Journal of critical care
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Journal of critical care · Dec 2016
Impact of monitoring endotracheal tube cuff leak pressure on postextubation stridor in children.
To determine if implementing a protocol maintaining an air leak when using cuffed endotracheal tubes (ETT) throughout the course of mechanical ventilation (MV) in children would decrease the rate of postextubation stridor (PES). ⋯ Maintaining an appropriate air leak throughout the course of MV using cuffed ETT decreases the rate of PES in children.
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Journal of critical care · Dec 2016
Observational StudyInferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis.
Currently, physicians employ pulse pressure variation (PPV) as a gold standard for predicting fluid responsiveness. However, employing ultrasonography in intensive care units is increasing, including using the ultrasonography for assessment of fluid responsiveness. Data comparing the performance of both methods are still lacking. This is the reason for the present study. ⋯ The present study demonstrated better performance of the PPV than the IVDV. A threshold value more than 10% may be used for identifying fluid responders.
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Journal of critical care · Dec 2016
Ultrasound-guided laryngeal air column width difference and the cuff leak volume in predicting the effectiveness of steroid therapy on postextubation stridor in adult. Are they useful?
To evaluate the effectiveness of steroids therapy on postextubation stridor (PES) depending on the clinical response, the ultrasound guided laryngeal air column width difference (LACWD) and the cuff leak volume (CLV). ⋯ Steroids therapy improves postextubation stridor. Both LACWD and CLV are non-invasive and simple methods for monitoring of laryngeal edema regression after steroid therapy. We recommend administration of corticosteroids to patients with a lower level of leak volume and LACWD before extubation.
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Journal of critical care · Dec 2016
Medication-induced and spontaneous hypoglycemia carry the same risk for hospital mortality in critically ill patients.
Hypoglycemia is associated with increased mortality, but the role of its etiology is unclear. This study aimed to examine the impact of hypoglycemia etiology on mortality risk among critically ill patients. ⋯ Medication-induced hypoglycemia appears to be equally harmful as spontaneous hypoglycemia during critical illness. Future studies should aim to identify strategies to minimize hypoglycemia regardless of etiology, while also minimizing glycemic variability associated with hypoglycemia treatment.
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Journal of critical care · Dec 2016
Use of ultrasound guidance for central venous catheterization: a national survey of intensivists and hospitalists.
The purpose of the study is to evaluate the frequency and barriers to use of ultrasound guidance for central venous catheter (CVC) insertion by physicians specializing in critical care and hospital medicine. ⋯ Most intensivists routinely use ultrasound guidance to insert internal jugular CVCs but not subclavian CVCs. The most commonly reported barrier to ultrasound use was limited access to an ultrasound machine.