Journal of critical care
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Journal of critical care · Jun 2017
Observational StudyRisk factors for noninvasive ventilation failure in patients with acute cardiogenic pulmonary edema: A prospective, observational cohort study.
We identified risk factors for noninvasive ventilation (NIV) failure in patients with acute cardiogenic pulmonary edema (ACPE). ⋯ NCT02653365.
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Journal of critical care · Jun 2017
Review Meta AnalysisEffect of ulinastatin combined with thymosin alpha1 on sepsis: A systematic review and meta-analysis of Chinese and Indian patients.
To assess the effects of urinary trypsin inhibitor (UTI) ulinastatin combined with thymosin alpha1 (Tα1) on sepsis. ⋯ Treatment of UTI+Tα1 can suppress the production of proinflammatory cytokines, decrease the APACHE II score, shorten the duration of mechanical ventilation, and improve the 28-day survival rate.
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Journal of critical care · Jun 2017
Observational StudyContinuous electroencephalography in a mixed non-neurological intensive care population, an observational study.
Continuous electroencephalography (cEEG) improves monitoring of the brain in unconscious patients, but implementation at ICU is difficult. The present investigation shows a way to introduce cEEG at an anesthesiological ICU and discusses the first experiences. ⋯ Continuous electroencephalography recording is feasible and manageable. Automatic seizure detection was often false negative/positive; therefore, the interpretation of the cEEG should be supported by EEG-trained neurologists. Background EEG activity was not associated with outcome parameters, which suggests that background activity is a poor outcome predictor.
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Journal of critical care · Jun 2017
Community analysis of dental plaque and endotracheal tube biofilms from mechanically ventilated patients.
Mechanically ventilated patients are at risk for developing ventilator-associated pneumonia, and it has been reported that dental plaque provides a reservoir of respiratory pathogens that may aspirate to the lungs and endotracheal tube (ETT) biofilms. For the first time, metataxonomics was used to simultaneously characterize the microbiome of dental plaque, ETTs, and non-directed bronchial lavages (NBLs) in mechanically ventilated patients to determine similarities in respective microbial communities and therefore likely associations. ⋯ The high similarity between the microbiomes of dental plaque, NBLs, and ETTs suggests that the oral cavity is indeed an important site involved in microbial aspiration to the lower airway and ETT. As such, maintenance of good oral hygiene is likely to be highly important in limiting aspiration of bacteria in this vulnerable patient group.
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Journal of critical care · Jun 2017
ReviewDying in intensive care units of India: Commentaries on policies and position papers on palliative and end-of-life care.
This study critically examines the available policy guidelines on integration of palliative and end-of-life care in Indian intensive care units to appraise their congruence with Indian reality. ⋯ The article suggests the need to reexamine policies in terms of their attainability and congruence with Indian reality.