Journal of critical care
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Journal of critical care · Apr 2012
ReviewEmotional consequences of intensive care unit delirium and delusional memories after intensive care unit admission: a systematic review.
The aim of this study was to review literature exploring the emotional consequences of delirium and delusional memories in intensive care unit patients. ⋯ Based on current literature, no relationship could be shown for delirium and emotional outcome. Regarding delusional memories and adverse emotional outcome, results were in contradiction.
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Journal of critical care · Apr 2012
Randomized Controlled TrialUse of simulation-based education to improve resident learning and patient care in the medical intensive care unit: a randomized trial.
The purpose of this study is to determine the effect of simulation-based education on the knowledge and skills of internal medicine residents in the medical intensive care unit (MICU). ⋯ Simulation-based education significantly improved resident knowledge and skill in the MICU. Knowledge acquired in the simulated environment was transferred to improved bedside skills caring for MICU patients. Simulation-based education is a valuable adjunct to standard clinical training for residents in the MICU.
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Journal of critical care · Apr 2012
ReviewEffects of intracellular acidosis on endothelial function: an overview.
The endothelium represents the largest functional organ in the human body playing an active role in vasoregulation, coagulation, inflammation, and microvascular permeability. Endothelium contributes to maintain vascular integrity, intravascular volume, and tissue oxygenation promoting inflammatory network response for local defense and repair. Acid-basis homeostasis is an important physiologic parameter that controls cell function, and changes in pH can influence vascular tone by regulating endothelium and vascular smooth muscle cells. This review presents a current perspective of the effects of intracellular acidosis on the function and the basic regulatory mechanisms of endothelial cells.
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Journal of critical care · Apr 2012
Multicenter Study Comparative StudyPlasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis.
The purpose of the study was to determine the effects of Plasma-Lyte 148 (PL) vs 0.9% saline (NS) fluid resuscitation in diabetic ketoacidosis (DKA). ⋯ Patients with DKA resuscitated with PL instead of NS had faster initial resolution of metabolic acidosis and less hyperchloremia, with a transiently improved blood pressure profile and urine output.
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Journal of critical care · Apr 2012
ReviewEffectiveness of extracorporeal membrane oxygenation when conventional ventilation fails: valuable option or vague remedy?
The mortality and morbidity of patients with severe acute respiratory distress syndrome (ARDS) remains high despite the advances in intensive care practice. The low-tidal-volume ventilation strategy (ARDS net protocol) has been shown to be effective in improving survival. Unfortunately, however, some patients have such severe ARDS that they cannot be managed with the ARDS net strategy. ⋯ The recent increased incidence of severe respiratory failure due to H1N1 influenza pandemic has led to an increased use of ECMO. Although several reports showed ECMO use to be encouraging, some scepticism remains. In this article, we reviewed the usefulness of ECMO in patients with severe ARDS in the light of current evidence.