Critical care : the official journal of the Critical Care Forum
-
The Portex Soft Seal high-volume, low-pressure cuffed tracheal tube was compared with the Mallinckrodt HiLo, Sheridan Preformed and Portex Profile tracheal tubes for leakage of dye placed in the subglottic space of a pig's trachea which was used in a benchtop mechanical ventilation model and in six isolated pig tracheas. ⋯ This benchtop study suggests that the improved compliance characteristics of the Portex Soft Seal cuff are beneficial in preventing leakage of fluid in these models.
-
Adequate humidification in long-term jet ventilation is a critical aspect in terms of clinical safety. AIM: To assess a prototype of an electronic jet-ventilator and its humidification system. ⋯ The problems of humidification associated with jet ventilation can be fully prevented by using this new jet-ventilator. These data were sustained by nondeteriorating MIS values at the end of the 4-day study period in groups A, C and D.
-
Pulse oximetry is one of the most commonly employed monitoring modalities in the critical care setting. This review describes the latest technological advances in the field of pulse oximetry. Accuracy of pulse oximeters and their limitations are critically examined. Finally, the existing data regarding the clinical applications and cost-effectiveness of pulse oximeters are discussed.
-
The relation of procalcitonin (PCT) plasma concentrations compared with C-reactive protein (CRP) was analyzed in patients with different severity of multiple organ dysfunction syndrome (MODS) and systemic inflammation. PATIENTS AND ⋯ Measurement of PCT concentrations during multiple organ dysfunction syndrome provides more information about the severity and the course of the disease than that of CRP. Regarding the strong association of PCT and the respective score systems in future studies we recommend evaluation also of the severity of inflammation and MODS when PCT concentrations were compared between different types of disease.
-
To determine the degree of interinstitutional transfusion practice variation and reasons why red cells are administered in critically ill patients. STUDY DESIGN: Multicentre cohort study combined with a cross-sectional survey of physicians requesting red cell transfusions for patients in the cohort. STUDY POPULATION: The cohort included 5298 consecutive patients admitted to six tertiary level intensive care units in addition to administering a survey to 223 physicians requesting red cell transfusions in these units. MEASUREMENTS: Haemoglobin concentrations were collected, along with the number and reasons for red cell transfusions plus demographic, diagnostic, disease severity (APACHE II score), intensive care unit (ICU) mortality and lengths of stay in the ICU. ⋯ There is significant institutional variation in critical care transfusion practice, many intensivists adhering to a 100g/l threshold, and opting to administer multiple units despite published guidelines to the contrary. There is a need for prospective studies to define optimal practice in the critically ill.