Journal of critical care
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Journal of critical care · Mar 2010
Usefulness of intra-abdominal pressure in a predominantly medical intensive care unit.
The deleterious effects of elevated intra-abdominal pressure (IAP) have been known for more than a century. The proposed objectives were to measure changes in IAP and analyze increase-related factors and complications and whether high IAP and its persistence are related to complications and mortality in a predominantly medical intensive care unit. ⋯ In this study, a threshold IAP of 20 mm Hg and its permanence over time were the best predictive factors of complications and mortality. Among other relationships, we also observed that older patients had higher IAP. High IAP was a cause of intolerance to enteral nutrition.
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Journal of critical care · Dec 2009
Differences in acid-base behavior between intensive care unit survivors and nonsurvivors using both a physicochemical and a standard base excess approach: a prospective, observational study.
This study aimed to test the hypothesis that intensive care unit survivors and nonsurvivors differ with regard to type and severity of acid-base disorders. ⋯ Intensive care unit survivors and nonsurvivors differed in the severity of metabolic acidosis; however, the proportion of the different anions causing the acidosis on admission was similar between these 2 groups.
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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.
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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.