Journal of critical care
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Journal of critical care · Jun 2017
Brain death after decompressive craniectomy: Incidence and pathophysiological mechanisms.
Patients who received decompressive craniectomy (DC) are usually not regarded to qualify for brain death (BD) as intracranial pressure (ICP) is not assumed to reach levels critical enough to cause cerebral perfusion failure. Here we investigated the incidence of BD after DC and analyzed the pathophysiological mechanisms. ⋯ Our study evidences that DC does not exclude BD. Even after DC, BD is preceded by a severely reduced CPP, supporting loss of cerebral perfusion as a critical step in BD pathophysiology.
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Journal of critical care · Jun 2017
Monitoring sound and light continuously in an intensive care unit patient room: A pilot study.
To determine the feasibility of continuous recording of sound and light in the intensive care unit (ICU). ⋯ Combined sound and light can be continuously and easily monitored in the ICU setting. Incorporating sound and light monitors in ICU rooms may promote an enhanced patient- and staff-centered healing environment.
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Journal of critical care · Jun 2017
Acute kidney injury is an independent risk factor for myocardial injury after noncardiac surgery in critical patients.
Myocardial injury after noncardiac surgery (MINS) contributes to mortality and morbidity. However, risk factors accelerating its development remain unclear. The aim of this study was to identify the incidence and risk factors of MINS. ⋯ The incidence of MINS in critical patients is high. Postoperative AKI is an independent risk factor of MINS in critical patients. It is recommended that postoperative kidney functions be routinely assessed in all critical patients after noncardiac surgery.
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Journal of critical care · Jun 2017
Cytokine profiles as novel diagnostic markers of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children.
The aim of this study was to identify specific laboratory indices to distinguish Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children. ⋯ This study showed that IFN-γ, IL-10/IL-6, and IFN-γ/IL-6 are novel specific indicators for differential diagnosis of EBV-HLH. Additionally, IL-6, IL-10, TNF-α, and IFN-γ are useful indices for monitoring the effects of treatment on EBV-HLH.
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Journal of critical care · Jun 2017
Selective digestive decontamination in critically ill children: A survey of Canadian providers.
Selective digestive decontamination of the digestive tract involves the routine administration of oral, gastric, and intravenous antibiotics to mechanically ventilated children to prevent hospital-acquired infections. It has a strong evidence base in adults, with limited pediatric evidence. Current utilization of this intervention among pediatric physicians in North America is unknown. ⋯ Among surveyed providers, there is little knowledge and no use of selective digestive decontamination for the prevention of hospital-acquired infections. Before interventional studies are performed in pediatric practice, there is a need for study of facilitators, barriers and acceptability of SDD in practice.