Journal of critical care
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Journal of critical care · Dec 2012
Acute respiratory distress syndrome related to influenza A H1N1 infection: correlation of pulmonary computed tomography findings to extracorporeal membrane oxygenation treatment and clinical outcome.
The aim of the present study was to correlate computed tomography appearances with clinical severity and outcome using a total lung disease (TLD) score in patients with acute respiratory distress syndrome (ARDS) related to influenza A H1N1 infection. ⋯ A greater extent of air-space disease in ARDS related to influenza A H1N1 infection is associated with progression to ECMO treatment and, therefore, clinical severity. The extent of total air-space disease is greater in younger patients, and obesity is related to a more extensive consolidation.
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Journal of critical care · Dec 2012
Comparative StudyComparison of 3 modes of automated weaning from mechanical ventilation: a bench study.
Automated weaning modes are available in some mechanical ventilators, but no studies compared them hitherto. We compared the performance of 3 automated modes under standard and challenging situations. ⋯ Smartcare, ASV, and MRV were equally able to recognize weaning success and failure, despite the presence of anxiety or irregular breathing but performed incorrectly in the presence of Cheyne-Stokes. PS behavior over the time differs among modes, with ASV showing larger and more frequent PS oscillations over the time. Clinical studies are needed to confirm our results.
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Journal of critical care · Dec 2012
Circuit lifespan during continuous renal replacement therapy for combined liver and kidney failure.
To evaluate circuit lifespan (CL) and bleeding risk during continuous renal replacement therapy (CRRT), in combined liver and renal failure. ⋯ CRRT CL is short in patients with liver failure despite apparent coagulopathy. Thrombocytopenia predicts longer CL and bleeding complications.
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Journal of critical care · Dec 2012
Predictors of mortality of mechanically ventilated patients in internal medicine wards.
Budget restrictions have led to shortage of intensive care unit (ICU) beds in several countries. Consequently, ventilated patients are often kept on the wards. This study examined survival likelihood among patients ventilated on the wards and the predictive value of commonly used severity-of-illness scores. ⋯ Mortality in patients ventilated on the ward was high, especially in the subgroup of patients with an APS score greater than 90. The early calculation of APS may assist in focusing therapeutic efforts on patients with better survival chances.
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Journal of critical care · Dec 2012
Comparative StudyA comparison of seriously ill patients with or without AIDS requiring prolonged mechanical ventilation.
The aim of this study was to compare differences in underlying diagnoses, weaning outcomes, discharge disposition, and survival in prolonged mechanical ventilator (PMV)-dependent patients with and without AIDS. ⋯ AIDS had little effect on weaning success or survival. Successful weaning increased survival regardless of a diagnosis of AIDS. The AIDS patients had more home discharges and fewer to nursing facilities, which likely resulted from the AIDS patients having more acute illnesses leading to PMV than the non-AIDS patients.