Journal of critical care
-
Journal of critical care · Oct 2012
Randomized Controlled TrialTopical nitroglycerin and lidocaine locally vasodilate the radial artery without affecting systemic blood pressure: a dose-finding phase I study.
Small radial artery diameter (RAD) and vasospasm are barriers to radial artery cannulation. We performed this study to determine if topical nitroglycerin and/or nitroglycerin plus topical lidocaine increases RAD without affecting systemic blood pressure. ⋯ Topical nitroglycerin and lidocaine significantly increase RAD within 30 to 60 minutes with no effect on contralateral radial artery or blood pressure, indicating a direct, local effect on the radial artery. (Clinicaltrials.gov number NCT00686231).
-
Journal of critical care · Oct 2012
Multicenter Study Clinical TrialPrehospital amiodarone may increase the incidence of acute respiratory distress syndrome among patients at risk.
Amiodarone has been implicated as a risk factor for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) when used in the hospital. This study aims to estimate whether prehospital amiodarone also increases the risk of ALI/ARDS. ⋯ Prehospital use of amiodarone may independently increase the risk for ARDS in patients who have at least 1 predisposing condition for ALI.
-
Journal of critical care · Oct 2012
Randomized Controlled TrialEffect of osmotic agents on regional cerebral blood flow in traumatic brain injury.
Cerebral blood flow (CBF) is reduced after severe traumatic brain injury (TBI) with considerable regional variation. Osmotic agents are used to reduce elevated intracranial pressure (ICP), improve cerebral perfusion pressure, and presumably improve CBF. Yet, osmotic agents have other physiologic effects that can influence CBF. We sought to determine the regional effect of osmotic agents on CBF when administered to treat intracranial hypertension. ⋯ Osmotic agents, in addition to lowering ICP, improve CBF to hypoperfused brain regions in patients with intracranial hypertension after TBI.
-
Journal of critical care · Oct 2012
Randomized Controlled Trial Comparative StudyComparative study of pressure- and volume-controlled ventilation on stroke volume variation as a predictor of fluid responsiveness in patients undergoing major abdominal surgery.
We hypothesized that the 2 ventilation modes might have a different influence on the stroke volume variation (SVV). This study investigated the effect of the ventilation modes on SVV as a predictor of fluid responsiveness during major abdominal surgery. ⋯ Stroke volume variation can predict fluid responsiveness during both VCV and PCV modes. However, the optimal threshold values of SVV may differ according to the ventilation modes.
-
Journal of critical care · Oct 2012
ReviewNoise in hospital intensive care units--a critical review of a critical topic.
The aims of the study were to examine the studies related to hospital noise in intensive care units (ICUs) to understand the sources and effects of noise and to describe best practices and common problems in the varying methods commonly applied to reduce the noise level. ⋯ Significant opportunities exist to improve methodologies to study noise levels to reduce noise in hospital ICUs. Many previous studies have used inconsistent methodologies with poorly defined parameters that make it difficult to compare results. Our work points out common pitfalls in the recording and sharing of hospital acoustic parameters and also points to the paucity of important economic considerations in extant studies. These results can be helpful for future research in this area. Many past salutary interventions--including educational noise reduction programs, behavioral modification using sound detection equipment, and low- as well as high-cost environmental alterations--do not generally appear to be adequate to minimize noise to levels for hospital rooms specified by international agencies. But a potentially important clue for future work involves the finding that as the number of patients and staff of the ICU increases, noise levels appear to also increase.