Journal of critical care
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Journal of critical care · Jun 2017
ReviewEchocardiographic approach to cardiac tamponade in critically ill patients.
Cardiac tamponade should be considered in a critically ill patient in whom the cause of haemodynamic shock is unclear. When considering tamponade, transthoracic echocardiography plays an essential role and is the initial investigation of choice. ⋯ Knowledge of the pathophysiology and echocardiographic features of cardiac tamponade are essential for the practicing Intensivist. This review presents an approach to the recognition, diagnosis, and treatment of cardiac tamponade in critically ill patients.
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Journal of critical care · Jun 2017
Review Meta AnalysisAnticoagulation practices and the prevalence of major bleeding, thromboembolic events, and mortality in venoarterial extracorporeal membrane oxygenation: A systematic review and meta-analysis.
The purpose was to evaluate the safety of anticoagulation in venoarterial extracorporeal membrane oxygenation (VA-ECMO). ⋯ The optimal targets and strategies for anticoagulation in VA-ECMO are unclear. Evaluation of major bleeding and thromboembolic events is limited by study quality and between-study heterogeneity. Clinical trials are needed to investigate the optimal anticoagulation strategy.
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Journal of critical care · Jun 2017
ReviewDying in intensive care units of India: Commentaries on policies and position papers on palliative and end-of-life care.
This study critically examines the available policy guidelines on integration of palliative and end-of-life care in Indian intensive care units to appraise their congruence with Indian reality. ⋯ The article suggests the need to reexamine policies in terms of their attainability and congruence with Indian reality.
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Journal of critical care · Jun 2017
ReviewRecent developments in the management of patients resuscitated from cardiac arrest.
Cardiac arrest is the leading cause of death in Europe and the United States. Many patients who are initially resuscitated die in the hospital, and hospital survivors often have substantial neurologic dysfunction. Most cardiac arrests are caused by coronary artery disease; patients with coronary artery disease likely benefit from early coronary angiography and intervention. ⋯ Accurate neurologic assessment is central to managing care of cardiac arrest survivors and should combine physical examination with objective neurologic testing, with the caveat that delaying neurologic prognosis is essential to avoid premature withdrawal of supportive care. A combination of clinical findings and diagnostic results should be used to estimate the likelihood of functional recovery. This review focuses on recent advances in care and specific cardiac intensive care strategies that may improve morbidity and mortality for patients after cardiac arrest.
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Journal of critical care · Apr 2017
Review Meta AnalysisImpact of transfusion on stroke after cardiovascular interventions: Meta-analysis of comparative studies.
To evaluate the impact of transfusion on the development of stroke after cardiovascular interventions. ⋯ The present meta-analysis is registered in PROSPERO, code CRD42016046426.