Crit Care Resusc
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Randomized Controlled Trial
Increased brain tissue oxygen tension in children with traumatic brain injury using temperature-corrected guided ventilation during prophylactic hypothermia.
To investigate whether ventilatory management using a temperature-corrected (pH-stat) or uncorrected (alpha-stat) blood gas analysis strategy improves brain tissue oxygen tension (PbrO(2)) in children prophylactically treated with moderate hypothermia for traumatic brain injury. ⋯ PbrO(2) may be improved using a pH-stat blood gas management strategy in prophylactic hypothermia for paediatric patients with traumatic brain injury without any clinically relevant increase in ICP.
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Paracetamol is one of the commonest medications used worldwide. This review was conceived as a consequence of evaluating the literature in the protocol development of two randomised, controlled clinical trials investigating the safety and efficacy of paracetamol in ICU patients (the HEAT [Permissive HyperthErmiA Through Avoidance of Paracetamol in Known or Suspected Infection in the Intensive Care Unit] study; the Paracetamol After traumatic Brain Injury [PARITY] Study). ⋯ Despite the widespread use of paracetamol in critical illness, there is a paucity of data supporting its utility in this setting. Further research is required to determine how paracetamol should be used in the critically ill.
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We describe a case of a 51-year-old man who ingested methylene chloride and presented with the classical clinical features. He developed an acute abdomen that required repeated laparotomy. The effect of an ethanol infusion on carboxyhaemoglobin concentrations in this case was also of interest and could potentially be a new treatment modality.
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Intensive care patients with traumatic brain injury (TBI) are at high risk of developing deep vein thrombosis (DVT). A high rate of DVT was reported before routine thromboprophylaxis, but the current DVT rate in TBI patients receiving best-practice mechanical and pharmacological prophylaxis is unknown. ⋯ Mechanical and pharmacological prophylaxis appeared to be effective. The incidence of clinically identified PE is of concern and suggests that thromboembolic sources other than large leg veins may not be being adequately controlled by modern thromboprophylaxis regimens.
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Comparative Study
Relationship between illness severity scores in acute kidney injury.
In the field of critical care nephrology, recent publications have used different illness severity scoring systems, making outcome comparisons difficult. ⋯ Simple, robust translational formulae can be developed to allow clinicians to compare illness severity of patients with AKI when illness severity is expressed with different scoring systems.