Journal of critical care
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Journal of critical care · Aug 2014
Review Meta AnalysisPredictive value of plasma brain natriuretic peptide for postoperative cardiac complications-A systemic review and meta-analysis.
We aimed to undertake a systematic review and meta-analysis of studies addressing perioperative natriuretic peptide (NP) levels to predict postoperative major adverse cardiac events (MACE) after major surgery. ⋯ The existing literature suggests that perioperative NP testing have reasonable accuracy and can be useful in perioperative risk stratification. Natriuretic peptide testing has high rule-out value and low rule-in value for predicting postoperative MACE. Medical decisions should be made in the context of these characteristics.
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Journal of critical care · Aug 2014
Randomized Controlled Trial Comparative StudyComparison of invasive and noninvasive positive pressure ventilation delivered by means of a helmet for weaning of patients from mechanical ventilation.
The effectiveness of noninvasive positive pressure ventilation delivered by helmet (H-NPPV) as a weaning approach in patients with acute respiratory failure is unclear. ⋯ H-NPPV was well tolerated and effective in patients who were difficult to wean.
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Journal of critical care · Aug 2014
ReviewAutomated pupillometer for monitoring the critically ill patient: A critical appraisal.
Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary examination is confounded by interobserver discrepancies and errors in detecting a reflex under certain conditions. The automated pupillometer is a computer-based infrared digital video device that can obtain objective measurements of pupillary size and reactivity. ⋯ Pupillometric measurements had better precision and reproducibility compared with the manual pupillary examination. Based on these data, we conclude that pupillometry monitoring can serve as an important tool in the ICU. Further large scale studies on patients in the neurocritical care unit and medical ICU are needed to support the routine use of automated pupillometry.
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Journal of critical care · Aug 2014
Multicenter StudyDuration of oral endotracheal intubation is associated with dysphagia symptoms in acute lung injury patients.
The purpose of this study is to evaluate demographic and clinical factors associated with self-reported dysphagia after oral endotracheal intubation and mechanical ventilation in patients with acute lung injury (ALI). ⋯ In ALI survivors, patient-reported, postexubation dysphagia at hospital discharge was significantly associated with upper gastrointestinal comorbidity and a longer duration of oral endotracheal intubation during the first 6 days of intubation.
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Journal of critical care · Aug 2014
Randomized Controlled TrialThe effect of high-frequency oscillatory ventilation combined with tracheal gas insufflation on extravascular lung water in patients with acute respiratory distress syndrome: A randomized, crossover, physiologic study.
High-frequency oscillation combined with tracheal gas insufflation (HFO-TGI) improves oxygenation in patients with acute respiratory distress syndrome (ARDS). There are limited physiologic data regarding the effects of HFO-TGI on hemodynamics and pulmonary edema during ARDS. The aim of this study was to investigate the effect of HFO-TGI on extravascular lung water (EVLW). ⋯ High-frequency oscillation combined with tracheal gas insufflation improves gas exchange and lung mechanics in ARDS and potentially attenuates EVLW accumulation.