Critical care medicine
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Critical care medicine · Sep 2016
Multicenter StudyCardiac Arrests Associated With Tracheal Intubations in PICUs: A Multicenter Cohort Study.
To determine the incidence and epidemiologic characteristics of cardiac arrests among tracheal intubations in PICUs. ⋯ Tracheal intubation-associated cardiac arrests occurred during 1.7% of PICU tracheal intubations. Tracheal intubation-associated cardiac arrests were much more common with tracheal intubations when the child had acute hemodynamic instability or oxygen failure and when the child had a history of difficult airway or cardiac disease.
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Critical care medicine · Sep 2016
Multicenter Study Observational StudyCoping as a Multifaceted Construct: Associations With Psychological Outcomes Among Family Members of Mechanical Ventilation Survivors.
To develop and evaluate a preliminary multifaceted model for coping among family members of patients who survive mechanical ventilation. ⋯ To our knowledge, this is the first study to explore coping as a multifaceted construct and its relationship with family psychological outcomes among survivors of mechanical ventilation. We found certain family characteristics of coping such as optimism, resilience, and social support to be associated with less psychological distress. Further research is warranted to identify potentially modifiable aspects of coping that might guide future interventions.
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Critical care medicine · Sep 2016
Multicenter StudyAutomatic Classification of Sedation Levels in ICU Patients Using Heart Rate Variability.
To explore the potential value of heart rate variability features for automated monitoring of sedation levels in mechanically ventilated ICU patients. ⋯ With further refinement, the methodology reported herein could lead to a fully automated system for depth of sedation monitoring. By enabling monitoring to be continuous, such technology may help clinical staff to monitor sedation levels more effectively and to reduce complications related to over- and undersedation.
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Critical care medicine · Sep 2016
Predicting Intracranial Pressure and Brain Tissue Oxygen Crises in Patients With Severe Traumatic Brain Injury.
To develop computer algorithms that can recognize physiologic patterns in traumatic brain injury patients that occur in advance of intracranial pressure and partial brain tissue oxygenation crises. The automated early detection of crisis precursors can provide clinicians with time to intervene in order to prevent or mitigate secondary brain injury. ⋯ Our algorithms provide accurate and timely predictions of intracranial hypertension and tissue hypoxia crises in patients with severe traumatic brain injury. Almost all of the information needed to predict the onset of these events is contained within the signal of interest and the time since last crisis.
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Critical care medicine · Sep 2016
Multicenter StudyCerebral Oximetry During Cardiac Arrest: A Multicenter Study of Neurologic Outcomes and Survival.
Cardiac arrest is associated with morbidity and mortality because of cerebral ischemia. Therefore, we tested the hypothesis that higher regional cerebral oxygenation during resuscitation is associated with improved return of spontaneous circulation, survival, and neurologic outcomes at hospital discharge. We further examined the validity of regional cerebral oxygenation as a test to predict these outcomes. ⋯ Cerebral oximetry allows real-time, noninvasive cerebral oxygenation monitoring during cardiopulmonary resuscitation. Higher cerebral oxygenation during cardiopulmonary resuscitation is associated with return of spontaneous circulation and neurologically favorable survival to hospital discharge. Achieving higher regional cerebral oxygenation during resuscitation may optimize the chances of cardiac arrest favorable outcomes.