Journal of critical care
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Journal of critical care · Dec 2015
Time to reach target glucose level and outcome after cardiac arrest patients treated with therapeutic hypothermia.
Hyperglycemia after cardiac arrest is common and associated with unfavorable neurologic outcomes and mortality. This study tested the hypothesis that time to reach target blood glucose level is associated with the outcome of patients after cardiac arrest treated with therapeutic hypothermia (TH). ⋯ The time to reach target glucose level was significantly associated with survival and favorable neurologic outcomes at hospital discharge in patients treated with TH after cardiac arrest.
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Journal of critical care · Dec 2015
Where do we go from here? A small scale observation of transfer results from chronic to skilled ventilator facilities.
Skilled nursing facility ventilator units (SNF) are a recent attempt to reduce the costs of an increasing number of patients who are in acute intensive care units and are not able to be liberated from ventilators. Transfers of such patients from long-term care chronic vent units (LTCVs) to SNFs in Maryland began in 2006. The safety of these transfers needs to be assessed. ⋯ We recognize that bias may occur in patients choosing to remain in our LTCV compared to those accepting transfers, the magnitude of the difference in mortality indicates the need for more comprehensive well designed analysis investigating the outcome of all transfers occurring to and from LTCVs.
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Journal of critical care · Dec 2015
Sleep apnea is associated with new-onset atrial fibrillation after coronary artery bypass grafting.
New-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG) remains a prevalent problem. We investigated the relationship between sleep apnea and new-onset post-CABG AF during inhospital stay. ⋯ Sleep apnea is prevalent in patients undergoing CABG. It increases the susceptibility to new-onset AF after CABG, probably related to atrial and ventricular remodeling.
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Journal of critical care · Dec 2015
Outcome of tuberculous meningitis patients requiring mechanical ventilation.
There is paucity of information about the outcome of tuberculous meningitis (TBM) patients on mechanical ventilation (MV). In this communication, we report the clinical characteristics, predictors of MV, and outcome of TBM patients requiring MV. ⋯ Mechanical ventilation was needed in 18% TBM patients because of TBM-related or systemic complications. Those requiring MV had high mortality and may be categorized separately.
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Journal of critical care · Dec 2015
Interobserver agreement in the evaluation of B-lines using bedside ultrasound.
We evaluated agreement among trained emergency physicians assessing the degree of B-line presence on bedside ultrasound in patients presenting to the emergency department (ED) with acute undifferentiated dyspnea. We also determined which thoracic zones offered the highest level of interobserver reliability for sonographic B-line assessment. ⋯ Interrater agreement was best in the anterior/superior thoracic zones followed by the lateral/superior zones for both expert/expert and expert/novice pairs. Agreement in the lateral/inferior lung zones was overall inferior. Intrarater agreement was highest at extreme high or low numbers of B-lines.