Critical care medicine
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Critical care medicine · Jun 2005
Clinical predictors of and mortality in acute respiratory distress syndrome: potential role of red cell transfusion.
Clinical predictors for acute respiratory distress syndrome (ARDS) have been studied in few prospective studies. Although transfusions are common in the intensive care unit, the role of submassive transfusion in non-trauma-related ARDS has not been studied. We describe here the clinical predictors of ARDS risk and mortality including the role of red cell transfusion. ⋯ Important predictors for the development of and mortality in ARDS were identified. Packed red blood cell transfusion was associated with an increased development of and increased mortality in ARDS.
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Critical care medicine · Jun 2005
Myocardial ischemia, cardiac troponin, and long-term survival of high-cardiac risk critically ill intensive care unit patients.
To determine the incidence and association of myocardial ischemia with troponin elevation and survival in high-cardiac-risk intensive care patients. ⋯ Silent ischemia is strongly associated with troponin elevation in high-cardiac-risk intensive care unit patients, and troponin elevation predicts both early and late mortality.
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Critical care medicine · Jun 2005
Comparative StudyClinical resolution in patients with suspicion of ventilator-associated pneumonia: a cohort study comparing patients with and without acute respiratory distress syndrome.
To determine the pattern of resolution of classic infectious and respiratory variables in patients with ventilator-associated pneumonia (VAP) and appropriate empirical therapy, depending on the presence of acute respiratory distress syndrome (ARDS). A secondary objective was to identify clinical variables that might be useful for monitoring response to therapy. ⋯ Measures of oxygenation and core temperature can help physicians to individualize and shorten the duration of antibiotic therapy in VAP episodes. ARDS patients with VAP take twice as long to resolve fever, whereas hypoxemia should be ignored in defining resolution in this subset.
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Pneumothorax can be missed by bedside radiography, and computed tomography is the current alternative. We asked whether lung ultrasound could be of any help in this situation. ⋯ For the diagnosis of occult pneumothorax, ultrasound can decrease the need for computed tomography.
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Critical care medicine · Jun 2005
Effects of hypothermia for a short period on histologic outcome and extracellular glutamate concentration during and after cardiac arrest in rats.
To evaluate the therapeutic effects of hypothermia for a short period (20 mins, 31 degrees C) using a cardiac arrest model (5 mins) in rats. ⋯ Hypothermia for a short period decreased glutamate concentration when it was initiated before DC recovery and attenuated neuronal damage when it was initiated before or immediately after DC recovery. The therapeutic time window for hypothermia for a short period is about 10 mins after the onset of ischemia.