Journal of critical care
-
Journal of critical care · Dec 2015
Clinical TrialEffects of ketanserin on microcirculatory alterations in septic shock: An open-label pilot study.
Microcirculatory alterations in sepsis are associated with increased morbidity and mortality. These alterations occur despite macrohemodynamic resuscitation. Alternative pro-microcirculatory strategies, including vasodilatory drugs, have been suggested to improve capillary blood flow. Ketanserin, a serotonin receptor antagonist, is an attractive candidate because of its vasodilatory, antithrombotic, and anti-inflammatory effects. ⋯ An improvement in microcirculatory perfusion was observed during ketanserin administration in patients with septic shock after macrohemodynamic resuscitation. This finding needs further exploration in a placebo-controlled setting.
-
Journal of critical care · Dec 2015
Does difficulty functioning in the surrogate role equate to vulnerability in critical illness research? Use of path analysis to examine the relationship between difficulty providing substituted judgment and receptivity to critical illness research participation.
Individuals who struggle to provide substitute judgment for the critically ill often find it challenging to engage in decision making for therapeutic interventions. Although essential to the conduct of research, how these individuals respond to requests for clinical trial participation is poorly understood. ⋯ We were unable to demonstrate a relationship between perceived difficulty in decision making in the surrogate role and receptivity to clinical trial participation.
-
Journal of critical care · Dec 2015
Mobilization of ventilated patients in the intensive care unit: An elicitation study using the theory of planned behavior.
Early mobilization in intensive care unit (ICU) is safe, feasible, and beneficial. However, mobilization frequently does not occur in practice. The study objective was to elicit attitudinal, normative, and control beliefs (barriers and enablers) toward the mobilization of ventilated patients, to inform development of targeted implementation interventions. ⋯ Intensive care unit staff expressed positive and negative attitudinal, normative, and control beliefs across the spectrum, and disadvantages were most frequently reported. Identified beliefs can be used to inform development of future interventions.
-
Journal of critical care · Dec 2015
Carotid artery corrected flow time measurement via bedside ultrasonography in monitoring volume status.
The purpose of this study is to investigate the possible correlation between corrected flow time (FTc) in carotid artery and changes in volume status. ⋯ The assessment of changes in FTc of carotid artery via Doppler waveform analysis may predict the changes in intravascular volume. The use of this diagnostic modality may be an accurate and noninvasive alternative to currently available methods.
-
Journal of critical care · Dec 2015
Higher-volume hypertonic saline and increased thrombotic risk in pediatric traumatic brain injury.
Hyperosmolar therapy is a mainstay in the acute medical management of traumatic brain injury (TBI). Emerging literature suggests that a hyperosmolar state may lead to thrombotic complications. The primary objective of this study was to investigate associations between hypertonic saline (HTS) and the outcome of deep venous thrombosis (DVT) in pediatric patients with severe TBI. ⋯ In children with severe TBI, the total bolus volume of 3% HTS and sustained sodium levels greater than 160 mmol/L are independently associated with DVT.