Articles: critical-care.
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Randomized Controlled Trial
Ultrasound guided transcutaneous phrenic nerve stimulation in critically ill patients: a new method to evaluate diaphragmatic function.
Diaphragm dysfunction is common in intensive care unit and associated with weaning failure and mortality. The diagnosis gold standard is the transdiaphragmatic or tracheal pressure induced by magnetic phrenic nerve stimulation. However, the equipment is not commonly available and requires specific technical skills. This study aimed to evaluate ultrasound-guided transcutaneous phrenic nerve stimulation for daily bedside assessment of diaphragm function by targeted electrical phrenic nerve stimulation. ⋯ The SONOTEPS method is a simple and accurate tool for bedside assessment of diaphragm function with ultrasound-guided transcutaneous phrenic nerve stimulation in sedated patients with no or minimal spontaneous respiratory activity.
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Comment Randomized Controlled Trial Multicenter Study Comparative Study
Effect of Tele-ICU on Clinical Outcomes of Critically Ill Patients: The TELESCOPE Randomized Clinical Trial.
Despite its implementation in several countries, there has not been a randomized clinical trial to assess whether telemedicine in intensive care units (ICUs) could improve clinical outcomes of critically ill patients. ⋯ Daily multidisciplinary rounds conducted by a board-certified intensivist through telemedicine did not reduce ICU LOS in critically ill adult patients.
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Comment Randomized Controlled Trial Multicenter Study
Fever Prevention in Patients With Acute Vascular Brain Injury: The INTREPID Randomized Clinical Trial.
Fever is associated with worse outcomes in patients with stroke, but whether preventing fever improves outcomes is unclear. ⋯ In patients with acute vascular brain injury, preventive normothermia using an automated surface temperature management device effectively reduced fever burden but did not improve functional outcomes.
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Randomized Controlled Trial Comparative Study
A Prospective Randomized Comparison of INTELLIVENT-ASV and PSV Modes in Terms of Weaning in Intensive Care Patients, Istanbul, Turkiye.
INTELLIVENT-Adaptive Support Ventilation (I-ASV; C6; Hamilton Medical; Bonaduz, Switzerland) is a closed-loop ventilation mode that continuously controls the patient's ventilation and oxygenation. It sets the minute ventilation, PEEP, and oxygen levels based on the targets set by the clinician and on physiological input from the patient. ⋯ I-ASV mode had no effect on weaning duration compared to PSV mode but decreased PEEP, FiO2, Pinsp, and Ppeak values in weaning patients.
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Randomized Controlled Trial Multicenter Study
Characterizing usual-care physical rehabilitation in Canadian intensive care unit patients: a secondary analysis of the Canadian multicentre Critical Care Cycling to Improve Lower Extremity Strength pilot randomized controlled trial.
Physical rehabilitation (PR) in the intensive care unit (ICU) may improve outcomes for survivors but clinical trial results have been discordant. We hypothesized that discordant results may reflect treatment heterogeneity received by "usual care" comparator groups in PR studies. Usual-care PR is typically underspecified, which is a barrier to comparing results across treatment studies. The primary objective of the present study was to describe the usual-care PR received by critically ill patients enrolled in the Canadian multicentre Critical Care Cycling to Improve Lower Extremity Strength (CYCLE) pilot randomized controlled trial (RCT) of PR. Other objectives were to help contextualize current research and provide data for international comparison. ⋯ ClinicalTrials.gov ( NCT02377830 ); first posted 4 March 2015.