Journal of critical care
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Journal of critical care · Oct 2016
Review Meta Analysis Comparative StudyComparison of high-flow nasal oxygen therapy with conventional oxygen therapy and noninvasive ventilation in adult patients with acute hypoxemic respiratory failure: A meta-analysis and systematic review.
The role of high-flow nasal oxygen (HFNO) therapy in adult patients with acute hypoxemic respiratory failure is controversial. ⋯ High-flow nasal oxygen does not offer any benefit over NIV or conventional oxygen therapy in terms of requirement of higher respiratory support.
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Journal of critical care · Oct 2016
Review Meta AnalysisHow safe is gelatin? A systematic review and meta-analysis of gelatin-containing plasma expanders vs crystalloids and albumin.
Gelatin is a widely used synthetic colloid resuscitation fluid. We undertook a systematic review and meta-analysis of adverse effects in randomized and nonrandomized studies comparing gelatin with crystalloid or albumin for treatment of hypovolemia. Multiple databases were searched systematically without language restrictions until August 2015. ⋯ The mean crystalloid-to-colloid ratio was 1.4. Gelatin solutions increase the risk of anaphylaxis and may be harmful by increasing mortality, renal failure, and bleeding possibly due to extravascular uptake and coagulation impairment. Until well-designed randomized controlled trials show that gelatin is safe, we caution against the use of gelatins because cheaper and safer fluid alternatives are available.
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Journal of critical care · Oct 2016
ReviewElectrical impedance tomography in adult patients undergoing mechanical ventilation: A systematic review.
The purpose of the study is to systematically review and summarize current literature concerning the validation and application of electrical impedance tomography (EIT) in mechanically ventilated adult patients. ⋯ In adult patients, EIT has been successfully validated for assessing ventilation distribution, measuring changes in lung volume, studying regional respiratory mechanics, and investigating nonventilatory parameters. Electrical impedance tomography has also been demonstrated to be useful in monitoring regional respiratory system changes during MV interventions, although existing literature lacks clinical outcome evidence.
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Journal of critical care · Oct 2016
Changes in peripheral perfusion relate to visceral organ perfusion in early septic shock: A pilot study.
To correlate clinical indicators of peripheral perfusion with visceral organ vascular tone in 30 septic shock patients. ⋯ Capillary refill time and skin mottling may be correlated with the pulsatility index, a sonographic surrogate of vascular tone, of visceral organs in early septic shock.
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Journal of critical care · Oct 2016
ReviewMusic therapy, a review of the potential therapeutic benefits for the critically ill.
Intensive care units are a stressful milieu for patients, particularly when under mechanical ventilation which they refer to as inhumane and anxiety producing. Anxiety can impose harmful effects on the course of recovery and overall well-being of the patient. Resulting adverse effects may prolong weaning and recovery time. ⋯ It can abate the stress response, decrease anxiety during mechanical ventilation, and induce an overall relaxation response without the use of medication. This relaxation response can lower cardiac workload and oxygen consumption resulting in more effective ventilation. Music may also improve sleep quality and reduce patient's pain with a subsequent decrease in sedative exposure leading to an accelerated ventilator weaning process and a speedier recovery.