Journal of critical care
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Journal of critical care · Apr 2020
Randomized Controlled TrialA clinical trial of silver-coated and tapered cuff plus supraglottic suctioning endotracheal tubes in preventing ventilator-associated pneumonia.
Novel designs of the endotracheal tube (ETT) are emerged to reduce the risk of ventilator-associated pneumonia (VAP). We evaluated the effect of two different types, namely silver-coated (Bactiguard) and subglottic suctioning (Taperguard) ETTs, on the incidence of VAP in critically-ill patients. ⋯ The use of Bactiguard or Taperguard ETTs was not associated with any difference in the incidence of VAP or ICU mortality.
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Journal of critical care · Feb 2020
Randomized Controlled Trial Multicenter StudyGender differences in mortality and quality of life after septic shock: A post-hoc analysis of the ARISE study.
To assess the impact of gender and pre-menopausal state on short- and long-term outcomes in patients with septic shock. ⋯ This post-hoc analysis of a large multi-center trial in early septic shock has shown no short- or long-term survival effect for women overall as well as in the pre-menopausal age-group.
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Journal of critical care · Oct 2019
Randomized Controlled Trial Multicenter StudyVariability in triage practices for critically ill cancer patients: A randomized controlled trial.
Intensive care triage practices and end-user interpretation of triage guidelines have rarely been assessed. We evaluated agreement between providers on the prioritization of patients for ICU admission using different triage guidelines. ⋯ The low agreement amongst practitioners on the prioritization of cancer patient cases for ICU admission existed using both general triage guidelines and guidelines tailored only to cancer patients. The lack of consensus on intensive care unit triage practices in the oncological population exposes a potential barrier to appropriate resource allocation that needs to be addressed.
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Journal of critical care · Oct 2019
Randomized Controlled Trial Multicenter Study Comparative StudyAnalgesia-first sedation in critically ill adults: A U.S. pilot, randomized controlled trial.
To determine the feasibility of conducting a multicenter ICU RCT of AFS compared to either protocol-directed sedation (PDS) or both PDS and daily sedation interruption (DSI) in North America. ⋯ A multicenter RCT evaluating AFS is feasible to conduct in North America.
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Journal of critical care · Oct 2019
Randomized Controlled TrialAeration changes induced by high flow nasal cannula are more homogeneous than those generated by non-invasive ventilation in healthy subjects.
Non-invasive mechanical ventilation (NIV) is a standard respiratory support technique used in intensive care units. High-Flow Nasal Cannula (HFNC) has emerged as an alternative, but further evidence is needed. The lung aeration and diaphragm changes achieved with these two strategies in healthy subjects have not been compared to date. ⋯ NIV and HFNC increased EELI in healthy subjects, suggesting an increase in the functional residual capacity. The EELI increase may be higher in NIV, but HFNC produced a more homogeneous change in lung ventilation. HFNC group has a higher MAR-index that could reflect a different ventilatory system adaptation.