Critical care medicine
-
Critical care medicine · Sep 2012
Comparative StudyEffects of fluid resuscitation with synthetic colloids or crystalloids alone on shock reversal, fluid balance, and patient outcomes in patients with severe sepsis: a prospective sequential analysis.
To assess shock reversal and required fluid volumes in patients with septic shock. ⋯ Shock reversal was achieved equally fast with synthetic colloids or crystalloids. Use of colloids resulted in only marginally lower required volumes of resuscitation fluid. Both low molecular weight hydroxyethyl starch and gelatin may impair renal function.
-
Critical care medicine · Sep 2012
Randomized Controlled Trial Comparative StudyEffect of high-frequency chest wall oscillation on pulmonary function after pulmonary lobectomy for non-small cell lung cancer.
We examined the feasibility of high-frequency chest wall oscillationtherapy in immediate postoperative lung recruitment after pulmonary lobectomy for non-small cell lung cancer compared to conventional chest physiotherapy. ⋯ High-frequency chest wall oscillation therapy after pulmonary lobectomy resulted in significantly improved immediate postoperative pulmonary function recovery compared to conventional physiotherapy, without any significant adverse effects. These results suggest that high-frequency chest wall oscillation therapy may be a valuable tool in the postoperative care of non-small cell lung cancer patients with lobectomy.
-
Critical care medicine · Sep 2012
Comparative StudySustained effectiveness of a primary-team-based rapid response system.
Laws and regulations require many hospitals to implement rapid-response systems. However, the optimal resource intensity for such systems is unknown. We sought to determine whether a rapid-response system that relied on a patient's usual care providers, not a critical-care-trained rapid-response team, would improve patient outcomes. ⋯ A primary-team-based implementation of a rapid response system was independently associated with reduced unexpected mortality. This system relied on the patient's usual care providers, not an intensive care unit based rapid response team, and may offer a more cost-effective approach to rapid response systems, particularly for systems with limited intensivist availability.