Journal of critical care
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Journal of critical care · Oct 2011
Prevention of extubation failure in high-risk patients with neuromuscular disease.
A substantial proportion of patients with neuromuscular disease (NMD) who undergo positive pressure ventilation via endotracheal intubation for acute respiratory failure fail to pass spontaneous breathing trials and should be considered at high risk for extubation failure. In our study, we prospectively investigated the efficacy of early application of noninvasive ventilation (NIV) combined with assisted coughing as an intervention aimed at preventing extubation failure in patients with NMD. ⋯ Preventive application of NIV combined with assisted coughing after extubation provides a clinically important advantage to patients with NMD by averting the need for reintubation or tracheostomy and shortening their stay in the RICU; its use should be included in the routine approach to patients with NMD at high risk for postextubation respiratory failure.
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Journal of critical care · Oct 2011
Acinetobacter baumannii infection in patients with hematologic malignancies in intensive care unit: risk factors and impact on mortality.
We investigated the characteristics of Acinetobacter baumannii infection in critically ill patients with hematologic malignancies. ⋯ Despite the high mortality rate in critically ill patients with hematologic malignancies, presence of A baumannii infection was not an independent risk factor for mortality.
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Journal of critical care · Oct 2011
Case ReportsProlonged acute care in a 52-year-old man with respiratory failure: lessons learned from 70-day intensive care unit hospitalization.
This study was undertaken to record the experiences of a patient who survived prolonged intensive care unit (ICU) care secondary to acute respiratory failure. ⋯ Patient debriefing may improve outcomes after prolonged acute care. Current survey instruments provide a good estimate of a patient's mental status. Patients themselves can provide important information about hospital care and areas needing improvement.
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Journal of critical care · Oct 2011
Vasopressor administration and sepsis: a survey of Canadian intensivists.
Patients with septic shock often receive intravenous vasopressor infusions, with little evidence available to guide their titration. We surveyed Canadian intensivists to document self-reported vasopressor titration strategies for patients with septic shock. ⋯ Self-reported vasopressor use for the treatment of septic shock is relatively uniform among Canadian intensivists; however, practice is variable in patients with chronic comorbidities or acute concurrent illnesses.
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Journal of critical care · Oct 2011
The impact of coagulation parameters on the outcomes of patients with severe community-acquired pneumonia requiring intensive care unit admission.
Coagulation abnormalities are frequent in patients with severe infections. However, the predictive value of d-dimer and of the presence of associated coagulation derangements in severe community-acquired pneumonia (CAP) remains to be thoroughly evaluated. The aim of this study was to investigate the predictive value of coagulation parameters in patients with severe CAP admitted to the intensive care unit. ⋯ d-Dimer levels are good predictors of outcome in severe CAP and may augment the predictive ability of scoring systems as APACHE II and SOFA.