Journal of critical care
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Journal of critical care · Aug 2013
Randomized Controlled TrialEffect of intraoperative dobutamine on splanchnic tissue perfusion and outcome after Whipple surgery.
Splanchnic hypoperfusion during abdominal surgery contributes to postoperative gut sepsis and mortality. Dobutamine is an inotrope with vasodilator properties that improve hepatosplanchnic perfusion. The aim of this study was to examine the effect of intraoperative dobutamine infusion during Whipple surgery on splanchnic perfusion, hemodynamic, and overall postoperative outcome. ⋯ Intraoperative use of dobutamine improved global oxygen delivery, splanchnic perfusion, and postoperative outcome after Whipple surgery. These findings may be of clinical importance when the therapeutic goal is to improve gut perfusion.
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Journal of critical care · Aug 2013
Multicenter StudyPediatric upper airway obstruction: interobserver variability is the road to perdition.
The purposes of the study are to determine the interobserver variability in the clinical assessment of pediatric upper airway obstruction (UAO) and to explore how variability in assessment of UAO may contribute to risk factors and incidence of postextubation UAO. ⋯ Physical findings routinely used for UAO have poor interobserver reliability among bedside providers. This variability may contribute to inconsistent findings regarding incidence, risk factors, and therapies for postextubation UAO.
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Journal of critical care · Aug 2013
Comparative StudyUrine biochemistry in septic and non-septic acute kidney injury: a prospective observational study.
Determine whether there are unique patterns to the urine biochemistry profile in septic compared with non-septic acute kidney injury (AKI) and whether urinary biochemistry predicts worsening AKI, need for renal replacement therapy and mortality. ⋯ Urine biochemical profiles do not discriminate septic and non-septic AKI. UNa, FeNa, and FeU do not reliably predict biomarker release, worsening AKI, RRT or mortality. These data imply limited utility for these measures in clinical practice in critically ill patients with AKI.
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Journal of critical care · Aug 2013
Multicenter StudyLength of stay and mortality due to Clostridium difficile infection acquired in the intensive care unit.
The purpose of this study was to determine the attributable intensive care unit (ICU) and hospital length of stay and mortality of ICU-acquired Clostridium difficile infection (CDI). ⋯ C difficile infection acquired in ICU is associated with an increase in length of ICU and hospital stay but not with any difference in ICU or hospital mortality.
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Journal of critical care · Aug 2013
Correlation of oxygen saturation as measured by pulse oximetry/fraction of inspired oxygen ratio with Pao2/fraction of inspired oxygen ratio in a heterogeneous sample of critically ill children.
Oxygen saturation as measured by pulse oximetry (Spo2)/fraction of inspired oxygen (Fio2) (SF) ratio has demonstrated to be an adequate marker for lung disease severity in children under mechanical ventilation. We sought to validate the utility of SF ratio in a population of critically ill children under mechanical ventilation, noninvasive ventilation support, and breathing spontaneously. ⋯ Oxygen saturation as measured by pulse oximetry/Fio2 ratio is an adequate noninvasive surrogate marker for PF ratio. Oxygen saturation as measured by pulse oximetry/Fio2 ratio may be an ideal noninvasive marker for patients with acute hypoxemic respiratory failure.