Critical care medicine
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Critical care medicine · May 2015
Inhibition of Forkhead BoxO-Specific Transcription Prevents Mechanical Ventilation-Induced Diaphragm Dysfunction.
Mechanical ventilation is a lifesaving measure for patients with respiratory failure. However, prolonged mechanical ventilation results in diaphragm weakness, which contributes to problems in weaning from the ventilator. Therefore, identifying the signaling pathways responsible for mechanical ventilation-induced diaphragm weakness is essential to developing effective countermeasures to combat this important problem. In this regard, the forkhead boxO family of transcription factors is activated in the diaphragm during mechanical ventilation, and forkhead boxO-specific transcription can lead to enhanced proteolysis and muscle protein breakdown. Currently, the role that forkhead boxO activation plays in the development of mechanical ventilation-induced diaphragm weakness remains unknown. ⋯ Forkhead boxO is necessary for the activation of key proteolytic systems essential for mechanical ventilation-induced diaphragm atrophy and contractile dysfunction. Collectively, these results suggest that targeting forkhead boxO transcription could be a key therapeutic target to combat ventilator-induced diaphragm dysfunction.
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Critical care medicine · May 2015
Randomized Controlled Trial Multicenter StudyImproving Use of Targeted Temperature Management After Out-of-Hospital Cardiac Arrest: A Stepped Wedge Cluster Randomized Controlled Trial.
International guidelines recommend use of targeted temperature management following resuscitation from out-of-hospital cardiac arrest. This treatment, however, is often neglected or delayed. ⋯ Simple quality improvement interventions significantly increased the rates of achieving successful targeted temperature management following out-of-hospital cardiac arrest in a large network of hospitals but did not improve clinical outcomes.
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Critical care medicine · May 2015
Randomized Controlled Trial Comparative StudyVolatile-Based Short-Term Sedation in Cardiac Surgical Patients: A Prospective Randomized Controlled Trial.
To evaluate the differences in extubation times in a group of cardiac surgical patients who were anesthetized and sedated with either IV propofol or inhaled volatile anesthetic agents. ⋯ Inhaled volatile anesthesia and sedation facilitates faster extubation times in comparison with IV propofol for patient undergoing coronary artery bypass graft surgery.