Journal of critical care
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Journal of critical care · Jun 2011
The effects of vasoactive drugs on pulse pressure and stroke volume variation in postoperative ventilated patients.
Although pulse pressure variation (PPV) and stroke volume variation (SVV) during mechanical ventilation have been shown to predict preload responsiveness, the effect of vasoactive therapy on PPV and SVV is unknown. ⋯ Volume loading decreased PPV and SVV; and vasodilators increased both, consistent with their known cardiovascular effects. Thus, SVV and PPV can be used to drive fluid resuscitation algorithms in the setting of changing vasoactive drug therapy.
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Journal of critical care · Jun 2011
Survival and quality of life after tracheostomy for acute respiratory failure in patients with amyotrophic lateral sclerosis.
Acute respiratory failure (ARF) is a common event in the advanced stage of amyotrophic lateral sclerosis (ALS) and may be rarely a presenting symptom. Frequently, such patients require intubation and mechanical ventilation (MV) and, in a large proportion, receive tracheostomy, as a consequence of weaning failure. In our study, we investigated postdischarge survival and quality of life (QoL) after tracheostomy for ARF in patients with ALS. ⋯ Patients with ALS have a high chance of long-term survival after tracheostomy for ARF. Although administered at the time of a respiratory crisis without being discussed in advance, tracheostomy shows good acceptance and results in acceptable QoL.
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Journal of critical care · Jun 2011
Ventilator-associated pneumonia in critically ill stroke patients: frequency, risk factors, and outcomes.
Our main objective was to assess incidence, risk factors, and outcomes of ventilator-associated pneumonia (VAP) in stroke patients. ⋯ Pneumonia appears as a frequent problem in mechanically ventilated stroke patients. Chronic lung disease history, severity of stroke level at admission, and hemorrhagic transformation of stroke set the stage for developing VAP. The duration of both mechanical ventilation and intensive care unit stay gets significantly prolonged by VAP, but it does not affect mortality.
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Journal of critical care · Jun 2011
A polyurethane cuffed endotracheal tube is associated with decreased rates of ventilator-associated pneumonia.
The aim of this study was to determine whether the use of a polyurethane-cuffed endotracheal tube would result in a decrease in ventilator-associated pneumonia rate. ⋯ Use of a polyurethane-cuffed endotracheal tube was associated with a significant decrease in the rate of ventilator-associated pneumonia in our study.
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Journal of critical care · Jun 2011
Changes of heart and respiratory rate dynamics during weaning from mechanical ventilation: a study of physiologic complexity in surgical critically ill patients.
The aim of the study was to investigate heart rate (HR) and respiratory rate (RR) complexity in patients with weaning failure or success, using both linear and nonlinear techniques. ⋯ We suggest that nonlinear analysis of cardiorespiratory dynamics has increased prognostic impact upon weaning outcome in surgical patients.