Heart-Protective Mechanical Ventilation in Postoperative Cardiosurgical Patients
CONCLUSIONS: In postoperative cardiosurgical patients, MV with Vt 6 ml × kg-1 and PEEP 10 cm H2O is characterized by worsened oxygenation and elimination of CO2 and a less favorable hemodynamic profile than ventilation with Vt 10 ml × kg-1 and PEEP 5 cmH2O. New and Noteworthy. (i) Patients after CABG may be especially sensitive to low tidal volume and increased PEEP as it negatively affects hemodynamic profile by means of the right heart preload decrease and afterload increase. (ii) Mechanical ventilation settings aiming to minimize mean airway pressure reduce the negative effects of positive inspiratory pressu...
Source: Critical Care Research and Practice - April 16, 2021 Category: Intensive Care Authors: Vadim Mazurok Igor Kasherininov Andrey Bautin Olga Kulemina Ryta Rzheutskaya Source Type: research

Thoracic Surgery Consultations in COVID-19 Critically Ill Patients: Beyond Conservative Approach
CONCLUSION: Noniatrogenic pneumothorax, subcutaneous emphysema, and mediastinal emphysema are well-known thoracic entities, but their presence in the context of COVID-19 disease is a harbinger for worse prognosis and outcomes. The presence of pneumothorax may be associated with better prognosis and outcome compared to surgical and mediastinal emphysema.PMID:33815840 | PMC:PMC8010523 | DOI:10.1155/2021/6626150 (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - April 5, 2021 Category: Intensive Care Authors: Yasser Aljehani Sharifah A Othman Yousif Almubarak Ayman Elbaz Mohammed Sabry Farouk Alreshaid Hatem Y Elbawab Zeead M Alghamdi Mohammed Alshahrani Source Type: research

Conceptual Models of Nursing in Critical Care
CONCLUSION: For the selection of a conceptual model of nursing for these contexts, the focus should be on the person and the choice should fall on the model that is most appropriate to the patient, and not on the philosophy that supports the model. Considering the nature of care, the nursing team can select a model or a combination of models.PMID:33777452 | PMC:PMC7981178 | DOI:10.1155/2021/5583319 (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - March 29, 2021 Category: Intensive Care Authors: Jo ão V Vieira S érgio Deodato Felismina Mendes Source Type: research

Suxamethonium-Induced Hyperkalemia: A Short Review of Causes and Recommendations for Clinical Applications
Crit Care Res Pract. 2021 Feb 25;2021:6613118. doi: 10.1155/2021/6613118. eCollection 2021.ABSTRACTAfter the introduction of suxamethonium in 1953, cases of cardiac arrest during induction of anesthesia were recorded. In the following years, hyperkalemia was identified as the cause, and the connection to acetylcholine receptor modulation as the underlying molecular mechanism was made. Activation of the acetylcholine receptor with suxamethonium, acetylcholine, or choline causes an efflux of potassium to the extracellular space. However, certain pathological conditions cause acetylcholine receptor proliferation and the emerg...
Source: Critical Care Research and Practice - March 12, 2021 Category: Intensive Care Authors: Henrik Lynge Hovgaard Peter Juhl-Olsen Source Type: research

Massive Blood Transfusion for Trauma Score to Predict Massive Blood Transfusion in Trauma
This study was a retrospective cohort that collected data from trauma patients who met the trauma team activation criteria. The predicting parameters included in the analysis were retrieved from the history, physical examination, and initial laboratory results. The significant parameters from a multivariable analysis were used to develop a clinical scoring system. The discrimination was evaluated by the area under a receiver operating characteristic (AuROC) curve. The calibration was demonstrated with Hosmer-Lemeshow goodness of fit, and an internal validation was done.RESULTS: Among 867 patients, 102 (11.8%) patients rece...
Source: Critical Care Research and Practice - March 8, 2021 Category: Intensive Care Authors: Osaree Akaraborworn Boonying Siribumrungwong Burapat Sangthong Komet Thongkhao Source Type: research

