Journal of critical care
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Journal of critical care · Dec 2018
Poor agreement in the calculation of venoarterial PCO2 to arteriovenous O2 content difference ratio using central and mixed venous blood samples in septic patients.
Central venous minus arterial PCO2 to arterial minus central venous O2 content difference ratio (Pcv-aCO2/Ca-cvO2) has been proposed as a clinical surrogate for respiratory quotient. Our goal was to assess its interchangeability with mixed venous minus arterial PCO2 to arterial minus mixed venous O2 content difference ratio (Pmv-aCO2/Ca-mvO2). ⋯ In this study, Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 were not interchangeable. In addition, Pmv-aCO2/Ca-mvO2 is a composite variable, which depends on several determinants. Values of Pcv-aCO2/Ca-cvO2 should be cautiously interpreted in the assessment of critically ill patients.
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Journal of critical care · Dec 2018
Obesity survival paradox in pneumonia supported with extracorporeal membrane oxygenation: Analysis of the national registry.
To investigate whether the obesity survival paradox, where obesity is associated with improved survival, exists for pneumonia supported with extracorporeal membrane oxygenation (ECMO). ⋯ An obesity survival paradox exists in pneumonia supported with ECMO.
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Journal of critical care · Dec 2018
Ultrasound-guided percutaneous dilatational tracheostomy using a saline-filled endotracheal tube cuff as an ultrasonographic puncture target: A feasibility study.
The saline-filled endotracheal tube (ETT) cuff can be easily identified under cervical ultrasound and can serve as an ideal puncture target during percutaneous dilatational tracheostomy (PDT). The authors present their initial experience with this novel technique. ⋯ PDT performed using a saline-filled cuff as the ultrasound-guided puncture target and an endotracheal tube exchanger is feasible, and appeared to be easier to perform than standard PDT. Larger studies are required to confirm the safety and benefits of this technique.
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Journal of critical care · Dec 2018
Low-flow time is associated with a favorable neurological outcome in out-of-hospital cardiac arrest patients resuscitated with extracorporeal cardiopulmonary resuscitation.
The aim of this retrospective study was to investigate the prognostic factors in extracorporeal cardiopulmonary resuscitation (ECPR) patients and to assess their accuracy as predictors of a favorable neurological outcome. ⋯ In ECPR patients, low-flow time was significantly associated with a favorable neurological outcome, and ECPR should be performed within 58 min of the low-flow time.
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Journal of critical care · Dec 2018
Patient views regarding the impact of hydrotherapy on critically ill ventilated patients: A qualitative exploration study.
Intensive Care Unit Acquired Weakness can be mitigated by early activity and progressive mobilization. Hydrotherapy enables patients to work on their recovery in a very early stage. This may lead to higher levels of self-efficacy, subsequently higher activity-rates and faster functional recovery. Hydrotherapy might positively affect the regaining of control, hope and trust. Our aim is to explore patient perspective regarding the impact of hydrotherapy on critically ill ventilated patients. ⋯ Hydrotherapy seemed to help patients regain control and belief in their recovery. Patients experienced exercising in water as a turning point in their recovery process. This study encourages to continue providing hydrotherapy to critically ill ventilated patients and may stimulate future research.