Journal of critical care
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Journal of critical care · Apr 2017
Factors predicting failure of noninvasive ventilation assist for preventing reintubation among medical critically ill patients.
Reintubation after failed extubation is associated with high mortality. Noninvasive ventilation (NIV) has been used to prevent reintubation, but the results have been inconclusive. We investigated the factors predicting failure of NIV-assisted extubation among medical critically ill patients. ⋯ Respiratory failure caused by pneumonia is predictive of failure of NIV-assisted extubation.
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Journal of critical care · Apr 2017
Observational StudyChanges of central venous oxygen saturation define fluid responsiveness in patients with septic shock: A prospective observational study.
To evaluate whether the changes of central venous oxygen saturation (Scvo2) after fluid challenge can define fluid responsiveness in patients with septic shock. ⋯ The changes of Scvo2 correlate with the changes of CI, and the changes of Scvo2 define fluid responsiveness in patients with septic shock.
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Journal of critical care · Apr 2017
A nursing perspective of interprofessional work in critical care: Findings from a secondary analysis.
This article presents a secondary analysis of nurse interviews from a 2-year comparative ethnographic study exploring cultures of collaboration across intensive care units (ICU). Critically ill patients rely on their interprofessional health care team to communicate and problem-solve quickly to give patients the best outcome available. Critical care nurses function at the hub of patient care giving them a distinct perspective of how interprofessional interactions impact collaborative practice. ⋯ Deliberative development of ICU nurses' interprofessional skills is essential if nursing is to move from primary coordinator to active collaborator in patient management.
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Journal of critical care · Apr 2017
Noninvasive ventilation during acute respiratory distress syndrome in patients with cancer: Trends in use and outcome.
The objectives of our study were to describe the outcome of patients with malignancies treated for acute respiratory distress syndrome (ARDS) with noninvasive ventilation (NIV) and to evaluate factors associated with NIV failure. ⋯ Noninvasive ventilation failure in ARDS patients with malignancies is frequent and related to ARDS severity, SOFA score, and pulmonary infection-related ARDS. Noninvasive ventilation failure is associated with in-hospital mortality.
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Journal of critical care · Apr 2017
Coagulation in acutely ill patients with severe chronic liver disease: Insights from thromboelastography.
There is controversy about the true coagulation state of acutely ill patients with chronic liver disease (CLD) due to simultaneous pro- and anticoagulant factor deficits and limitations of conventional coagulation tests (CCTs). Thromboelastography (TEG) may provide more physiologically relevant insights. ⋯ In acutely ill patients with CLD, TEG demonstrates delayed clot formation and weaker thrombus strength despite decreased clot lysis. This challenges the notion that such patients experience a balanced coagulation state, highlighting the complexity of their coagulopathies.