Journal of critical care
-
Journal of critical care · Jun 2014
Randomized Controlled Trial Multicenter StudyRelative adrenal insufficiency in critically ill patient after rapid sequence intubation: KETASED ancillary study.
Relative adrenal insufficiency (RAI) has been reported as a predictor of mortality in septic patient; however, its effects on mortality and outcomes for critically ill patients remain debatable. The objective of this study was to assess the effect of RAI on prognostic outcomes in patients after out-of-hospital rapid sequence intubation (RSI) and factors associated with the onset of RAI. ⋯ In critically ill patients who require RSI, RAI is common and is not associated with worsened outcomes in our cohort.
-
Journal of critical care · Jun 2014
Influenza A (H1N1) vs non-H1N1 ARDS: Analysis of clinical course.
The purpose of the study is to compare H1N1-induced acute respiratory distress syndrome (ARDS) with ARDS due to other causes of severe community-acquired pneumonia focusing on pulmonary function. ⋯ Clinical course of H1N1-ARDS is substantially different from non-H1N1-ARDS. Affected patients may require extensive therapy including extracorporeal lung support in ARDS referral centers.
-
Journal of critical care · Jun 2014
ReviewEfficacy and safety of fibrinogen concentrate in trauma patients-a systematic review.
Uncontrolled bleeding is the main preventable cause of death in severe trauma patients. Fibrinogen is the first coagulation factor to decrease during trauma-induced coagulopathy, suggesting that pharmacological replacement might assist early hemorrhage control. Several sources of fibrinogen are available; however, fibrinogen concentrate (FC) is not routinely used in trauma settings in most countries. The aim of this review is to summarize the available literature evaluating the use of FC in the management of severe trauma. ⋯ Despite methodological flaws, some of the available studies suggested that FC administration may be associated with a reduced blood product requirement. Randomized trials are warranted to determine whether FC improves outcomes in prehospital management of trauma patients or whether FC is superior to another source of fibrinogen in early hospital management of trauma patients.
-
Journal of critical care · Jun 2014
Randomized Controlled TrialThe effect of the arterial catheter insertion technique on the success of radial artery cannulation: A prospective and randomized study.
The main objective of the current investigation was to compare a single wall puncture to vessel transfixing on the success of radial artery cannulation by resident physicians. ⋯ Our findings suggest that there does not appear to be an advantage of the transfixing technique over the single wall puncture method for cannulating the radial artery by resident physicians. Cannulation was achieved in shorter time using the single wall puncture technique even after accounting for differences between residents and prior levels of experience.
-
Journal of critical care · Jun 2014
ReviewPersistent organ dysfunction after severe sepsis: A systematic review.
Sepsis is a prevalent disease with high mortality. Survivors of sepsis often suffer significant resultant morbidity, including organ dysfunction. However, little is known about persistent or long-term organ dysfunction in this patient population. Our objective was to systematically review original research studies evaluating organ-specific outcomes at 28 days or greater in patients surviving severe sepsis. ⋯ Our review found variable rates of organ dysfunction at 1 month after severe sepsis. Future studies should attempt to characterize organ dysfunction at greater than 1 month after an acute severe sepsis episode to determine the true prevalence long-term organ dysfunction and treatments for prevention. Additionally, standardized objective measures of organ dysfunction are needed so that future studies can be directly compared.