Journal of critical care
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Journal of critical care · Aug 2016
The validity and reliability of the clinical assessment of increased work of breathing in acutely ill patients.
Mechanical ventilation is frequently indicated to reduce the work of breathing. Because it cannot be measured easily at the bedside, physicians rely on surrogate measurements such as patient appearance of distress and increased breathing effort. ⋯ Assessing the increased work of breathing by rating the severity of respiratory distress based on subject appearance is a valid and moderately reliable sign that predicts the presence of serious respiratory dysfunction. The reliability of the individual signs of increased breathing effort is moderate at best.
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Journal of critical care · Aug 2016
ReviewTime to loss of brain function and activity during circulatory arrest.
Brain function during the dying process and around the time of cardiac arrest is poorly understood. To better inform the clinical physiology of the dying process and organ donation practices, we performed a scoping review of the literature to assess time to loss of brain function and activity after circulatory arrest. ⋯ The time required to lose brain function varied according to clinical context and method by which this function is measured. Most studies show that clinical loss of consciousness and loss of EEG activity occur within 30seconds after abrupt circulatory arrest and may occur before circulatory arrest after progressive hypoxia-ischemia. Prospective clinical studies are required to confirm these observations.
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Journal of critical care · Aug 2016
Neutrophil gelatinase-associated lipocalin levels during the first 48 hours of intensive care may indicate upcoming acute kidney injury.
The recognition of acute kidney injury (AKI) as early as possible is important in the intensive care unit. This study proposes that serum and urine levels of neutrophil gelatinase-associated lipocalin (NGAL) may be used for this purpose. ⋯ Most AKI cases were diagnosed within the first 48 hours after admission, and NGAL was useful for predicting upcoming AKI.
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Journal of critical care · Aug 2016
Review Meta AnalysisEffect of traditional Chinese medicine on intra-abdominal hypertension and abdominal compartment syndrome: A systematic review and Meta-analysis.
Traditional Chinese medicine (TCM) recently become a widely used treatment option for treating intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). However, we still lack large-scale, high-quality, randomized controlled trials (RCTs). The purpose of this systematic review was to evaluate the existing clinical trials and to provide additional specific evidence. ⋯ TCMs seem to be effective for patients with IAH and ACS; however, most of the reviewed trials are of poor quality. Large-scale, high-quality clinical trials are warranted.