Critical care medicine
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Critical care medicine · Jan 2014
Randomized Controlled Trial Multicenter StudyEffect of Oropharyngeal Povidone-Iodine Preventive Oral Care on Ventilator-Associated Pneumonia in Severely Brain-Injured or Cerebral Hemorrhage Patients: A Multicenter, Randomized Controlled Trial.
To evaluate the efficacy and safety of oral care with povidone-iodine on the occurrence of ventilator-associated pneumonia in a high-risk population. ⋯ There is no evidence to recommend oral care with povidone-iodine to prevent ventilator-associated pneumonia in high-risk patients. Furthermore, this strategy seems to increase the rate of acute respiratory distress syndrome.
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Critical care medicine · Jan 2014
Review Meta AnalysisCritical Care Transition Programs and the Risk of Readmission or Death After Discharge From an ICU: A Systematic Review and Meta-Analysis.
To determine whether critical care transition programs reduce the risk of ICU readmission or death, when compared with standard care among adults who survived their incident ICU admission. ⋯ Critical care transition programs appear to reduce the risk of ICU readmission in patients discharged from ICU to a general hospital ward. Given methodological limitations of the included before-and-after studies, additional research should confirm these observations and explore the ideal model for these programs before recommending implementation.
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Critical care medicine · Jan 2014
Review Meta AnalysisAdvanced Airway Management Simulation Training in Medical Education: A Systematic Review and Meta-Analysis.
To perform a systematic review and meta-analysis of the literature on teaching airway management using technology-enhanced simulation. ⋯ Simulation-based airway management curriculum is superior to no intervention and nonsimulation intervention for important education outcomes. Further research is required to fine-tune optimal curricular design.
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Critical care medicine · Jan 2014
Randomized Controlled TrialEffects of Propofol on Patient-Ventilator Synchrony and Interaction During Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist.
Evaluating the physiologic effects of varying depths of propofol sedation on patient-ventilator interaction and synchrony during pressure support ventilation and neurally adjusted ventilatory assist. ⋯ In pressure support ventilation, deep propofol sedation increased asynchronies, while light sedation did not. Propofol reduced the respiratory drive, while breathing timing was not significantly affected. Gas exchange and breathing pattern were also influenced by propofol infusion to an extent that varied with the depth of sedation and the mode of ventilation.