Journal of critical care
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The objective of this study was to determine the effect of early vs late vasopressin therapy on catecholamine dose and duration. ⋯ Early initiation of vasopressin therapy in adult critically ill patients with septic shock was associated with no difference in total catecholamine requirements but decreased incidence of new onset arrhythmias.
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Journal of critical care · Aug 2014
Critical care ultrasound training: A survey of US fellowship directors.
The purpose of this study is to describe the current state of bedside ultrasound use and training among critical care (CC) training programs in the United States. ⋯ This study identified deficiencies in current training, suggesting a need for a formal curriculum for bedside ultrasound training in CC fellowship programs.
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Journal of critical care · Aug 2014
Usefulness of interleukin 6 levels in the cerebrospinal fluid for the diagnosis of bacterial meningitis.
Interleukin 6 (IL-6) is a proinflammatory cytokine produced during infections. We hypothesized that IL-6 levels in the cerebrospinal fluid (CSF) would be elevated in bacterial meningitis and useful for diagnosing and predicting neurologic outcomes. ⋯ Measurement of the CSF IL-6 level is useful for diagnosing bacterial meningitis.
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Journal of critical care · Aug 2014
Successful weaning and decannulation after interventional bronchoscopic recanalization of tracheal stenosis.
Early posttracheostomy tracheal stenosis (PTTS) may cause weaning and decannulation failure. Although bronchoscopic recanalization offers an effective treatment, it is not known how successfully patients can be weaned and decannulated after recanalization. The aims of this study were to determine the incidence of PTTS in a modern weaning center and to elucidate the benefit of interventional recanalization in terms of weaning and decannulation success. ⋯ Posttracheostomy tracheal stenosis remains a relevant cause of weaning and decannulation failure. Bronchoscopic recanalization is safe and facilitates weaning and successful decannulation in about half of the cases.
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Journal of critical care · Aug 2014
Microcirculatory perfusion derangements during continuous hemofiltration with fixed dose of ultrafiltration in stabilized intensive care unit patients.
Acute kidney injury (AKI) is a well-known complication in critically ill patients. Little is known about the timing and the ultrafiltration dose after initial resuscitation. In vivo microscopy of the microcirculation has been suggested as alternative for the assessment of volume status. Previous studies contribute to the understanding that intravascular hypovolemia is reflected by microcirculatory blood flow changes not detected by conventional methods. The aim of our study was to assess microcirculatory blood flow changes during negative fluid balance ultrafiltration in patients with oliguric AKI. ⋯ Microcirculatory blood flow is not altered by reduced substitution during renal replacement therapy.