Journal of critical care
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Journal of critical care · Jun 2012
Comparative Study Clinical TrialNear-infrared spectroscopy cerebral and somatic (renal) oxygen saturation correlation to continuous venous oxygen saturation via intravenous oximetry catheter.
Near-infrared spectroscopy (NIRS) and continuous central venous oxygen saturation (ScvO(2)) via oximetry catheter are 2 modalities available to estimate adequacy of oxygen delivery in postoperative pediatric cardiac patients. Near-infrared spectroscopy measures regional tissue oxygenation and is routinely used in pediatric cardiac surgery patients. By not requiring an invasive catheter, NIRS has the advantage over mixed venous oxygen saturation (SvO(2)) monitoring. An alternative marker of global tissue oxygenation is central venous oxygen saturation (ScvO(2)). A recently developed pediatric-sized oximetric catheter (PediaSat; Edwards Lifesciences, Irvine, CA, USA) functions as a central venous catheter and provides a continuous ScvO(2) reading, an accepted surrogate to SvO(2). To date, the correlation between NIRS and ScvO(2) has not been quantified. The aim of this study was to examine the strength of the bivariate correlation between NIRS and ScvO(2) measurements. ⋯ In this small cohort of pediatric patients undergoing heart surgery, there was a moderate but statistically significant correlation between the ScvO(2)-catheter and the NIRS-C values. Further studies are required to determine which oxymetric modality of monitoring cardiac output most aids in the postoperative management of these patients.
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Journal of critical care · Jun 2012
Predictors of prolonged vasopressin infusion for the treatment of septic shock.
Prolonged catecholamine use has been linked with poor clinical outcomes, including higher mortality. The objective was to identify characteristics that may be predictive of prolonged arginine vasopressin (AVP) use for 7 days or more in patients with septic shock. ⋯ Patients with preexisting PVD and AKI and those experiencing a new ICU arrhythmia on AVP may be more likely to remain on AVP for 7 or more days.
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Journal of critical care · Jun 2012
Pleural antigen assay in the diagnosis of pediatric pneumococcal empyema.
The purpose of the study was to assess the diagnostic value of rapid pneumococcal antigen detection (PAD) in pleural fluid samples of children with empyema. ⋯ Pneumococcal antigen detection in pleural fluid specimens from children provides a rapid, simple, sensitive, and reliable method of diagnosis for pneumococcal empyema at bedside.
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Journal of critical care · Jun 2012
Multicenter StudyEpidemiology and management of atrial fibrillation in medical and noncardiac surgical adult intensive care unit patients.
The aim of the study was to describe the epidemiology and management of atrial fibrillation (AF) in noncardiac surgery critically ill patients in a retrospective, observational study at 3 mixed medical-surgical, university-affiliated intensive care units (ICUs). ⋯ Atrial fibrillation is common but transient in most ICU patients. Electrical cardioversion is often unsuccessful, and pharmacologic rhythm conversion is often only transiently effective. Modifiable risk factors are common among these patients. Future studies are needed to address the management of AF in the ICU.
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Journal of critical care · Jun 2012
Clinical implications of right ventricular dysfunction in patients with acute symptomatic pulmonary embolism: short- and long-term clinical outcomes.
Right ventricular dysfunction (RVD) has been found to have a negative impact on the short-term prognosis of patients with pulmonary embolism (PE). However, the long-term prognosis of such patients has not been well defined. We evaluated the effect of RVD on short- and long-term mortality in Korean patients with PE. ⋯ Right ventricular dysfunction without hemodynamic instability was not associated with short- or long-term mortality of patients with PE.