Critical care medicine
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Critical care medicine · Dec 2009
Multicenter StudyUse of intravenous infusion sedation among mechanically ventilated patients in the United States.
Many studies compare the efficacy of different forms of intravenous infusion sedation for critically ill patients, but little is known about the actual use of these medications. We sought to describe current use of intravenous infusion sedation in mechanically ventilated patients in U.S. intensive care units. ⋯ The percentage of mechanically ventilated patients receiving intravenous infusion sedation has increased over time. Sedation with an infusion of propofol was much more common than with benzodiazepines or dexmedetomidine, even for patients mechanically ventilated beyond 96 hrs.
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Critical care medicine · Dec 2009
Comparative StudyRight ventricular function in myocardial infarction complicated by cardiogenic shock: Improvement with levosimendan.
Levosimendan improves left ventricular hemodynamic function in patients with cardiogenic shock. However, its impact on right ventricular performance has not been determined. We compared the hemodynamic effects of levosimendan on left and right ventricular function in patients with intractable cardiogenic shock following myocardial infarction. ⋯ Levosimendan infusion for cardiogenic shock following acute myocardial infarction improved hemodynamic parameters of right ventricular performance. Furthermore, we describe the use of right ventricular cardiac power index as a hemodynamic parameter of right ventricular performance.
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Critical care medicine · Dec 2009
Early alterations of red blood cell rheology in critically ill patients.
To investigate red blood cell rheology in a large intensive care unit population on admission, and to assess the possible influence of comorbidities on the rheology. ⋯ Early alterations of red blood cell rheology are common in intensive care unit patients, especially in those with sepsis. Comorbidities (other than hematologic diseases) do not significantly influence these abnormalities. These alterations could contribute to the microcirculatory alterations observed in critically ill patients.
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Critical care medicine · Dec 2009
Examination of non-clinical factors affecting tracheostomy practice in an academic surgical intensive care unit.
To gain insight into nonclinical factors potentially influencing tracheostomy practice and determine whether a specialized consultation form impacts tracheostomy utilization. ⋯ We identified variation among clinicians with respect to tracheostomy practice as well as discrepancies between perceptions of this practice and actual utilization. These factors may underlie the liberal use of this procedure in our SICU. Processes for providing accurate physician feedback may assist in optimizing tracheostomy use.
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Critical care medicine · Dec 2009
Practice GuidelineClinical practice guideline: red blood cell transfusion in adult trauma and critical care.
To develop a clinical practice guideline for red blood cell transfusion in adult trauma and critical care. ⋯ Evidence-based recommendations regarding the use of RBC transfusion in adult trauma and critical care will provide important information to critical care practitioners.