Journal of critical care
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Journal of critical care · Dec 2014
Observational StudyGoal-directed therapy after cardiac surgery and the incidence of acute kidney injury.
The purpose of this study was to assess the effect of goal-directed therapy (GDT), after cardiac surgery, on the incidence of acute kidney injury (AKI). ⋯ Postoperative GDT in patients after cardiac surgery was associated with reduction in the incidence of AKI and a reduction in ICU and hospital duration of stay.
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Journal of critical care · Dec 2014
Observational StudyRoom-temperature vs iced saline indicator injection for transpulmonary thermodilution.
Ice-cold injectate is assumed to provide best accuracy for transpulmonary thermodilution (TPTD)-derived cardiac index (CI), global end-diastolic volume index (GEDVI), and extravascular lung-water index (EVLWI). Room-temperature injectate might facilitate TPTD. Therefore, this study compares TPTD-results derived from iced injectate with room-temperature injectate TPTDs (TPTDRoom). ⋯ Room-temperature injectate TPTDs results in slight but significant overestimation of CI, GEDVI, and EVLWI. Percentage error values for GEDVIRoom and EVLWIRoom are acceptable only in case of "jugular" indicator injection.
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Journal of critical care · Dec 2014
ReviewNeurocritical care complications of pregnancy and puerperum.
Neurocritical care complications of pregnancy and puerperum such as preeclampsia/eclampsia, hemolysis, elevated liver enzymes, low platelets syndrome, thrombotic thrombocytopenic purpura, seizures, ischemic and hemorrhagic stroke, postpartum angiopathy, cerebral sinus thrombosis, amniotic fluid emboli, choriocarcinoma, and acute fatty liver of pregnancy are rare but can be devastating. These conditions can present a challenge to physicians because pregnancy is a unique physiologic state, most therapeutic options available in the intensive care unit were not studied in pregnant patients, and in many situations, physicians need to deliver care to both the mother and the fetus, simultaneously. Timely recognition and management of critical neurologic complications of pregnancy/puerperum can be life saving for both the mother and fetus.
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Journal of critical care · Dec 2014
Clinical TrialPulse pressure variation-guided fluid therapy after cardiac surgery: A pilot before-and-after trial.
The aim of this study is to study the feasibility, safety, and physiological effects of pulse pressure variation (PPV)-guided fluid therapy in patients after cardiac surgery. ⋯ Pulse pressure variation-guided fluid management was feasible and safe during mandatory ventilation after cardiac surgery. However, its advantages may be clinically small.
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Journal of critical care · Dec 2014
Letter ReviewThe shortage of critical care physicians: Is there a solution?
The objective of this study is to provide a solution to the critical care physician shortage. ⋯ Family Practice is the second largest collective group of physicians in the United States-second only to internal medicine. In most of rural America, where there are limited physicians serving the population, family practitioners fill the gap and provide services otherwise unavailable to those patients. This group that can potentially be trained in critical care and help solve the crisis has been prevented from doing so.