Critical care medicine
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Critical care medicine · Apr 2017
Review Meta AnalysisThe Effect of High-Flow Nasal Cannula Oxygen Therapy on Mortality and Intubation Rate in Acute Respiratory Failure: A Systematic Review and Meta-Analysis.
High-flow nasal cannulae are used in adults with or at risk of acute respiratory failure. We conducted a systematic review and meta-analysis to evaluate the evidence for their use in this setting. ⋯ No difference in mortality or intubation was detected in patients with acute respiratory failure treated with high-flow nasal cannulae compared with usual care. High-flow nasal cannulae seem well tolerated by patients. Further large randomized controlled trials are required to evaluate their utility in this setting.
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Critical care medicine · Apr 2017
Review Meta AnalysisDiagnostic Accuracy of Central Venous Catheter Confirmation by Bedside Ultrasound Versus Chest Radiography in Critically Ill Patients: A Systematic Review and Meta-Analysis.
We performed a systematic review and meta-analysis to examine the accuracy of bedside ultrasound for confirmation of central venous catheter position and exclusion of pneumothorax compared with chest radiography. ⋯ Bedside ultrasound is faster than radiography at identifying pneumothorax after central venous catheter insertion. When a central venous catheter malposition exists, bedside ultrasound will identify four out of every five earlier than chest radiography.
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Critical care medicine · Apr 2017
Controlled Clinical TrialA Quasi-Experimental, Before-After Trial Examining the Impact of an Emergency Department Mechanical Ventilator Protocol on Clinical Outcomes and Lung-Protective Ventilation in Acute Respiratory Distress Syndrome.
To evaluate the impact of an emergency department mechanical ventilation protocol on clinical outcomes and adherence to lung-protective ventilation in patients with acute respiratory distress syndrome. ⋯ This before-after study of mechanically ventilated patients with acute respiratory distress syndrome demonstrates that implementing a mechanical ventilator protocol in the emergency department is feasible and associated with improved clinical outcomes.
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Critical care medicine · Apr 2017
Multicenter Study Observational StudyDelirium in Critically Ill Children: An International Point Prevalence Study.
To determine prevalence of delirium in critically ill children and explore associated risk factors. ⋯ Delirium is a prevalent complication of critical illness in children, with identifiable risk factors. Further multi-institutional, longitudinal studies are required to investigate effect of delirium on long-term outcomes and possible preventive and treatment measures. Universal delirium screening is practical and can be implemented in pediatric critical care units.