Crit Care Resusc
-
Comparative Study
Characteristics and outcomes of patients subject to intensive care nurse consultant review in a teaching hospital.
To describe the evolution of our Intensive Care Nurse Consultant (ICNC) service, the characteristics and outcomes of the patients reviewed, and interventions performed. ⋯ Most interventions are relatively simple, and the ICNC role may be augmented by limited rights to prescribe electrolyte replacement. The effect of the intervention on patient outcomes and the reproducibility of our findings in other hospitals remain to be determined.
-
Case Reports
Normothermic extracorporeal human liver perfusion following donation after cardiac death.
Liver transplantation is a major life-saving procedure and donation after cardiac death (DCD) has increased the pool of potential liver donors. However, livers procured after DCD are at increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to protect, evaluate and, in future, transplant DCD livers. ⋯ We achieved NELP with evidence of liver function (bile production, paracetamol removal and control of ammonia, bilirubin and lactate levels) for 3 hours. There was essentially normal liver and biliary tract histology after 8 hours of perfusion. Our experiment justifies further investigation of the feasibility and efficacy of human DCD liver preservation by NELP.
-
To evaluate the efficacy of methylene blue in raising mean arterial pressure in hypotensive patients. ⋯ Methylene blue increases arterial blood pressure and systemic vascular resistances in vasoplegic patients without a detrimental effect on survival.