Articles: function.
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Minerva anestesiologica · Feb 2014
Observational StudyUse of B-type natriuretic peptides to detect the existence and severity of diastolic dysfunction in non-cardiac critically ill patients: a pilot study.
This observational study was designed to evaluate and compare the usefulness of BNP and NT-proBNP concentrations to detect the existence and severity of left ventricular diastolic dysfunction (LVDD) in critically ill patients. ⋯ Both BNP and NT-proBNP are useful screening tools to detect the presence of advanced degrees of LVDD, and especially to rule out elevated filling pressures.
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Critical care nurse · Feb 2014
The importance of tracheostomy progression in the intensive care unit.
A plan to progress a tracheostomy toward decannulation should be initiated unless the tracheostomy has been placed for irreversible conditions. In most cases, tracheostomy progression can begin once a patient is free from ventilator dependence. ⋯ A systematic approach to tracheostomy progression involves assessing (1) hemodynamic stability, (2) whether the patient has been free from ventilator support for at least 24 hours, (3) swallowing, cough strength, and aspiration risk, (4) management of secretions, and (5) toleration of cuff deflation, followed by (6) changing to a cuffless tube, (7) capping trials, (8) functional decannulation trials, (9) measuring cough strength, and (10) decannulation. Critical care nurses can facilitate the process and avoid unnecessary delays and complications.
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Critical care medicine · Feb 2014
Inhibiting the Toll-Like Receptor 4 Toll/Interleukin-1 Receptor Domain Protects Against Hepatic Warm Ischemia and Reperfusion Injury in Mice.
During Toll-like receptor 4 signaling, the Toll/interleukin-1 receptor domain is essential for interactions with downstream Toll/interleukin-1 receptor domain-containing adaptor proteins. The aim of this study is to investigate the role of the Toll/interleukin-1 receptor domain in the Toll-like receptor 4 signaling pathway during hepatic ischemia and reperfusion injury. ⋯ Toll/interleukin-1 receptor domain inhibition disrupts the interaction of Toll-like receptor 4 with its adaptor proteins, which abrogates downstream signaling pathways and prevents the activation of nuclear factor-κB and Jun N-terminal kinase/p38. This reduction in signaling consequently reduces hepatic inflammation, cell apoptosis, and hepatic damage. Toll/interleukin-1 receptor domain-targeted therapy thus represents a new approach to inhibit the intracellular Toll-like receptor 4 signaling pathway and reveals novel therapeutic target sites, which will facilitate the development of specific therapeutic agents.
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Anesthesia and analgesia · Feb 2014
ReviewDNA testing for malignant hyperthermia: the reality and the dream.
The advent of the polymerase chain reaction and the availability of data from various global human genome projects should make it possible, using a DNA sample isolated from white blood cells, to diagnose rapidly and accurately almost any monogenic condition resulting from single nucleotide changes. DNA-based diagnosis for malignant hyperthermia (MH) is an attractive proposition, because it could replace the invasive and morbid caffeine-halothane/in vitro contracture tests of skeletal muscle biopsy tissue. Moreover, MH is preventable if an accurate diagnosis of susceptibility can be made before general anesthesia, the most common trigger of an MH episode. ⋯ This will remain the bottleneck unless high throughput platforms can be designed for functional work. Analysis of entire genomes from several individuals simultaneously is a reality. DNA testing for MH, based on current criteria, remains the dream.