Articles: critical-illness.
-
Randomized Controlled Trial Multicenter Study
A pilot feasibility trial of allocation of freshest available red blood cells versus standard care in critically ill patients.
Prolonged storage of red blood cells (RBCs) may increase posttransfusion adverse events in critically ill patients. We aimed to evaluate in intensive care unit (ICU) patients 1) the feasibility of allocating freshest available compatible RBCs versus standard care and 2) the suitability of this approach in the design of a large randomized controlled trial (RCT). ⋯ Randomized delivery of the freshest available RBCs versus standard care to ICU patients who were prescribed transfusion for clinical reasons is feasible, with a clinically relevant degree of storage duration separation achievable between the two study groups. These findings support the feasibility of a future large pragmatic RCT.
-
Chinese Med J Peking · Jun 2012
Randomized Controlled TrialEarly versus late percutaneous dilational tracheostomy in critically ill patients anticipated requiring prolonged mechanical ventilation.
Tracheostomy should be considered to replace endotracheal intubation in patients requiring prolonged mechanical ventilation (MV). However, the optimal timing for tracheostomy is still a topic of debate. The present study aimed to investigate whether early percutaneous dilational tracheostomy (PDT) can reduce duration of MV, and to further verify whether early PDT can reduce sedative use, shorten intensive care unit (ICU) stay, decrease the incidence of ventilator associated pneumonia (VAP), and increase successful weaning and ICU discharge rate. ⋯ The early PDT resulted in more ventilator-free, sedation-free, and ICU-free days, higher successful weaning and ICU discharge rate, and lower incidence of VAP, but did not change the cumulative 60-day incidence of death in the patients' anticipated requiring prolonged mechanical ventilation.
-
Randomized Controlled Trial Multicenter Study
Intensive care diaries and relatives' symptoms of posttraumatic stress disorder after critical illness: a pilot study.
Relatives of patients recovering from critical illness are at risk of developing posttraumatic stress disorder. ⋯ Provision of a diary may help psychological recovery in patients' families after critical illness.
-
Anaesth Intensive Care · May 2012
Randomized Controlled TrialAssessing the performance of a continuous infusion for potassium supplementation in the critically ill.
Hypokalaemia is a common problem in critically ill patients, which if untreated, can result in dysrhythmia or another adverse outcome. We assessed the safety and efficacy of a continuous infusion of potassium chloride versus an existing intermittent infusion regimen. In this open-label randomised parallel-arm active-controlled pilot study, critically ill adults with plasma potassium concentration between 2.5 and 3.8 mmol/l were randomised to receive either a continuous infusion or intermittent infusions of potassium chloride for establishment and maintenance of normokalaemia. ⋯ We recorded no adverse events directly attributable to infusion of potassium chloride in either study arm. Although titrated continuous infusion did not demonstrate a clinically important difference by comparison with intermittent infusions for the maintenance of normokalaemia, there was more consistent control of plasma potassium with no observed complications or adverse events. Therefore, this trial showed an acceptable efficacy and safety profile for the continuous infusion regimen, suggesting scope for further study.
-
Intensive care medicine · Apr 2012
Randomized Controlled Trial Multicenter StudySleep and other factors associated with mental health and psychological distress after intensive care for critical illness.
Some patients who survive intensive care unit (ICU) treatment report psychological sequelae during recovery. This study examined factors associated with psychological outcomes of former ICU patients up to 6 months after hospital discharge. ⋯ Female gender, early levels of increased stress and problems sleeping are associated with worse psychological recovery for survivors of critical illness.