World journal of critical care medicine
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World J Crit Care Med · Feb 2017
Implementation of enteral feeding protocol in an intensive care unit: Before-and-after study.
To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. ⋯ The use of a nurse-driven feeding protocol improves the delivery of enteral nutrition in ICU patients without concomitant increases in gastrointestinal symptoms or intra-abdominal hypertension.
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World J Crit Care Med · Feb 2017
ReviewExertional rhabdomyolysis and heat stroke: Beware of volatile anesthetic sedation.
In view of the enormous popularity of mass sporting events such as half-marathons, the number of patients with exertional rhabdomyolysis or exercise-induced heat stroke admitted to intensive care units (ICUs) has increased over the last decade. Because these patients have been reported to be at risk for malignant hyperthermia during general anesthesia, the intensive care community should bear in mind that the same risk of life-threatening rhabdomyolysis is present when these patients are admitted to an ICU, and volatile anesthetic sedation is chosen as the sedative technique. As illustrated by the three case studies we elaborate upon, a thorough diagnostic work-up is needed to clarify the subsequent risk of strenuous exercise, and the anesthetic exposure to volatile agents in these patients and their families. Other contraindications for the use of volatile intensive care sedation consist of known malignant hyperthermia susceptibility, congenital myopathies, Duchenne muscular dystrophy, and intracranial hypertension.
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World J Crit Care Med · Feb 2017
Comparison of inhaled milrinone, nitric oxide and prostacyclin in acute respiratory distress syndrome.
To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). ⋯ When comparing the effects of inhaled NO, milrinone and epoprostenol, only NO significantly improved oxygenation. Inhaled milrinone appeared safe but failed to improve oxygenation in ARDS.
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World J Crit Care Med · Feb 2017
Timing, method and discontinuation of hydrocortisone administration for septic shock patients.
To characterize the prescribing patterns for hydrocortisone for patients with septic shock and perform an exploratory analysis in order to identify the variables associated with better outcomes. ⋯ Continuous infusion of hydrocortisone could hasten the resolution of septic shock compared to bolus administration. Earlier initiation corresponds with a higher probability of shock reversal. Tapering strategy is unnecessary.