Journal of critical care
-
Journal of critical care · Dec 2009
Multicenter StudyBehavioral and physiologic indicators during a nociceptive procedure in conscious and unconscious mechanically ventilated adults: similar or different?
The purpose of this study was to describe behavioral and physiologic indicators to a nociceptive procedure in conscious and unconscious mechanically ventilated adults and to examine their association with the patients' self-reports of pain. ⋯ The use of behaviors is strongly recommended for pain assessment in unconscious patients, and results from this study support this clinical guideline. Vital signs should be used with caution for the detection of pain as they can be influenced by other factors besides pain.
-
Journal of critical care · Dec 2009
Constipation in intensive care unit: incidence and risk factors.
Although gastrointestinal motility disorders are common in critically ill patients, constipation and its implications have received very little attention. We aimed to determine the incidence of constipation to find risk factors and its implications in critically ill patients ⋯ Constipation is very common among critically ill patients. Early enteral nutrition is associated with earlier return of bowel function.
-
Journal of critical care · Dec 2009
Clinical TrialInfluence of hypercapnia on cardiovascular responses to tracheal intubation.
Laryngoscopy and tracheal intubation are often associated with tachycardia, hypertension, and arrhythmias. There is a risk of hypercapnia in the case of difficult mask ventilation. The circulatory response to hypercapnia is increases in arterial pressure and heart rate. We evaluated the difference of cardiovascular responses to tracheal intubation between normocapnia and hypercapnia during mask ventilation before tracheal intubation. ⋯ Hypercapnia during mask ventilation before tracheal intubation may exaggerate the increase of SAP during intubation compared to normocapnia. Ventilation was important in minimizing hemodynamic responses during induction regardless of using drugs.
-
Journal of critical care · Dec 2009
Drotrecogin alfa (activated) for severe sepsis: could we consider a shorter treatment period in patients with a favorable course?
The objective of this study was to develop a model to identify patients in whom drotrecogin alfa (activated) (DAA) might be administered for periods shorter than the recommended 96 hours. ⋯ A simple model based on sequential organ failure assessment score and arterial pH can help identify patients with a rapid favorable course in whom a shorter duration of DAA treatment may be justified.