Journal of critical care
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Journal of critical care · Apr 2014
Prediction equation to estimate dead space to tidal volume fraction correlates with mortality in critically ill patients.
The measurement of dead space to tidal volume fraction (Vd/Vt) using various methodologies has been shown to be a reliable predictor of mortality in critically ill patients. In this study, we evaluated the correlation of a validated equation using clinically available information to predict calculation of Vd/Vt with clinically relevant outcome parameters in patients requiring mechanical ventilation. ⋯ In this study-specific population of critically ill patients, the prediction equation of Vd/Vt using clinically available parameters correlates with mortality. In addition, we provide a simple method to estimate Vd/Vt that can be potentially applicable to all critically ill intensive care unit patients.
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Journal of critical care · Apr 2014
Review Meta Analysis Comparative StudyComparison of the safety and efficacy of propofol with midazolam for sedation of patients with severe traumatic brain injury: A meta-analysis.
To perform a meta-analysis to compare the safety and efficacy of propofol with midazolam for sedation of patients with severe traumatic brain injury. ⋯ Our meta-analysis of 4 studies showed that there are no important differences between propofol and midazolam when administered to provide sedation for patients with severe traumatic brain injury. Further randomized, controlled trials comparing propofol with midazolam for sedation of such patients are needed.
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Journal of critical care · Apr 2014
Review Meta AnalysisCo-administration of furosemide with albumin for overcoming diuretic resistance in patients with hypoalbuminemia: A meta-analysis.
To systematically review clinical studies of co-administration of albumin and loop diuretics in hypoalbuminemic patients as a strategy to overcome diuretic resistance. ⋯ Synthesis of a heterogeneous body of evidence shows transient effects of modest clinical significance for co-administration of albumin with furosemide in hypoalbuminemic patients. Pragmatic, large-scale randomized studies are needed to delineate the role of this strategy.
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Journal of critical care · Apr 2014
ReviewSixty-four-slice computed tomographic scanner to clear traumatic cervical spine injury: Systematic review of the literature.
Cervical spine (CS) injury in blunt trauma is a prevalent and devastating complication. Clearing CS injuries in obtunded patients is fraught with challenges, and no single imaging modality or algorithm is both safe and effective. Increased time in c-spine precautions is associated with greater patient morbidity including increased ventilator associated pneumonia, delirium and ulceration. We systemically reviewed the literature to assess the effectiveness of 64-slice computed tomographic (CT) scanners in clearing traumatic CS injuries. ⋯ Data suggests that using 64-slice CT scans on obtunded trauma patients with grossly intact motor function, in the context of a defined clearance protocol with interpretation by an experienced radiologist, may be sufficient to safely clear significant CS injury. A prospective study comparing MRI and 64-slice CT scan clearance in this population is necessary to corroborate these conclusions.