Journal of critical care
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Journal of critical care · Oct 2013
Prolonged sevoflurane administration in the off-pump coronary artery bypass graft surgery: Beneficial effects.
The benefits of intraoperative administration of halogenated agents in patients undergoing cardiac surgery have been shown by numerous studies. The mechanisms of preconditioning and postconditioning appear to be the cause of these benefits. The possibility of maintaining the early postoperative sedation with halogenated agents, after its intraoperative administration, can increase their benefits. ⋯ Sevoflurane administration in patients undergoing off-pump coronary artery bypass graft, in the operating room and the intensive care unit, decreases myocardial injury markers compared with patients who only received sevoflurane in the intraoperative period, but both were a better option to decrease levels of myocardial markers when compared with the propofol group.
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Journal of critical care · Oct 2013
Comparative StudyIntroducing a new generation indirect calorimeter for estimating energy requirements in adult intensive care unit patients: Feasibility, practical considerations, and comparison with a mathematical equation.
Indirect calorimetry (IC) is increasingly advocated for individualizing nutritional therapy in critically ill adult patients, but questions remain regarding its practical implementation. ⋯ Indirect calorimetry is increasingly advocated for individualizing nutritional therapy in critically ill adult patients. Practical feasibility is tested in this study. Large differences between measured and calculated energy expenditure are observed. Together with patients' characteristics, feasibility results can guide clinicians or institutes in using IC in their daily clinical practice.
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Journal of critical care · Oct 2013
Evaluation of glucose variability when converting from insulin infusion to basal-bolus regimen in a surgical-trauma intensive care unit.
This study aimed to identify predictive factors resulting in glucose values greater than 200 mg/dL in patients with trauma transitioned from an insulin infusion to a basal-bolus subcutaneous insulin regimen. ⋯ Older patients with trauma and patients with higher blood glucose on admission are more likely to experience severe hyperglycemia when transitioned to basal-bolus glucose control. Higher insulin infusion rates at 48 hours before transition are also associated with severe hyperglycemia.
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Journal of critical care · Oct 2013
Comparative StudyDynamic evaluation of near-infrared peripheral oximetry in healthy volunteers: A comparison between INVOS and EQUANOX.
The present study aimed to compare peripheral regional tissue oxygen saturation (rSO2) values and desaturation/resaturation rates given by INVOS and EQUANOX devices. ⋯ INVOS and EQUANOX are not comparable in measuring both absolute values and dynamic changes of peripheral rSO2 and near-infrared spectroscopy-derived parameters during occlusion vascular tests.
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Journal of critical care · Oct 2013
Augmented renal clearance is a common finding with worse clinical outcome in critically ill patients receiving antimicrobial therapy.
We describe incidence and patient factors associated with augmented renal clearance (ARC) in adult intensive care unit (ICU) patients. ⋯ ARC was documented in approximately 52% of a mixed ICU patient population receiving antibiotic treatment with worse clinical outcome. Young age and male gender were independently associated with ARC presence.