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
Feasibility and observed safety of interactive video games for physical rehabilitation in the intensive care unit: a case series.
Early rehabilitation in the intensive care unit (ICU) improves patients' physical function. Despite reports of using commercially available interactive video game systems for rehabilitation, there are few data evaluating feasibility and safety as part of routine in-patient rehabilitation, particularly in the ICU. ⋯ Novel use of interactive video games as part of routine PT in critically ill patients is feasible and appears safe in our case series. Video game therapy may complement existing rehabilitation techniques for ICU patients.
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Journal of critical care · Apr 2012
Physiologic determinants of prolonged mechanical ventilation in patients after major surgery.
The aim of the study was to evaluate the physiologic determinants of ventilator dependency in patients who underwent major surgery. ⋯ Difficult-to-wean patients after major surgery have overall a limited diaphragm endurance time, in particular, FW breathe very close to the fatigue threshold, and they adopt a rapid shallow breathing respiratory pattern to avoid crossing this threshold.
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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.
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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.