Journal of critical care
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Journal of critical care · Jun 2019
Case ReportsSuccessful treatment of abdominal compartment syndrome with chemotherapy in a patient with a newly diagnosed Burkitt lymphoma.
Mortality of patients treated on the intensive care unit suffering from cancer is high, especially when admitted with an unknown malignancy. Still, anti-tumor therapy in critically ill patients requiring mechanical ventilation is a clinical challenge. Over the last years, successful chemotherapy has been reported, even in critically ill patients with infections and organ failure. ⋯ By obtaining negative fluid balances closure of the abdomen succeeded 18 days after laparotomy. The patient was transferred to the normal ward without organ dysfunction on day 27 and discharged home after a second cycle of chemotherapy. In conclusion, aggressive treatment using chemotherapy in critically ill patients with initially unkown malignancy may be successful.
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Journal of critical care · Jun 2019
Multicenter StudyUsefulness of a quantitative analysis of the cerebrospinal fluid volume proportion in brain computed tomography for predicting neurological prognosis in cardiac arrest survivors who undergo target temperature management.
Brain swelling post-cardiac arrest may affect cerebrospinal fluid volume. We aimed to investigate the prognostic performance of the proportion of cerebrospinal fluid volume (pCSFV) using brain computed tomography (CT) in cardiac arrest survivors. ⋯ pCSFV was independently associated with neurological outcome 6 months following cardiac arrest, however prognostic performance was not good.
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Journal of critical care · Jun 2019
Sodium bicarbonate therapy for critically ill patients with metabolic acidosis: A scoping and a systematic review.
We aimed to assess the biochemical and physiological effects, clinical efficacy, and safety, of intravenous NaHCO3 therapy in critically ill patients with acute metabolic acidosis. ⋯ Given the lack of data on the effects of intravenous NaHCO3 therapy to support its clinical use and the frequency of bicarbonate therapy, a program of investigation appears justified.
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Acute Respiratory Distress Syndrome is a major complication of leptospirosis, leading to the majority of fatalities. ⋯ Leptospirosis can induce serious but transient ARDS with a better prognosis than that of other causes of ARDS. Several patients have been successfully treated with ECMO.
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Journal of critical care · Jun 2019
Association between strained ICU capacity and healthcare costs in Canada: A population-based cohort study.
Intensive care is resource intensive, with costs representing a substantial quantity of total hospitalization costs. Strained ICU capacity compromises care quality and adversely impacts outcomes; however, the association between strain and healthcare costs has not been explored. ⋯ Admissions to ICUs experiencing strain incur incremental costs, attributed to longer hospitalization and physician services.