International journal of critical illness and injury science
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Int J Crit Illn Inj Sci · Jul 2013
Evaluation of the efficacy of simplified Fencl-Stewart equation in analyzing the changes in acid base status following resuscitation with two different fluids.
Metabolic acid-base disorders in critically ill patients may not be identified by base excess (BE) approach. Anion gap method can detect approximately 1/3 hidden "gap acidosis". In such conditions, when adjusted for hypoalbuminemia, Fencl-Stewart's approach can reliably detect the hidden abnormal anions. ⋯ Simplified Fencl-Stewart equation is effective in identifying a mixed acid-base disorder, which otherwise would remain undetected.
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Int J Crit Illn Inj Sci · Jul 2013
Comparison of heparin dosing based on actual body weight in non-obese, obese and morbidly obese critically ill patients.
Obesity is endemic in the United States and obese patients are at increased risk of thromboembolism but little data are available for dosing unfractionated heparin (UFH). We evaluated the relationship between obesity and UFH efficacy during critical illness by examining UFH infusions in non-obese, obese, and morbidly obese critically ill patients. ⋯ Dosing of UFH in morbidly obese and obese critically ill patients based on actual body weight and a reduced initial dose was associated with similar time to first therapeutic aPTT and steady state.
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Int J Crit Illn Inj Sci · Apr 2013
Secondary confirmation of endotracheal tube position by diaphragm motion in right subcostal ultrasound view.
To assess the sensitivity and specificity of right subcostal ultrasound view to confirm correct endotracheal tube intubation (ETT). ⋯ This study suggests that diaphragm motion in right subcostal ultrasound view is an effective adjunct to diagnose ETT place in patients undergoing intubation in emergency department.
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Int J Crit Illn Inj Sci · Apr 2013
Intubation of patients with angioedema: A retrospective study of different methods over three year period.
Angioedema (AE) is edema of the skin, subcutaneous tissue and/or submucosal tissues, resulting from extravasation of intravascular fluid. Swelling of the supraglottic mucosa can lead to airway obstruction with consequent hypoxia, brain damage and death. To date, fiberoptic bronchoscope (FOB) intubation of the spontaneously breathing patient is the preferred method for an anticipated difficult intubation. However, other alternative devices can be utilized to intubate angioedema successfully. ⋯ This retrospective review of intubation methods showed that VL could be performed faster than FOB without an increase in adverse events.