Journal of critical care
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Journal of critical care · Jun 2011
Respiratory impact of paracentesis in cirrhotic patients with acute lung injury.
Ascites may contribute to the loss of lung volume and alter the gas exchange in cirrhotic patients with acute lung injury (ALI). ⋯ In contrast to ventilatory recruitment maneuvers, paracentesis is a simple and well-tolerated technique able to improve oxygenation and alveolar recruitment without the risk of the lung overdistension in severely hypoxemic cirrhotic patients.
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Journal of critical care · Jun 2011
The effects of vasoactive drugs on pulse pressure and stroke volume variation in postoperative ventilated patients.
Although pulse pressure variation (PPV) and stroke volume variation (SVV) during mechanical ventilation have been shown to predict preload responsiveness, the effect of vasoactive therapy on PPV and SVV is unknown. ⋯ Volume loading decreased PPV and SVV; and vasodilators increased both, consistent with their known cardiovascular effects. Thus, SVV and PPV can be used to drive fluid resuscitation algorithms in the setting of changing vasoactive drug therapy.
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Journal of critical care · Jun 2011
Survival and quality of life after tracheostomy for acute respiratory failure in patients with amyotrophic lateral sclerosis.
Acute respiratory failure (ARF) is a common event in the advanced stage of amyotrophic lateral sclerosis (ALS) and may be rarely a presenting symptom. Frequently, such patients require intubation and mechanical ventilation (MV) and, in a large proportion, receive tracheostomy, as a consequence of weaning failure. In our study, we investigated postdischarge survival and quality of life (QoL) after tracheostomy for ARF in patients with ALS. ⋯ Patients with ALS have a high chance of long-term survival after tracheostomy for ARF. Although administered at the time of a respiratory crisis without being discussed in advance, tracheostomy shows good acceptance and results in acceptable QoL.
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Journal of critical care · Jun 2011
Protein C as an early biomarker to distinguish pneumonia from sepsis.
Patients with pneumonia often are unrecognized as also having sepsis. We evaluated protein C, as a potential biomarker, to differentiate between patients with pneumonia and sepsis. ⋯ In this study, protein C levels performed well in differentiating between patients with sepsis or pneumonia in the early period after diagnosis.
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Journal of critical care · Jun 2011
Telemedicine in the intensive care unit environment--a survey of the attitudes and perspectives of critical care clinicians.
This study was conducted to assess the preimplementation knowledge and perceptions of intensive care unit (ICU) clinicians regarding the ability of telemedicine in the ICU environment (Tele-ICU) to address challenges resulting from the shortages of experienced critical care human resources and the drive to improve quality of care. ⋯ Significant uncertainty and skepticism were expressed by critical care clinicians regarding the ability of Tele-ICU to address the challenges of human resource limitation and the delivery of quality care. This suggests the need for further research and education of system impact beyond patient outcomes related to this new technology.