest (OHCA) and treated with hypothermia. ⋯ After an OHCA treated with therapeutic hypothermia, StO2 was correlated with outcome. Further research is needed to better understand the pathophysiological process underlying our results.
-
Journal of critical care · Dec 2015
ReviewPANCREATITIS OR NOT? - Elevated lipase and amylase in ICU patients.
Elevation in serum levels of pancreatic enzymes (Hyperamylasemia and/or Hyperlipasemia) can occur in any Intensive Care Unit (ICU) patient either as a result of true acute pancreatitis (AP) or as a reflection of a non-pancreatic disease. Although most patients may not have clinical pancreatitis, identifying true acute pancreatitis in the ICU setting may be critical in the presence of associated co-morbid conditions of the disease for which the patient is being managed. With neither amylase nor lipase being specific for pancreatitis, it is important for the clinician to be aware of different causes of hyperamylasemia and hyperlipasemia, especially when clinical diagnosis of pancreatitis is unclear. This review will focus on understanding different non-pancreatic conditions where there is elevation of pancreatitis enzymes and to identify true acute pancreatitis in critically ill patients without typical symptoms.