Critical care medicine
-
Critical care medicine · Nov 2017
Multicenter StudyHypoxemic Patients With Bilateral Infiltrates Treated With High-Flow Nasal Cannula Present a Similar Pattern of Biomarkers of Inflammation and Injury to Acute Respiratory Distress Syndrome Patients.
To examine whether patients with acute hypoxemia and bilateral opacities treated with high-flow nasal cannula and acute respiratory distress syndrome patients who were directly mechanically ventilated are similar in terms of lung epithelial, endothelial, and inflammatory biomarkers. ⋯ Acute hypoxemic patients with bilateral infiltrates treated with high-flow nasal cannula presented a similar pattern of biomarkers of inflammation and injury to acute respiratory distress syndrome patients undergoing direct mechanical ventilation. The results suggest that these high-flow nasal cannula patients should be considered as acute respiratory distress syndrome patients.
-
Critical care medicine · Nov 2017
Randomized Controlled Trial Multicenter StudyBrain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II: A Phase II Randomized Trial.
Brain tissue oxygentation monitoring after severe traumatic brain injury may improve mortality and neurological morbidity compared with ICP monitoring alone.
pearl -
Critical care medicine · Nov 2017
Review Meta AnalysisAntifungal Prevention of Systemic Candidiasis in Immunocompetent ICU Adults: Systematic Review and Meta-Analysis of Clinical Trials.
The aim of this study was to identify the impact of antifungal prevention in critically ill immunocompetent adult patients on mortality and subsequent infection. ⋯ Antifungal prevention of systemic candidiasis in immunocompetent critically ill adults did not reduce mortality and may have decreased secondary fungal infection rates. However, significant publication bias was present.
-
Critical care medicine · Nov 2017
Predicting Fluid Responsiveness in Critically Ill Patients by Using Combined End-Expiratory and End-Inspiratory Occlusions With Echocardiography.
First, we aimed at assessing whether fluid responsiveness is predicted by the effects of an end-expiratory occlusion on the velocity-time integral of the left ventricular outflow tract. Second, we investigated whether adding the effects of an end-inspiratory occlusion and of an end-expiratory occlusion on velocity-time integral can predict fluid responsiveness with similar reliability than end-expiratory occlusion alone but with a higher threshold, which might be more compatible with the precision of echocardiography. ⋯ If consecutive end-inspiratory occlusion and end-expiratory occlusion change velocity-time integral is greater than or equal to 13% in total, fluid responsiveness is accurately predicted. This threshold is more compatible with the precision of echocardiography than that obtained by end-expiratory occlusion alone.