Intensive care medicine
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Intensive care medicine · Jun 2011
A modified technique for insertion of dual lumen bicaval cannulae for venovenous extracorporeal membrane oxygenation.
Venovenous extracorporeal membrane oxygenation is used increasingly in adults with severe acute reversible respiratory failure. Cannulation is associated with a risk of vascular damage or cardiac perforation. ⋯ We suggest that the technique may mitigate the risk of guidewire looping during insertion of the dilators/cannula and thereby reduce the risk of perforation of the right ventricle.
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Intensive care medicine · Jun 2011
ReviewNon-invasive ventilation in postoperative patients: a systematic review.
Postoperative pulmonary complications, generally defined as any pulmonary abnormality occurring in the postoperative period, are still a significant issue in clinical practice increasing hospital length of stay, morbidity and mortality. Non-invasive ventilation (NIV), primarily applied in cardiogenic pulmonary edema, decompensated COPD and hypoxemic pulmonary failure, is nowadays also used in perioperative settings. ⋯ Despite these limited data and the necessity of new randomized trials, NIV could be considered as a prophylactic and therapeutic tool to improve gas exchange in postoperative patients.
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Intensive care medicine · Jun 2011
ReviewThe effect of etomidate on adrenal function in critical illness: a systematic review.
Although etomidate is a preferred anesthetic agent for rapid sequence intubation (RSI) in critical illness, as an inhibitor of cortisol synthesis (11β-hydroxylase), it may be associated with adrenal dysfunction. The objectives are to review the effects of etomidate versus comparator anesthetics in critical illness for: primary outcome of mortality and secondary outcome of adrenal insufficiency (AI). ⋯ There is an increased rate of AI and mortality in critically ill patients who received etomidate.
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Intensive care medicine · Jun 2011
Multicenter StudyDose-related effect of smoking on mortality in critically ill patients: a multicentre cohort study.
It is uncertain whether smoking has an independent dose-related adverse effect on mortality in critically ill patients. This study assessed whether the intensity of smoking history, measured in pack-years, has a dose-related effect on mortality in critically ill patients. ⋯ Smoking has a dose-related adverse effect on mortality of critically ill patients after adjusting for other confounders.