Journal of critical care
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Journal of critical care · Sep 2009
Assessing the predictive value of the bispectral index vs patient state index on clinical assessment of sedation in postoperative cardiac surgery patients.
To compare the depth of sedation determined by Ramsay sedation scale (RSS) with electroencephalogram-based bispectral index (BIS) and patient state index (PSI). ⋯ There is significant positive correlation between the BIS and PSI but poor correlation and poor test agreement between the RSS and BIS as well as RSS and PSI. The BIS is a better predictor of oversedation compared with the PSI. There was no significant difference between the BIS and PSI with respect to the prediction of undersedation.
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Journal of critical care · Sep 2009
Randomized Controlled Trial Multicenter StudyA controlled trial of noninvasive ventilation for chronic obstructive pulmonary disease exacerbations.
This prospective, multicenter, double-blind, placebo-controlled study tested the hypothesis that noninvasive positive pressure ventilation reduces the need for endotracheal intubation in patients hospitalized in a pulmonary ward because of acute exacerbation of chronic obstructive pulmonary disease. ⋯ These results demonstrate that noninvasive positive pressure ventilation, in a pulmonary ward, reduces the need for endotracheal intubation, particularly in the more severe patients, and leads to a faster recovery in patients with acute exacerbation of chronic obstructive pulmonary disease.
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Journal of critical care · Sep 2009
Effect of interhospital transfer on resource utilization and outcomes at a tertiary pediatric intensive care unit.
The study aimed to examine the effect of interhospital transfer on resource utilization and clinical outcomes at a tertiary pediatric intensive care unit (PICU) among patients with sepsis or respiratory failure. ⋯ Interhospital transfer, particularly inter-PICU transfer, was associated with significant hospital resource consumption that often correlated with admission illness severity. Future prospective studies should identify determinants of pretransfer illness severity and investigate decision making underlying interhospital transfer.
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The aim of this study was to evaluate the factors related to outcome regarding in-intensive care unit (ICU) cardiac arrest (IICA) in a university hospital. ⋯ Shorter resuscitation duration and initial VT/VF are predictors for both ROSC and hospital survival, whereas lower Acute Physiology and Chronic Health Evaluation II scores predict the latter.
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Journal of critical care · Sep 2009
Effects of inhalational bronchodilator treatment during noninvasive ventilation in severe chronic obstructive pulmonary disease exacerbations.
To study the effects of withdrawing noninvasive ventilation (NIV) used during acute exacerbation of chronic obstructive pulmonary disease for the delivery of aerosolized medications on physiologic parameters and dyspnea sensation. ⋯ Short-term cessation of NIV for nebulization treatment did not result in distress, discomfort, or physiologic instabilities. The only detectable changes were increase in SBP and HR, probably due to the systemic adrenergic effects of salbutamol.