Journal of critical care
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Journal of critical care · Feb 2018
Positive end-expiratory pressure adjusted for intra-abdominal pressure - A pilot study.
Intra-abdominal hypertension (IAH) is associated with impaired respiratory function. Animal data suggest that positive end-expiratory pressure (PEEP) levels adjusted to intra-abdominal pressure (IAP) levels may counteract IAH-induced respiratory dysfunction. In this pilot study, our aim was to assess whether PEEP adjusted for IAP can be applied safely in patients with IAH. ⋯ PEEP=100% of IAP was not well-tolerated and only marginally improved oxygenation in ventilated patients with IAH.
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Journal of critical care · Feb 2018
Prior antimicrobial therapy duration influences causative pathogens identification in ventilator-associated pneumonia.
To determine whether prior antimicrobial therapy, divided in recent or current antibiotic treatment, influences the identification rate and/or the type of causative pathogens in patients with suspected episodes of ventilator-acquired pneumonia. ⋯ In patients with a high probability of VAP, current but not recent antibiotic use is associated with a lower rate of positive culture with a higher proportion of MDR pathogens, mostly MDR Pseudomonas aeruginosa.
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Journal of critical care · Feb 2018
Review Meta AnalysisEffect of antibiotics administered via the respiratory tract in the prevention of ventilator-associated pneumonia: A systematic review and meta-analysis.
We evaluated the effect of antibiotics administered via the respiratory tract to prevent the ventilator-associated pneumonia (VAP) in mechanically ventilated (MV) patients. ⋯ Prophylactic antibiotics administered through the respiratory tract by nebulization reduce the occurrence of VAP, without a significant effect on either the ICU mortality or occurrence of VAP due to MDR pathogens.
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Journal of critical care · Feb 2018
Randomized Controlled Trial Comparative StudyA randomized controlled trial of one bag vs. two bag system of fluid delivery in children with diabetic ketoacidosis: Experience from a developing country.
To compare one vs. two bag system with respect to blood glucose variability (BGV), time for resolution of acidosis and incidence of hypoglycemia, hypokalemia, and cerebral edema in children with diabetic ketoacidosis (DKA). ⋯ The one and two bag systems were similar to each other with respect to BGV, incidence of complications and time to resolution of acidosis.
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Journal of critical care · Feb 2018
ReviewSpatial methods for evaluating critical care and trauma transport: A scoping review.
The objective of this scoping review is to inform future applications of spatial research regarding transportation of critically ill patients. We hypothesized that this review would reveal gaps and limitations in the current research regarding use of spatial methods for critical care and trauma transport research. ⋯ There is a gap between the availability of spatial tools and their usage for analyzing and improving medical transportation. The adoption of geospatially guided transport decisions can meaningfully impact healthcare expenditures, especially in healthcare systems looking to strategically control expenditures with minimum impact on patient outcomes.