Journal of critical care
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Journal of critical care · Oct 2013
Comparative StudyInhaled epoprostenol vs inhaled nitric oxide for refractory hypoxemia in critically ill patients.
The purpose of this is to compare efficacy, safety, and cost outcomes in patients who have received either inhaled epoprostenol (iEPO) or inhaled nitric oxide (iNO) for hypoxic respiratory failure. ⋯ We found no difference in efficacy and safety outcomes when comparing iNO and iEPO in hypoxic, critically ill patients. Inhaled epoprostenol is associated with less drug expenditure than iNO.
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Journal of critical care · Oct 2013
Oral midodrine treatment accelerates the liberation of intensive care unit patients from intravenous vasopressor infusions.
Persistent low-level hypotension represents a barrier to discharging patients from the intensive care unit (ICU). Midodrine may be an effective adjunct to wean intravenous (IV) vasopressors and permit ICU discharge. We tested the hypothesis that midodrine, given to patients on IV vasopressors who otherwise met ICU discharge criteria, increased the magnitude of change in IV vasopressor rate. ⋯ Midodrine treatment was associated with an increase in the magnitude of decline of the IV vasopressor rate. Oral midodrine may facilitate liberation of surgical ICU patients from an IV vasopressor infusion, and this may affect discharge readiness of patients from the ICU.
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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
Comparative StudyThe use of the pulse oximetric saturation/fraction of inspired oxygen ratio for risk stratification of patients with severe sepsis and septic shock.
Our aims were to determine whether the pulse oximetric saturation/fraction of inspired oxygen (S/F) can be used for the early identification of patients with sepsis who are at increased risk for death and to compare the S/F ratio with the Pao2/fraction of inspired oxygen (P/F) ratio. ⋯ A low S/F at ICU admission is associated with increased risk of death in patients with severe sepsis or septic shock.
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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.