Crit Care Resusc
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To determine whether serum troponin I (TnI), measured 4 hours after surgery for congenital heart disease, is a predictor of myocardial dysfunction and low cardiac output syndrome (LCOS). ⋯ Measurement of early postoperative levels of TnI may aid in the early identification of children who will develop LCOS.
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To develop an outcome measure as a basis for prescribing and evaluating rehabilitation in the critically ill, and to measure its reliability and responsiveness to change. The study also aimed to assess the feasibility and safety of a pilot exercise training protocol in an intensive care unit. ⋯ The PFIT is a reliable and responsive outcome measure, and the pilot training protocol was safe and feasible. As exercise may attenuate weakness and functional impairment, the PFIT can be used to prescribe and evaluate exercise and mobilisation. Future research should aim to develop a PFIT score and investigate the ability of the PFIT to predict ICU readmission risk and functional outcome.
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To evaluate outcomes of patients admitted to an intensive care unit with idiopathic pulmonary fibrosis (IPF) and acute respiratory deterioration. ⋯ Outcomes of patients with IPF admitted to the ICU are poor. Indications for mechanical ventilation appear uncertain.
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Despite government encouragement for patients to make advance plans for medical treatment, and the increasing numbers of patients who have done this, there is little research that examines how doctors regard these plans. ⋯ Many intensive care doctors believe end-oflife decisions remain medical decisions, and MEPAs and ACPs need only be respected when they accord with the doctor's treatment decision. This study suggests a need for further education of doctors, particularly those working in intensive care, who are responsible for initiating and maintaining life support treatment.
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Editorial Comment
Treating intracranial hypertension: time to abandon mannitol?