Journal of critical care
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Journal of critical care · Jun 2006
Comparative StudyDaily evaluation of organ function during renal replacement therapy in intensive care unit patients with acute renal failure.
The aim of this study was to assess changes in organ function in acute renal failure patients during renal replacement therapy and relate them to outcome. ⋯ Assessment of these factors in the first 24 hours of renal replacement therapy could help identify patients at higher risk of mortality early during their ICU admission.
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Journal of critical care · Jun 2006
Comparative StudyProspective comparative study on the hemodynamic and functional consequences of arterial monitoring catheters in intensive care patients on the short and long term.
In intensive care wards, arterial catheters are a relevant instrument to monitor vital functions. However, the effect of arterial catheterization on hemodynamic function in elective patients in the short and long term is unknown. ⋯ There is significant change in the hemodynamic function of the artery 1 day and 5 days after removal, but this significant change disappears after 30 days. An arterial monitoring catheter causes a functional arterial change in the affected arm in the short term and no significant difference in the long term. Therefore, arterial catheterization is a safe procedure after short-term cannulation. Second, the systolic blood pressure ratio of the a. radialis/a. ulnaris is a valuable tool in the assessment of the hemodynamic function of the a. radialis after radial cannulation.
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Journal of critical care · Jun 2006
Predictors of extubation failure in patients with chronic obstructive pulmonary disease.
Few studies have focused on extubation outcome in patients with chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation (MV). We conducted a study using prospectively collected data in a cohort of patients with COPD requiring invasive MV to identify variables associated with extubation failure. Use of noninvasive or invasive MV within 48 hours after extubation was defined as extubation failure. ⋯ Despite high rate of extubation failure, survival to ICU discharge was 91% of the studied population. Extubation failure in patients with COPD remains high despite a successful spontaneous breathing on T piece. Simplified Acute Physiology Score II at ICU admission, home noninvasive MV, and isolated pathogens on quantitative cultures of tracheobronchial secretions within 72 hours preceding extubation were predictors of extubation failure in the study population.
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Journal of critical care · Jun 2006
Milrinone improves oxygenation in neonates with severe persistent pulmonary hypertension of the newborn.
Many neonates with severe persistent pulmonary hypertension of the newborn (PPHN) are nonresponders to inhaled nitric oxide (iNO). Milrinone is a promising adjunctive therapy because of its pulmonary vasodilator properties and cardiotropic effects. ⋯ Intravenous milrinone produces early improvements in oxygenation without compromising systemic blood pressure.
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Journal of critical care · Jun 2006
Transthoracic ultrasound approach of thoracic aorta in critically ill patients with lung consolidation.
Normally, the aortic arch and the descending aorta are not visible using transthoracic ultrasonography. We hypothesize that lung consolidation of upper and lower lobes, by opening an acoustic window, may allow the ultrasound examination of the thoracic aorta. ⋯ In critically ill patients, the presence of consolidated upper and left lower lobes may allow the ultrasound examination of the different parts of the thoracic aorta.