Journal of critical care
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Journal of critical care · Jun 2015
Heparin dose adjustment required to maintain goal-activated partial thromboplastin time during therapeutic hypothermia.
The impact of therapeutic hypothermia (TH) on unfractionated heparin (UFH) management is essentially unknown. The aim of this study was to evaluate the effect of TH on UFH dosing and activated partial thromboplastin (aPTT) response. ⋯ Using guideline-recommended heparin dosing without dose adjustment for temperature changes produced excessive aPTT during the cooling phase for TH patients. Reduction in the UFH dose of 43% to 54% may be required during TH. We recommend frequent aPTT monitoring during the cooling and rewarming phases to attain a desired aPTT range.
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Journal of critical care · Jun 2015
The use of the pulse oximetric saturation to fraction of inspired oxygen ratio in an automated acute respiratory distress syndrome screening tool.
To determine the relationship between the pulse oximetric saturation to fraction of inspired oxygen (SF) ratio and the arterial partial pressure of oxygen to the fraction of inspired oxygen (PF) ratio, and to assess the usefulness of the SF ratio in an automated acute respiratory distress syndrome (ARDS) screening tool. ⋯ The SF ratio may be an adequate substitute for the PF ratio in an automated ARDS screening tool.
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Journal of critical care · Jun 2015
Passive orthostatism (tilt table) in critical patients: Clinicophysiologic evaluation.
To assess the effects of passive orthostatism on various clinicophysiologic parameters of adult intensive care unit (ICU) patients, by daily placement on a tilt table. ⋯ A protocol with daily use of a tilt table for ICU patients is safe and improves the level of consciousness and inspiratory maximum pressure, without causing deleterious acute physiological effects.
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Journal of critical care · Jun 2015
Basal functional status predicts functional recovery in critically ill patients with multiple-organ failure.
We aimed to investigate the effect of baseline demographic, clinical, and functional characteristics of intensive care unit (ICU) patients with multiple-organ failure (MOF) on their functional recovery at 6 and 12 months posthospitalization. ⋯ The level of functional status befre ICU admission should be considered not only in research studies looking a long-term outcomes from ICU but also in the clinical care planning of critically ill patients during and after their ICU admission.
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Journal of critical care · Jun 2015
Glucose control positively influences patient outcome: A retrospective study.
The goal of this research is to demonstrate that well-regulated glycemia is beneficial to patient outcome, regardless of how it is achieved. ⋯ Increased cTIB was associated with higher OL. These results suggest that effective glycemic control positively influences patient outcome, regardless of how the glycemic regulation is achieved. Blood glucose < 7.0 mmol/L is associated with a measurable increase in the odds of survival, if hypoglycemia is avoided.