Journal of critical care
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Journal of critical care · Aug 2012
ReviewLiberation of neurosurgical patients from mechanical ventilation and tracheostomy in neurocritical care.
Neurosurgical patients commonly require mechanical ventilation and monitoring in a neurocritical care unit. There are only few studies that specifically address the process of liberation from mechanical ventilation in this population. Patients who remain ventilator or artificial airway dependent receive a tracheostomy. ⋯ In this article, we review the general principles of liberation and the current literature as it pertains to neurosurgical patients with primary brain injury. The criteria for "readiness of extubation" include a combination of neurologic assessment, hemodynamic, and respiratory parameters. Future studies are required to better assess indicators for extubation readiness, evaluate the predictors of extubation failure in brain-injured patients, and define the most appropriate timing for a tracheostomy.
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Journal of critical care · Aug 2012
Absolute eosinophils count as a marker of mortality in patients with severe sepsis and septic shock in an intensive care unit.
Eosinophils in the circulating blood undergo apoptosis during sepsis syndromes induced by the action of certain cytokines. ⋯ Eosinophils counts were lower in patients who died of sepsis than in those who survived, but its clinical usefulness seems limited. Their role as an indicator of clinical stability seems to be important.
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Journal of critical care · Aug 2012
The early phase of human sepsis is characterized by a combination of apoptosis and proliferation of T cells.
T cell activation as well as unresponsiveness has been described in separate studies in sepsis. Our aim was to establish the coexistence of both T cell fate in human sepsis. ⋯ Concomitant T cell proliferation and T cell apoptosis are observed in human sepsis, being related to a different pathway.