Journal of critical care
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Journal of critical care · Jun 2015
Tele-intensivists can instruct non-physicians to acquire high-quality ultrasound images.
Intensive care unit telemedicine (tele-ICU) uses audiovisual systems to remotely monitor and manage patients. Intensive care unit ultrasound can augment an otherwise limited bedside evaluation. To date, no studies have utilized tele-ICU technology to assess the quality and clinical use of real-time ultrasound images. We assessed whether tele-intensivists can instruct nonphysicians to obtain high-quality, clinically useful ultrasound images. ⋯ Tele-intensivists can guide minimally trained nonphysicians to obtain high-quality, clinically useful ultrasound images. For most anatomic sites, tele-ICU images are of similar quality to those acquired directly by ultrasound.
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Journal of critical care · Jun 2015
Causes of ischemic electrocardiographic changes in near drowning: A literature review.
Drowning is a main cause of accidental death among children and adolescents worldwide. Ischemic electrocardiographic (ECG) changes are often encountered in victims of near drowning. We reviewed the literature for near drowning cases reporting ischemic ECG changes to study the underlying etiology for these findings. Among the 8 cases included in the analysis, ischemic ECG changes were due to takotsubo cardiomyopathy (in elderly cases especially females); coronary artery spasm (in younger cases); or hypothermia effect on ECG; and, to a lesser extent, myocardial ischemia resulting from occlusive coronary artery disease.
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Journal of critical care · Jun 2015
ReviewRisk stratification in acute pulmonary embolism with heart-type fatty acid-binding protein: A meta-analysis.
Heart-type fatty acid-binding protein (H-FABP) has emerged as a new biomarker in risk stratification of patients with acute pulmonary embolism (PE). We performed a meta-analysis of studies in patients with acute PE to assess the prognostic value of elevated H-FABP for short-term adverse outcomes. ⋯ This meta-analysis indicates that elevated H-FABP levels are associated with increased risk of 30-day complicated clinical course, mortality, and RVD.
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Journal of critical care · Jun 2015
A pilot study of audiovisual family meetings in the intensive care unit.
We hypothesized that virtual family meetings in the intensive care unit with conference calling or Skype videoconferencing would result in increased family member satisfaction and more efficient decision making. ⋯ Although we do not report benefit from an audiovisual intervention, these results are preliminary and heavily influenced by notable limitations to the study. Given that the intervention was feasible in this pilot study, audiovisual and social media intervention strategies warrant additional investigation given their unique ability to facilitate communication among family members in the intensive care unit.
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Journal of critical care · Jun 2015
Long-term survival of adults with cardiogenic shock after venoarterial extracorporeal membrane oxygenation.
This study was designed to examine the long-term survival of patients who survived to be weaned from venoarterial extracorporeal membrane oxygenation (VA ECMO) and to determine which factors present at initiation and during ECMO predict long-term survival. We further sought to develop the preliminary long-term outcome after VA ECMO score that would predict patient outcome and to assess its accuracy at various time points. ⋯ Good long-term survival can be achieved in patients who have been successfully weaned from VA-ECMO. The factors present at initiation and during ECMO can relate to altered risk of long-term survival.