Journal of critical care
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Journal of critical care · Aug 2017
Randomized Controlled TrialThe effects of oral rinse with 0.2% and 2% chlorhexidine on oropharyngeal colonization and ventilator associated pneumonia in adults' intensive care units.
Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Units (ICUs) which increases the length of ICU stay, duration of mechanical ventilation, and mortality. The present study used an oral care protocol and compared the effects of two different concentrations of chlorhexidine on reduction of oropharyngeal colonization and VAP. ⋯ Oral decontamination with 2% compared to 0.2% chlorhexidine is a more effective method in the prevention of VAP and reduction of oropharyngeal colonization (especially gram-positive).
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Journal of critical care · Aug 2017
Randomized Controlled TrialHeated humidified high-flow nasal cannula oxygen after thoracic surgery - A randomized prospective clinical pilot trial.
Thoracic surgery patients are at high-risk for adverse pulmonary outcomes. Heated humidified high-flow nasal cannula oxygen (HHFNC O2) may decrease such events. We hypothesized that patients randomized to prophylactic HHFNC O2 would develop fewer pulmonary complications compared to conventional O2 therapy. ⋯ Pulmonary complications were rare after thoracic surgery. Although HHFNC O2 did not convey significant benefits, these results need to be interpreted with caution, as our study was likely underpowered to detect a reduction in pulmonary complications. High rates of patient-reported discomfort with HHFNC O2 need to be considered in clinical practice and future trials.
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Journal of critical care · Jun 2017
Randomized Controlled TrialMild induced hypothermia for patients with severe traumatic brain injury after decompressive craniectomy.
To evaluate the efficacy and safety of mild induced hypothermia for intracranial hypertension in patients with traumatic brain injury after decompressive craniectomy. ⋯ Mild induced hypothermia can reduce intracranial hypertension after decompressive craniectomy, decreasing patient mortality. Hypothermia should be considered one of the main treatments for intracranial hypertension after decompressive craniectomy in patients with traumatic brain injury.
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Journal of critical care · Apr 2017
Randomized Controlled Trial Multicenter StudyEffects of low-dose atrial natriuretic peptide infusion on cardiac surgery-associated acute kidney injury: A multicenter randomized controlled trial.
To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. ⋯ Atrial natriuretic peptide infusion did not show a renoprotective effect or cost-saving effect in the treatment of cardiac surgery-associated AKI.
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Journal of critical care · Apr 2017
Randomized Controlled TrialHydrochlorothiazide in intensive care unit-acquired hypernatremia: A randomized controlled trial.
Thiazides are suggested as a treatment for intensive care unit (ICU)-acquired hypernatremia (IAH). The primary aim of the study was reducing serum sodium concentration (sNa) in patients with IAH with hydrochlorothiazide (HCT) in comparison to placebo. Secondary end points were a difference in urine sodium concentration (uNa) and duration of severe IAH. ⋯ HCT 25 mg 1 qd did not significantly affect sNa or uNa in patients with IAH.