International journal of critical illness and injury science
-
Int J Crit Illn Inj Sci · Apr 2015
Ultra fast-track extubation in heart transplant surgery patients.
Heart transplant surgeries using cardiopulmonary bypass (CPB) typically requires mechanical ventilation in intensive care units (ICU) in post-operation period. Ultra fast-track extubation (UFE) have been described in patients undergoing various cardiac surgeries. ⋯ Patients undergoing cardiac transplant could be managed with "ultra-fast-track extubation", without increased morbidity and mortality.
-
Int J Crit Illn Inj Sci · Apr 2015
Predictors of 1 year mortality in adult injured patients admitted to the trauma center.
Traditional approach to predicting trauma-related mortality utilizes scores based on anatomical, physiological, or a combination of both types of criteria. However, several factors are reported in literature to predict mortality independent of severity scores. The objectives of the study were to identify predictors of 1 year mortality and determine their magnitude and significance of association in a resource constrained scenario. ⋯ Multivariate analysis (logistic and Cox proportionate hazard analysis) and subsequent bootstrapping provide us with a set of factors which may be considered as valid predictors universally. However, since bootstrapping only provides limited estimates of external validity, there is a need to test these factors against the well accepted requirements of external validity namely population, ecological, and temporal validity.
-
Int J Crit Illn Inj Sci · Apr 2015
Comparative study on the prognosis of critical ill patients transferred from another island compared to those patients transferred from emergency department to intensive care unit.
To compare outcomes of critically ill patients transferred from another island compared to those patients with direct admission from Emergency Department to intensive care unit (ICU). ⋯ No differences were found in the global prognosis of the admitted patients transferred from another island compared to those who were admitted directly from the Emergency Department. There is no impact on mortality in transferring a patient in our study population.
-
Int J Crit Illn Inj Sci · Apr 2015
Cardiac dysfunction following brain death after severe pediatric traumatic brain injury: A preliminary study of 32 children.
Cardiac dysfunction after brain death has been described in a variety of brain injury paradigms but is not well understood after severe pediatric traumatic brain injury (TBI). Cardiac dysfunction may have implications for organ donation in this patient population. ⋯ The incidence of cardiac dysfunction is higher among pediatric severe TBI patients with a diagnosis of brain death, as compared to patients without brain death. This finding may have implications for cardiac organ donation from this population and deserves further study.
-
Int J Crit Illn Inj Sci · Apr 2015
Dynamic behavior of venous collapsibility and central venous pressure during standardized crystalloid bolus: A prospective, observational, pilot study.
Measurement of intravascular volume status is an ongoing challenge for physicians in the surgical intensive care unit (SICU). Most surrogates for volume status, including central venous pressure (CVP) and pulmonary artery wedge pressure, require invasive lines associated with a number of potential complications. Sonographic assessment of the collapsibility of the inferior vena cava (IVC) has been described as a noninvasive method for determining volume status. The purpose of this study was to analyze the dynamic response in IVC collapsibility index (IVC-CI) to changes in CVP in SICU patients receiving fluid boluses for volume resuscitation. ⋯ Observable changes in both VCI and CVP are apparent during an infusion of a standardized fluid bolus. Dynamic changes in VCI as a measurement of responsiveness to fluid bolus are inversely related to changes seen in CVP. Moreover, an IV bolus tends to produce an early response in VCI, while the CVP response is more gradual. Given the noninvasive nature of the measurement technique, VCI shows promise as a method of dynamically measuring patient response to fluid resuscitation. Further studies with larger sample sizes are warranted.