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
Facilitators and barriers to initiating change in medical intensive care unit survivors with alcohol use disorders: A qualitative study.
Alcohol abuse and dependence are collectively referred to as alcohol use disorders (AUD). An AUD is present in up to one third of patients admitted to an intensive care unit (ICU). We sought to understand the barriers and facilitators to change in ICU survivors with an AUD to provide a foundation upon which to tailor alcohol-related interventions. ⋯ Alcohol-related interventions to motivate and sustain behavior change could be tailored to ICU survivors by accounting for unique barriers and facilitators.
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Journal of critical care · Oct 2013
Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock.
The goal of this study was to explore possible microcirculatory alterations by changing sedative infusion from propofol to midazolam in patients with septic shock. ⋯ In this study, sublingual microcirculatory perfusion improved when the infusion was changed from propofol to midazolam in patients with septic shock. This observation could not be explained by changes in systemic hemodynamics.
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Journal of critical care · Oct 2013
Ionized hypocalcemia is an early event and is associated with organ dysfunction in children admitted to the intensive care unit.
The purpose was to determine the frequency and risk factors of ionized hypocalcemia and to evaluate this disturbance as a predictor of mortality in a pediatric intensive care unit (ICU). ⋯ Ionized hypocalcemia is common during the ICU stay, particularly in the first 3 days of admission. This disturbance was not found to be a predictor of mortality, but it is independently associated with more severe organ dysfunction.
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Journal of critical care · Oct 2013
Procollagen type III aminoterminal propeptide as biomarker of host response in severe sepsis.
The purpose of this study is to test the hypothesis that procollagen type III aminoterminal propeptide (PIIINP) is early elevated in septic episodes and can indicate the acute organ dysfunction/failure characterizing severe sepsis. ⋯ Increased serum PIIINP can signify severe sepsis/septic shock and predict which patients with sepsis will eventually develop severe sepsis/septic shock, thus representing a biomarker of risk stratification of patients with sepsis.