Journal of critical care
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Most existing literature on noninvasive ventilation (NIV) in combination with helium-oxygen (HELIOX) mixtures focuses on its use in adults, basically for treatment of acute exacerbations of chronic obstructive pulmonary disease. This article reviews and summarizes the theoretical basis, existing clinical evidence, and practical aspects of the use of NIV with HELIOX in children. There is only a small body of literature on HELIOX in pediatric NIV but with positive results. ⋯ The inert nature of helium adds no biological risk to NIV performance. Noninvasive ventilation with HELIOX is a promising therapeutic option for children with various respiratory pathologies who do not respond to conventional treatment. Further controlled studies should be warranted.
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Journal of critical care · Apr 2012
Feasibility of continuous multiorgan variability analysis in the intensive care unit.
The aim of the study was to evaluate the feasibility of continuous heart and respiratory rate variability (HRV and RRV, respectively) monitoring in critically ill patients derived from electrocardiogram (ECG) and end-tidal capnography (etCO(2)) waveforms. ⋯ The quality of continuously recorded ECG and etCO(2) waveforms in critically ill patients is adequate for subsequent continuous variability monitoring in this pilot study. The clinical utility of continuous variability analysis merits further investigation.
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Journal of critical care · Apr 2012
Multicenter StudyBlood glucose amplitude variability as predictor for mortality in surgical and medical intensive care unit patients: a multicenter cohort study.
The aim of this study was to test the hypothesis that blood glucose amplitude variability (BGAV) is associated with mortality in critically ill patients. ⋯ Not all BGAV measures were associated with mortality. Blood glucose amplitude variability as quantified by SD was consistently independently associated with hospital mortality.
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Journal of critical care · Apr 2012
Weaning predictors do not predict extubation failure in simple-to-wean patients.
Predictor indexes are often included in weaning protocols and may help the intensive care unit (ICU) staff to reach expected weaning outcome in patients on mechanical ventilation. ⋯ Usual weaning indexes are poor predictors for extubation outcome in the overall ICU population.
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Journal of critical care · Apr 2012
Implementation challenges in the intensive care unit: the why, who, and how of daily interruption of sedation.
Despite strong medical evidence and policy initiatives supporting the use of daily interruption of sedation in mechanically ventilated patients, compliance remains suboptimal. We sought to identify new barriers to daily interruption of sedation. ⋯ Despite apparent consensus, lack of shared understanding of the rationale for an intervention may lead to divergent practice patterns and failure to implement standardized, evidence-based practice.