Journal of critical care
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Journal of critical care · Apr 2016
Balancing hope and despair at the end of life: The contribution of organ and tissue donation.
Concern for the grieving family can moderate the intentions of critical care staff to advocate deceased organ and tissue donation. Conversely, benevolent actions may provoke distress through missed opportunities to save or transform lives. This article provides insight into the perceived benefits of organ and tissue donation for grieving families who experienced end-of-life care in the intensive care unit. ⋯ Our study findings underlined the significance of donation decision making for grieving families. Organ and tissue donation has the potential to balance hope and despair at the end of life when the wishes of the dying, deceased, and bereaved are fulfilled.
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Journal of critical care · Apr 2016
Exposure to reprocessed single-use tracheal suction catheter and ventilator-associated pneumonia risk: A preliminary, single unit-based, matched case-control study.
The reuse of reprocessed single-use suction catheter for suctioning an amount of tracheal secretion among orally intubated, mechanically ventilated patients, who are at risk of acquiring ventilator-associated pneumonia (VAP), has not been thoroughly investigated. This study aimed to examine the association between the repetitive use of reprocessed single-use suction catheter and VAP development. ⋯ The estimated VAP risk of this traditional-based practice is essential to provide strong basis for infection control measures to reduce, if not totally eliminate, VAP.
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Journal of critical care · Apr 2016
Randomized Controlled TrialMarkers of endothelial damage and coagulation impairment in patients with severe sepsis resuscitated with hydroxyethyl starch 130/0.42 vs Ringer acetate.
The Scandinavian Starch for Severe Sepsis/Septic Shock (6S) trial showed increased mortality in patients resuscitated with hydroxyethyl starch 130/0.42 (HES) vs Ringer acetate. Different effects of the fluids on the endothelium may have contributed to the observed outcome. We aimed to investigate associations between HES vs Ringer and changes in plasma biomarkers reflecting endothelial damage and coagulation impairment. ⋯ Resuscitation with HES vs Ringer decreased early endothelial damage. Although this finding should be interpreted with caution, it indicates that the increased mortality observed with HES in the 6S trial may not be explained by endothelial damage and it emphasizes the challenge of using surrogate markers as outcome.
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Journal of critical care · Apr 2016
Heart rate variability is reduced during acute uncomplicated diverticulitis.
The aim of the present study was to report the trajectory of heart rate variability (HRV) indices during a low-grade acute inflammation and their associations to biomarkers for infection. ⋯ We found substantial HRV depression in relation to acute uncomplicated diverticulitis, and this was associated with the elevated CRP levels.
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Journal of critical care · Apr 2016
Can lung ultrasonography predict prone positioning response in acute respiratory distress syndrome patients?
The purpose was to assess whether lung ultrasonography (L-US) is a useful tool in prediction of prone positioning (PP) oxygenation response in patients with acute respiratory distress syndrome (ARDS). ⋯ Our results demonstrated that a simple and short L-US examination could be a useful tool in prediction of PP oxygenation response in ARDS patients. A normal L-US pattern of both anterobasal lung regions in supine position may predict a significant PaO2/FIO2 ratio improvement.