COVID-19: A Single-Center ICU Experience of the First Wave in the Philippines.
This study is a retrospective, descriptive study of ninety-one COVID-19 probable patients admitted in the COVID ICU of The Medical City from March 16 to May 7, 2020. We described clinical and demographic characteristics amongst COVID-19-confirmed and -negative patients. Therapeutic interventions including COVID-19 investigational drug use and other organ failure strategies were noted and tested for association with ICU survivors and nonsurvivors. We observed that there was no therapeutic intervention that was associated with improved outcomes, with some interventions showing trends favoring the ICU nonsurvivor group. These...
Source: Critical Care Research and Practice - February 20, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study.
Conclusions: COVID-19 is associated with a high burden of mortality for patients treated on the ward and the ICU and required substantial reconfiguration of critical care services. This has significant implications for planning and resource utilisation. PMID: 33564474 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - February 12, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

How Much PEEP Does High Flow Deliver via Tracheostomy? A Literature Review and Benchtop Experiment.
Authors: Thomas M, Joshi R, Cave G Abstract Background: High flow tracheostomy (HFT) is a commonly used weaning and humidification strategy for tracheostomised patients, but little is known as to how much PEEP or mechanical benefit it offers. Patient anatomy and device characteristics differentiate it from high flow nasal cannula and the physiological effects observed. Objectives: (1) To review the available literature on the effects of HFT on airway pressure and indices of gas exchange. (2) To quantify PEEP generated by a HFT  circuit. Methods: A randomised benchtop experiment was conducted, with a ...
Source: Critical Care Research and Practice - February 3, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Effect of Training Eye Care Clinical Guideline for ICU Patients on Clinical Competence of Eye Care in Nurses.
Conclusion: Training nurses based on EC clinical guidelines for anesthetized patients can improve the knowledge, attitude, and practice of ICU nurses. Evidence-based EC practice requires continuous training based on clinical guidelines and EC practice monitoring by nursing managers according to EC clinical guideline for an anesthetized patient. PMID: 33520313 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - February 3, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

A Retrospective Analysis of Thromboembolic Phenomena in Mechanically Ventilated Patients with COVID-19.
Authors: Faqihi F, Alharthy A, Balhamar A, Nasim N, Alanezi K, Alaklobi F, Memish ZA, Blaivas M, Alqahtani SA, Karakitsos D Abstract Background: Recent studies have shown an increased prevalence of thromboembolic disease in critically ill patients with the novel SARS-CoV-2 disease (COVID-19). However, the use of enhanced anticoagulation therapy in these patients remains controversial. Objectives: To determine the incidence of thromboembolic phenomena (TEP) and hemorrhagic events (HEs) in intensive care unit (ICU) COVID-19 patients. Methods: One hundred and sixty ICU patients with COVID-19 were enrolled. Cli...
Source: Critical Care Research and Practice - February 3, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Identification of the Range of Nursing Skills Used to Provide Social Support for Mothers of Preterm Infants in Neonatal Intensive Care.
Conclusion: There were positive associations between social support from nurses and mothers' satisfaction with the care of their infants. Therefore, planning to promote and create opportunities for neonatal nurses to support mothers in NICU is important to promote increased maternal satisfaction in infant care. PMID: 33505719 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - January 30, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Critical Incident Disclosing Behaviors and Associated Factors among Nurses Working in Amhara Region Referral Hospitals, Northwest Ethiopia: A Cross-Sectional Study.
Authors: Eshete Y, Tesfaye B, Dagnew Z, Kefale D, Mesfin Belay D, Minuye B Abstract Background: Though the goal of healthcare institutions is patient safety, errors have been committed by healthcare providers. Incident reporting behavior enhances patient safety by reducing the repeated occurrence of errors in the health facility. Therefore, this study aims to identify incident disclosing behaviors and associated factors among nurses working in referral hospitals, Northwest Ethiopia. Methods: Institution-based cross-sectional study design was conducted among randomly selected 319 nurses working in referral hospi...
Source: Critical Care Research and Practice - January 30, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

