Journal of critical care
-
Journal of critical care · Oct 2014
ReviewCritically ill cancer patient in intensive care unit: Issues that arise.
Advances in the management of malignancies and organ failures have led to substantial increases in survival as well as in the number of cancer patients requiring intensive care unit (ICU) admission. Although effectiveness of ICU in this group remains controversial, the heterogeneity of its population in terms of the nature and curability of their disease and the severity of critical illness and underlying conditions may explain the plethora of issues arising when considering cancer patients for ICU admission, especially from the view of limited resources and ICU beds. The most frequent reasons leading a cancer patient to ICU are postoperative, respiratory failure, infection, and sepsis. ⋯ A multidisciplinary treating team of physicians should aid in changing the goals from restorative to palliative care when there appears to be no possible benefit from any treatment. End-of life-decisions and code status should be made by consensus, based on patients' autonomy and dignity. Further interventional multicenter studies are required to assess post-ICU burden, long-term medical outcomes, and quality of life in this cohort of patients.
-
Journal of critical care · Oct 2014
Observational StudyDifficult peripheral venous access: Clinical evaluation of a catheter inserted with the Seldinger method under ultrasound guidance.
A preliminary observational study was undertaken to evaluate the risk of failure of ultrasound-guided peripheral intravenous catheterization of a deep arm vein for a maximum of 7 days, after peripheral intravenous (PIV) cannulation failure. ⋯ Our results suggest that catheters inserted with the Seldinger method are adapted to prolonged peripheral deep-vein infusion. Ultrasound can play a role in catheter monitoring by identifying early thrombosis formation.
-
Journal of critical care · Oct 2014
Observational StudyImpact of serial measurements of lysophosphatidylcholine on 28-day mortality prediction in patients admitted to the intensive care unit with severe sepsis or septic shock.
The purpose of this study is to investigate the effect of serial lysophosphatidylcholine (LPC) measurement on 28-day mortality prediction in patients with severe sepsis or septic shock admitted to the medical intensive care unit (ICU). ⋯ Serial measurements of LPC help in the prediction of 28-day mortality in ICU patients with severe sepsis or septic shock.
-
Journal of critical care · Oct 2014
An evaluation of the validity and potential utility of facial electromyelogram Responsiveness Index for sedation monitoring in critically ill patients.
The purpose of this study is to explore the validity of a novel sedation monitoring technology based on facial electromyelography (EMG) in sedated critically ill patients. ⋯ Responsiveness Index is not directly comparable with clinical sedation scores but is a potential continuous alert to possible deep sedation in critically ill patients.