Journal of critical care
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Journal of critical care · Jun 2004
Practice Guideline GuidelineClinical practice guideline for the use of noninvasive positive pressure ventilation in COPD patients with acute respiratory failure.
Noninvasive positive pressure ventilation has been demonstrated to be of benefit in preventing endotracheal intubation and reducing mortality in specific patients in the setting of acute exacerbations of chronic obstructive pulmonary disease. The successful application of noninvasive positive pressure ventilation depends on a multitude of factors, including patient selection, choice of interface, physician experience, and patient-ventilator synchrony. The use of clinical practice guidelines has been shown to improve the process and outcomes of care. This paper presents a guideline for the use of noninvasive positive pressure ventilation in the setting of acute ventilatory failure in patients with acute exacerbations of chronic obstructive pulmonary disease.
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Journal of critical care · Jun 2004
Intravenous immunoglobulin for severe infections: a survey of Canadian specialists.
To survey the opinions of Canadian critical care medicine and infectious disease specialists about the use of intravenous immunoglobulin (IVIG) for the treatment of severe infections. ⋯ Specialist's beliefs surrounding the efficacy of IVIG would challenge but not preclude the conduct of future placebo controlled trials of severe streptococcal infections in Canada.
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Journal of critical care · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of nebulized epinephrine and terbutaline in patients with acute severe asthma: a controlled trial.
To compare the efficacy and tolerability of nebulized adrenaline and terbutaline in acute severe asthma. ⋯ Adrenaline nebulization was as effective and as well tolerated as terbutaline in acute severe asthma. No synergistic effect between terbutaline and adrenaline was observed.
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Journal of critical care · Jun 2004
A content analysis of forms, guidelines, and other materials documenting end-of-life care in intensive care units.
The purpose of this study was to determine the extent to which data entry forms, guidelines, and other materials used for documentation in intensive care units (ICUs) attend to 6 key end-of-life care (EOLC) domains: 1) patient and family-centered decision making, 2) communication, 3) continuity of care, 4) emotional and practical support, 5) symptom management and comfort care, and 6) spiritual support. A second purpose was to determine how these materials might be modified to include more EOLC content and used to trigger clinical behaviors that might improve the quality of EOLC. ⋯ Inclusion of EOLC items on ICU formatted data entry forms and other materials capable of triggering and documenting clinician behaviors is limited, particularly for physicians. Standardized scales, protocols, and guidelines exist for many of the EOLC domains and should be evaluated for possible use in ICUs. Whether such materials can improve EOLC has yet to be determined.
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Journal of critical care · Jun 2004
Preoperative 24-hour urine amount as an independent predictor of renal outcome in poor cardiac function patients after coronary artery bypass grafting.
To investigate the incidence and the main pre-operative risk factors for the development of acute renal failure (ARF) in triple vessels coronary artery bypass grafting (CABG) with special reference to a subset of patients with poor cardiac function (ejection fraction <50%). ⋯ Preoperative 24-hour urine amount and pre-operative serum creatinine can provide valuable information for predicting the likelihood of developing acute renal failure and requiring dialysis in this subgroup of patients.