Journal of critical care
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Journal of critical care · Oct 2014
Low tissue oxygen saturation at emergency center triage is predictive of intensive care unit admission.
Timely recognition of critical patients by emergency center triage is an ongoing challenge. Peripheral tissue oxygen saturation (StO2) measurement has been used to monitor shock patients' responses to resuscitation. Interest has developed in evaluating StO2 as a triage tool, but limited studies have addressed critically ill patients. ⋯ In this patient population, an StO2 less than 70% significantly increased the risk of ICU admission. Tissue oxygen saturation at triage identifies critical patients who may not be recognized by vital signs alone. Tissue oxygen saturation measurement could help providers make earlier decisions regarding hospital resource allocation.
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Journal of critical care · Oct 2014
Enteral naloxone for the treatment of opioid-induced constipation in the medical intensive care unit.
To determine the safety and efficacy of enteral naloxone for the treatment of opioid-induced constipation in the medical intensive care unit (MICU). ⋯ Enteral naloxone appears safe for the treatment of opioid-induced constipation in the MICU. Enteral naloxone may be effective in treating opioid-induced constipation; however, further studies are warranted.
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Journal of critical care · Oct 2014
Cost savings with interventions to reduce aerosolized bronchodilator use in mechanically ventilated patients.
The purpose of this evaluation is to describe the cost savings associated with multimodal interventions aimed at reducing aerosolized bronchodilator use in mechanically ventilated patients without adversely affecting costs associated with length of stay (LOS). ⋯ Multimodal efforts to restrict aerosolized bronchodilator therapy in mechanically ventilated patients were successful and led to sustained reductions in use that was associated with substantial reductions in cost, without affecting LOS.
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Journal of critical care · Oct 2014
Polymyxin B-immobilized fiber column hemoperfusion removes endotoxin throughout a 24-hour treatment period.
The purpose of this study was to evaluate the extent of endotoxin adsorption by polymyxin B-immobilized fiber column hemoperfusion (PMX) performed for a 24-hour treatment period in patients with septic shock. ⋯ These findings suggest that 24-hour PMX treatment was effective in removing endotoxin continuously throughout the entire treatment period.
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Journal of critical care · Oct 2014
Observational StudyCorrected QT-interval prolongation and variability in intensive care patients.
Critically ill patients are at risk for prolongation of the interval between the Q wave and the T wave in the electrocardiogram (corrected QT [QTc]). Corrected QT prolongation is probably a dynamic process. It is unknown how many patients have a QTc prolongation during their intensive care stay and how variable QTc prolongation is. ⋯ Continuous QTc monitoring showed a prolonged QTc interval in 52% of intensive care patients. Severity of illness and QT and QTc variances are higher in these patients.