Articles: critical-illness.
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Revista médica de Chile · Jun 2008
Randomized Controlled Trial Comparative Study[Protocol based sedation versus conventional treatment in critically ill patients on mechanical ventilation].
Sedatives and analgesic drugs give comfort and allow adequate respiratory support to critically ill patients in mechanical ventilation (MV). Its improper use may increase the duration of MV. Clinical guidelines suggest implementation of protocols, however this is seldom done in clinical practice. ⋯ The implementation of sedation protocol applied by nurses improved the quality of sedation and reduced the doses of Midazolam in mechanically ventilated patients.
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Critical care medicine · May 2008
Randomized Controlled TrialThe impact of delaying enteral feeding on gastric emptying, plasma cholecystokinin, and peptide YY concentrations in critically ill patients.
Enteral nutrient (EN) deprivation slows gastric emptying (GE) and increases plasma cholecystokinin (CCK) concentrations in healthy humans and may potentially contribute to the delayed GE in the critically ill. This study examined the impact of delayed feeding on GE, plasma CCK, and peptide YY (PYY) concentrations in the critically ill. ⋯ In critical illness, delayed enteral feeding appears to have little impact on either GE or the enterogastric feedback hormones. However, the association between delayed feeding and increased duration of ventilation and length of stay in the ICU supports the current recommendation that enteral nutrition should be commenced early.
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Randomized Controlled Trial
Effect of low-dose naloxone infusion on fentanyl requirements in critically ill children.
Sedating critically ill patients often involves prolonged opioid infusions causing opioid tolerance. Naloxone has been hypothesized to limit opioid tolerance by decreasing adenylate cyclase/cyclic adenosine monophosphate activation. The study purpose was to investigate the effect of low-dose naloxone on the maximum cumulative daily fentanyl dose in critically ill children. ⋯ We conclude that administration of low-dose naloxone (0.25 microg/kg per hour) does not decrease fentanyl requirements in critically ill, mechanically ventilated children.
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Randomized Controlled Trial
Metabolic effects of enteral versus parenteral alanyl-glutamine dipeptide administration in critically ill patients receiving enteral feeding: a pilot study.
Glutamine (Gln) may become conditionally indispensable during critical illness. The short-term metabolic effects of enteral versus parenteral Gln supplementation are unknown in this clinical setting. ⋯ This study showed that alanyl-Gln administration by enteral or parenteral routes did not appear to affect antioxidant capacity or oxidative stress markers, T-lymphocyte subset (CD-3, CD-4, CD-8) number, gut barrier function or whole-body protein metabolism compared to unsupplemented ICU patients requiring enteral tube feeding. Enteral Gln appeared to maintain plasma tocopherol levels in this pilot metabolic study.
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialA novel vibrotactile display to improve the performance of anesthesiologists in a simulated critical incident.
Current methods of information transfer in the operating room between monitor and anesthesiologist rely on visual and auditory modalities. These modalities can easily become overloaded in a high cognitive workload situation, such as in a critical incident. The use of vibrotactile communication has been shown to improve information transfer in other high cognitive workload environments such as aviation. We designed a novel waist-mounted vibrotactile display to be worn by the anesthesiologist to test if a vibrotactile display could improve the clinical response time to begin treating a simulated case of anaphylaxis when compared with a group using traditional information displays. In addition, we evaluated differences in situational awareness (SA) between the two groups. ⋯ Our study provides evidence that vibrotactile communication can reduce response time to critical incidents.