Journal of critical care
-
Journal of critical care · Apr 2017
Observational StudyPlasma adrenomedullin in critically ill patients with sepsis after major surgery: A pilot study.
Adrenomedullin is released by different tissues in hypoxia, oxidative stress, and inflammation and is found in general and medical patients and, recently, in sepsis patients in emergency departments. The aim of this study was to evaluate biologically active adrenomedullin that mirrors directly the active peptide levels in plasma of surgical intensive care unit (ICU) patients with sepsis. ⋯ This is the first study investigating adrenomedullin in patients with sepsis following major surgery. Higher adrenomedullin on admission is associated with increased vasopressor need and mortality after 90 days. Thus, adrenomedullin may be a useful additional parameter in surgical patients with sepsis.
-
Journal of critical care · Apr 2017
Review Meta AnalysisDexmedetomidine vs propofol sedation reduces delirium in patients after cardiac surgery: A meta-analysis with trial sequential analysis of randomized controlled trials.
It is uncertain whether dexmedetomidine is better than propofol for sedation in postcardiac surgery patients. The purpose of this meta-analysis was to compare the effects of dexmedetomidine and propofol sedation on outcomes in adult patients after cardiac surgery. ⋯ Dexmedetomidine sedation could reduce postoperative delirium and was associated with shorter length of intubation, but might increase bradycardia in patients after cardiac surgery compared with propofol.
-
Journal of critical care · Apr 2017
Review Meta AnalysisHigh-flow nasal cannula oxygen therapy vs conventional oxygen therapy in cardiac surgical patients: A meta-analysis.
The use of high-flow nasal cannula (HFNC) for the treatment of many diseases has gained increasing popularity. In the present meta-analysis, we aimed to assess the efficacy and safety of HFNCs compared with conventional oxygen therapy (COT) in adult postextubation cardiac surgical patients. ⋯ The HFNC could reduce the need for escalation of respiratory support compared with COT, and it could be safely administered in adult postextubation cardiac surgical patients.
-
Journal of critical care · Apr 2017
Review Meta AnalysisVitamin D and outcomes in adult critically ill patients. A systematic review and meta-analysis of randomized trials.
Low vitamin D blood levels are associated with high mortality in critically ill patients. There is controversy about vitamin D supplementation in this population. The objective of this meta-analysis was to evaluate if vitamin D administration reduces mortality in critically ill patients. ⋯ In critically ill patients, vitamin D administration might be associated with a reduction in mortality without significant adverse events. A large multicenter randomized trial should conclusively confirm these findings.
-
Journal of critical care · Apr 2017
Review Meta AnalysisImpact of transfusion on stroke after cardiovascular interventions: Meta-analysis of comparative studies.
To evaluate the impact of transfusion on the development of stroke after cardiovascular interventions. ⋯ The present meta-analysis is registered in PROSPERO, code CRD42016046426.