Journal of critical care
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Journal of critical care · Apr 2012
High-frequency oscillatory ventilation with and without arteriovenous extracorporeal lung assist in patients with severe respiratory failure.
Elimination of carbon dioxide by an arteriovenous extracorporeal lung assist (av-ECLA) can facilitate the lung protective capabilities of high-frequency oscillatory ventilation (HFOV). This case series describes patients treated with HFOV because of severe respiratory failure with and without additional av-ECLA. ⋯ High-frequency oscillatory ventilation improved the oxygenation in patients with severe respiratory failure. Additional av-ECLA may facilitate using lung protective HFOV settings in more severe lung injury and hypercapnia.
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Journal of critical care · Apr 2012
High-frequency oscillatory ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease.
High-frequency oscillatory ventilation (HFOV) is usually considered not indicated for treatment of patients with chronic obstructive pulmonary disease (COPD) because of the theoretical risk of air trapping and hyperinflation. The aim of our study was to establish whether HFOV can be safely applied in patients with acute exacerbation of COPD and hypercapnic respiratory failure. ⋯ Our study indicates that short-term HFOV, using lower mean airway pressures than recommended for acute respiratory distress syndrome, appears safe in patients with COPD while securing adequate pulmonary gas exchange.
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Journal of critical care · Apr 2012
Stress hyperglycemia may not be harmful in critically ill patients with sepsis.
Stress hyperglycemia (SH) is commonly seen in critically ill patients. It has been shown to be associated with adverse outcomes in some groups of patients. The effects of SH on critically ill patients with sepsis have not been well studied. We aimed to evaluate the effects of SH in critically ill patients with sepsis. ⋯ Stress hyperglycemia may not be harmful in critically ill patients with sepsis. Patients with SH had lower ICU mortality.
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Journal of critical care · Apr 2012
The association of mean glucose level and glucose variability with intensive care unit mortality in patients with severe acute pancreatitis.
The objective of this study was to retrospectively analyze the association of mean glucose level (MGL) and glycemic lability index (GLI; as a measure of glucose variability) with intensive care unit (ICU) mortality in patients with severe acute pancreatitis (SAP). ⋯ We observed that GLI was a better predictor of ICU and hospital mortality than was MGL. Together with the second 24-hour APACHE II score and the number of organ failures upon ICU admission, GLI is an independent predictor of mortality in patients with SAP.
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Journal of critical care · Apr 2012
Relationship between the timing of administration of IgM and IgA enriched immunoglobulins in patients with severe sepsis and septic shock and the outcome: a retrospective analysis.
Because the use of IgM and IgA enriched polyclonal intravenous immunoglobulins (eIg) is a standard of care in critically ill patients admitted to our intensive care unit (ICU) with the diagnosis of severe sepsis or septic shock, we investigated if the delay from the onset of severe sepsis and septic shock and their administration could influence the outcome. ⋯ The efficacy of eIg, being maximal in early phases of severe sepsis and/or septic shock, is probably time dependent.