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
Prognosis and 1-year mortality of intensive care unit patients with severe hepatic encephalopathy.
Data regarding outcome of patients with chronic liver disease with severe hepatic encephalopathy in intensive care unit are currently scarce. ⋯ Predictors of outcome were similar to other groups of patients with liver disease admitted for other reasons. Intensive care unit mortality was lower than reported for other groups of patients with similar illness. Patients with severe HE admitted to ICU with no organ dysfunction other than mechanical ventilation had a better outcome and may require ICU admission.
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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
The diagnosis of myocardial infarction in critically ill patients: an agreement study.
The aim of the study was to assess agreement among 4 intensivists in diagnosing myocardial infarction (MI) in critically ill patients based on screening electrocardiograms (ECGs) and cardiac troponin (cTn) levels. ⋯ Diagnosing MI in the ICU remains a challenge due to variable agreement in 12-lead ECG interpretation. Such variation in practice may contribute to underrecognition of MI during critical illness.
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Journal of critical care · Sep 2009
Multicenter StudyTime series analysis of use patterns for common invasive technologies in critically ill patients.
Critically ill patients are frequently managed with invasive technologies as part of their medical care. Little is known about use patterns. We examined use trends for invasive technologies used in critically ill patients. ⋯ The use of invasive technologies in critically ill patients is changing and may have important implications for resource use, clinician education, and patient care. Initiatives should be considered for ensuring clinician competency during technology transitions.