Intensive care medicine
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Intensive care medicine · Dec 2018
Comparative StudyPercutaneous versus surgical femoro-femoral veno-arterial ECMO: a propensity score matched study.
Femoral artery surgical cannulation is the reference for venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adults. However, the less invasive percutaneous approach has been associated with lower rates of complications. This retrospective study compared complication rates and overall survival in a large series of patients who received surgical or percutaneous peripheral VA-ECMO. ⋯ Compared to the surgical approach, percutaneous cannulation for peripheral VA-ECMO was associated with fewer local infections, similar rates of ischemia and sensory-motor complications and improved 30-day survival. The higher rate of vascular complications following decannulation suggests that improvements in cannula removal techniques are needed to further improve patients' outcomes after percutaneous cannulation.
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Intensive care medicine · Dec 2018
Development of an ICU discharge instrument predicting psychological morbidity: a multinational study.
To develop an instrument for use at ICU discharge for prediction of psychological problems in ICU survivors. ⋯ We developed an instrument to predict individual patients' risk for psychological problems 3 months post-ICU, http://www.imm.ki.se/biostatistics/calculators/psychmorb/ . The instrument can be used for triage of patients for psychological ICU follow-up.
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Ultrasound can be used to non-invasively and rapidly examine airway conditions, but vocal cord visualization with the traditional approaches is poor. Our aim was to compare the accuracies of front-side transverse-axis ultrasound (FTU), lateral-side longitudinal-axis ultrasound (LLU), and the combination of both approaches for vocal cord movement disorder diagnoses (e.g., vocal cord paralysis or arytenoid cartilage dislocation). ⋯ LLU can be used to evaluate arytenoid cartilage activity in ICUs, and the results are highly correlated with the diagnosis of nasal fiber-optic endoscopy. The combination of FTU and LLU shows promise as a rapid primary screening method for vocal cord injury.
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Intensive care medicine · Dec 2018
Relationship between height and outcomes among critically ill adults: a cohort study.
Many diagnostic and therapeutic interventions for critically ill adult patients are not performed according to patient size, but are standardized for an idealized 174-cm man (ideal body weight 70 kg). This study aims to determine whether critically ill patients with heights significantly different from a standardized patient have higher hospital mortality or greater resource utilization. ⋯ Short stature may be a risk factor for mortality in critically ill patients. Further work is needed to determine which unmeasured patient characteristics and processes of care may contribute to the increased risk observed.
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Abstract