Journal of critical care
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Journal of critical care · Apr 2018
Randomized Controlled TrialBudesonide facilitates weaning from mechanical ventilation in difficult-to-wean very severe COPD patients: Association with inflammatory mediators and cells.
Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. ⋯ In COPD patients on MV, nebulized budesonide was associated with reduced BAL CXCL8 and IL-6 levels and neutrophil numbers as well as an improvement in ventilatory mechanics and facilitated weaning.
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Journal of critical care · Apr 2018
Phase angle assessment in critically ill cancer patients: Relationship with the nutritional status, prognostic factors and death.
To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. ⋯ PA was a prognostic marker in this population, independently of previously established prognostic factors. PA can represent a clinically feasible approach for the initial identification of critically ill cancer patients who require an early and specialized nutritional intervention.
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Journal of critical care · Apr 2018
End-organ recovery post-ventricular assist device can prognosticate survival.
This study examines our institutional ventricular assist devices (VADs) experience over two decades to understand trends towards predictors of mortality. ⋯ Persistent end-organ impairment in the first 2weeks after VAD placement could be a useful prognostic marker for survival to transplant.
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Journal of critical care · Apr 2018
Diagnostic accuracy of delirium assessment methods in critical care patients.
Delirium is a disorder of decreased ability to focus, sustain or shift attention, change in cognition and or perception. The main objective was to evaluate the diagnostic accuracy of Confusion Assessment Method for the ICU (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) among the nursing and medical staff in a multidisciplinary ICU. ⋯ In our mixed ICU population, CAM-ICU remained more sensitive than ICDSC. Though sensitivity and DOR were higher for medical staff, other diagnostic parameters were similar for both medical and nursing staff.
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Journal of critical care · Apr 2018
Apnea testing using the oxygen insufflation method for diagnosis of brain death may compromise pulmonary function.
The aim of our study was to compare the reliability and safety of the classical I-AT with the continuous positive airway pressure apnea test (CPAP-AT). ⋯ Our study indicates that I-AT may compromise pulmonary function and this may support the recommendation of safer CPAP-AT alternative.