The Effect of Fluid Overload on Attributable Morbidity after Cardiac Surgery: A Retrospective Study.
Authors: Koc V, Delmas Benito L, de With E, Boerma EC Abstract Introduction: Although the detrimental effects of excessive perioperative fluid administration are generally well established, data in the setting of cardiac surgery remain less robust. Methods: In this retrospective single-center observational study, the total fluid balance in the first 12 hours during and after surgery was evaluated. Primary endpoint was the relationship between total fluid balance and the incidence of prolonged mechanical ventilation. For this purpose, data were divided into quartiles (Q); prolonged mechanical ventilation and pro...
Source: Critical Care Research and Practice - January 27, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Current Physical Therapy Practice in the Intensive Care Unit in Saudi Arabia: A Multicentre Cross-Sectional Survey.
Conclusion: PTs reported significant variation in the choice of treatment for different clinical cases inside ICU. The main barriers in the ICU setting were low confidence and inadequate training. PMID: 33457013 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - January 20, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Area under the Curve-Based Dosing of Vancomycin in Critically Ill Patients Using 6-Hour Urine Creatinine Clearance Measurement.
Authors: Shahrami B, Najmeddin F, Ghaffari S, Najafi A, Rouini MR, Mojtahedzadeh M Abstract Background: The area under the curve- (AUC-) guided vancomycin dosing is the best strategy for individualized therapy in critical illnesses. Since AUC can be calculated directly using drug clearance (CLvan), any parameter estimating CLvan will be able to achieve the goal of 24-hour AUC (AUC24 h). The present study was aimed to determine CLvan based on 6-hour urine creatinine clearance measurement in critically ill patients with normal renal function. Method: 23 adult critically ill patients with an estimated glome...
Source: Critical Care Research and Practice - January 13, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Sleep Promotion among Critically Ill Patients: Earplugs/Eye Mask versus Ocean Sound-A Randomized Controlled Trial Study.
Conclusion: Earplugs and eye mask were better than ocean sound in improving sleep quality. Earplugs, eye mask, and ocean sound are safe and cost effective, which could be used as an adjuvant to pharmacological interventions to improve sleep quality among ICU patients. However, further research in this area needs to be conducted. This trial is registered with NCT03215212. PMID: 33425385 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - January 13, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Lung Ultrasound and Sonographic Subpleural Consolidation in COVID-19 Pneumonia Correlate with Disease Severity.
Authors: Bitar ZI, Shamsah M, Maadarani O, Bamasood OM, Bitar AZ, Alfoudri H Abstract Introduction: One of the ultrasonic features of COVID-19 pneumonia is the presence of subpleural consolidation (SPC), and the number of SPCs varies among patients with COVID-19 pneumonia. Aim: To examine the relationship between disease severity and the number of SPCs on admission. Methodology. This observational, prospective, single-center study included patients with suspected COVID-19 infection who had been transferred to the ICU. A specialized intensivist in critical care ultrasound performed lung ultrasound (LUS) and echo...
Source: Critical Care Research and Practice - January 13, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Hemodynamic Characteristics of Mechanically Ventilated COVID-19 Patients: A Cohort Analysis.
Authors: Boerma EC, Bethlehem C, Stellingwerf F, de Lange F, Streng KW, Koetsier PM, Bootsma IT Abstract Background: Solid data on cardiovascular derangements in critically ill COVID-19 patients remain scarce. The aim of this study is to describe hemodynamic characteristics in a cohort of COVID-19-related critically ill patients. Methods: A retrospective observational cohort study in twenty-eight consecutive mechanically ventilated COVID-19 patients. Pulse contour analysis-derived data were obtained from all patients, using the PiCCO® system. Results: The mean arterial pressure increased from 77 ...
Source: Critical Care Research and Practice - January 13, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CG.
Conclusion: The rapid design, development, and clinical implementation of a new barrier enclosure, the "SplashGuard CG," was feasible in this time of crisis thanks to close collaboration between medical and engineering teams and the use of recurring simulation sessions to test and improve the initial prototypes. Following this accelerated process, it is necessary to maintain team skills, monitor any undesirable effects, and evaluate and continuously improve this new device. PMID: 33381311 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - January 1, 2021 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure.
Conclusions: The novel practice of PEPP after liberation from prolonged mechanical ventilation in patients with COVID-19 respiratory failure is feasible and well tolerated, and may be associated with favourable clinical outcomes including improvement in oxygenation and respiratory rate and a low rate of reintubation. Larger prospective studies of PEPP are warranted. PMID: 33299605 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - December 12, 2020 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research