Critical care : the official journal of the Critical Care Forum
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Our objective was to determine the effect of ventilator-associated tracheobronchitis (VAT) on outcome in patients without chronic respiratory failure. ⋯ VAT is associated with longer durations of mechanical ventilation and ICU stay in patients not suffering from chronic respiratory failure.
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Randomized Controlled Trial Multicenter Study Comparative Study
Decreased duration of mechanical ventilation when comparing analgesia-based sedation using remifentanil with standard hypnotic-based sedation for up to 10 days in intensive care unit patients: a randomised trial [ISRCTN47583497].
This randomised, open-label, multicentre study compared the safety and efficacy of an analgesia-based sedation regime using remifentanil with a conventional hypnotic-based sedation regime in critically ill patients requiring prolonged mechanical ventilation for up to 10 days. ⋯ Analgesia-based sedation with remifentanil was well tolerated; it reduces the duration of mechanical ventilation and improves the weaning process compared with standard hypnotic-based sedation regimes in ICU patients requiring long-term ventilation for up to 10 days.
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The science and technology of CPR is only just emerging from its infancy. However, substantial improvements are anticipated, including the ability of lay rescuers to identify cardiac arrest promptly, the availability of additional measurements, and expanded intelligence provided by expanded AEDs with which to more effectively prompt the rescuer through the resuscitation procedure. ⋯ Better timing and better waveforms for defibrillation are emerging. The recognition of the importance of postresuscitation myocardial dysfunction and the selection of better vasopressor agents to minimize the adverse inotropic and chronotropic actions of adrenergic drugs are also likely to improve outcomes of CPR.
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Multicenter Study
Isolation of Aspergillus spp. from the respiratory tract in critically ill patients: risk factors, clinical presentation and outcome.
Our aims were to assess risk factors, clinical features, management and outcomes in critically ill patients in whom Aspergillus spp. were isolated from respiratory secretions, using a database from a study designed to assess fungal infections. ⋯ In critically ill patients, treatment should be considered if features of pulmonary infection are present and Aspergillus spp. are isolated from respiratory secretions.
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Anemia is a common problem in critically ill patients. The etiology of anemia of critical illness is often determined to be multifactorial in the clinical setting, but the pathophysiology remains to be elucidated. Erythropoietin (EPO) is an endogenous glycoprotein hormone that serves as the primary stimulus for erythropoiesis. Recent evidence has demonstrated a blunted EPO response as a factor contributing to anemia of critical illness in specific subsets of patients. Critically ill patients requiring mechanical ventilation who exhibit anemia have not been the subject of previous studies. Our goal was to evaluate the erythropoietic response to anemia in the critically ill mechanically ventilated patient. ⋯ Mechanically ventilated patients demonstrate a blunted EPO response to anemia. Further study of therapies directed at treating anemia of critical illness and evaluating its potential impact on mechanical ventilation outcomes and mortality is warranted.