Collections EM CC


Emergency Medicine Critical Care
Pedro de la Oliva, Juan J Menéndez-Suso, Mabel Iglesias-Bouzas, Elena Álvarez-Rojas, José M González-Gómez, Patricia Roselló, Juan I Sánchez-Díaz, Susana Jaraba
OBJECTIVES: To characterize cardiac preload responsiveness in pediatric patients with cardiovascular dysfunction and dilated cardiomyopathy using global end-diastolic volume index, stroke volume index, cardiac index, and extravascular lung water index. DESIGN: Prospective multicenter observational study. SETTING: Medical/surgical PICUs of seven Spanish University Medical Centers. PATIENTS: Seventy-five pediatric patients (42 male, 33 female), median age 36 months (range, 1-207 mo), were divided into three groups: normal cardiovascular status, cardiovascular dysfunction, and dilated cardiomyopathy...
January 2015: Pediatric Critical Care Medicine
Benjamin de Witt, Raj Joshi, Harvey Meislin, Jarrod M Mosier
BACKGROUND: Assessing volume responsiveness, defined as an increase in cardiac index after infusion of fluids, is important when caring for critically ill patients in septic shock, as both under- and over-resuscitation can worsen outcomes. This review article describes the currently available methods of assessing volume responsiveness for critically ill patients in the emergency department, with a focus on patients in septic shock. OBJECTIVE: The single-pump model of the circulation utilizing cardiac-filling pressures is reviewed in detail...
November 2014: Journal of Emergency Medicine
Emma Sydenham, Ian Roberts, Phil Alderson
BACKGROUND: Hypothermia has been used in the treatment of head injury for many years. Encouraging results from small trials and laboratory studies led to renewed interest in the area and some larger trials. OBJECTIVES: To estimate the effect of mild hypothermia for traumatic head injury on mortality and long-term functional outcome complications. SEARCH STRATEGY: We searched the Injuries Group Specialised Register, Current Controlled Trials MetaRegister of trials, Zetoc, ISI Web of Science: Science Citation Index Expanded (SCI-EXPANDED) and Conference Proceedings Citation Index-Science (CPCI-S), CENTRAL (The Cochrane Library), MEDLINE and EMBASE...
April 15, 2009: Cochrane Database of Systematic Reviews
Paul E Marik, Michael Baram, Bobbak Vahid
BACKGROUND: Central venous pressure (CVP) is used almost universally to guide fluid therapy in hospitalized patients. Both historical and recent data suggest that this approach may be flawed. OBJECTIVE: A systematic review of the literature to determine the following: (1) the relationship between CVP and blood volume, (2) the ability of CVP to predict fluid responsiveness, and (3) the ability of the change in CVP (DeltaCVP) to predict fluid responsiveness. DATA SOURCES: MEDLINE, Embase, Cochrane Register of Controlled Trials, and citation review of relevant primary and review articles...
July 2008: Chest
Paul E Marik, Rodrigo Cavallazzi
BACKGROUND: Despite a previous meta-analysis that concluded that central venous pressure should not be used to make clinical decisions regarding fluid management, central venous pressure continues to be recommended for this purpose. AIM: To perform an updated meta-analysis incorporating recent studies that investigated indices predictive of fluid responsiveness. A priori subgroup analysis was planned according to the location where the study was performed (ICU or operating room)...
July 2013: Critical Care Medicine
Beverley J Hunt
No abstract text is available yet for this article.
February 27, 2014: New England Journal of Medicine
Anthony J Weekes, David A Johnson, Stephen M Keller, Bradley Efune, Christopher Carey, Nigel L Rozario, H James Norton
OBJECTIVES: Central venous catheter (CVC) placement is a common procedure in critical care management. The authors set out to determine echocardiographic features during a saline flush of any type of CVC. The hypothesis was that the presence of a rapid saline swirl in the right atrium on bedside echocardiography would confirm correct placement of the CVC tip, similar to the accuracy of the postplacement chest radiograph (CXR). METHODS: This was a prospective convenience sample of emergency department (ED) and intensive care unit (ICU) patients who had CVCs placed...
January 2014: Academic Emergency Medicine
Oguz Kilickaya, Ognjen Gajic
The lung-protective mechanical ventilation strategy has been standard practice for management of acute respiratory distress syndrome (ARDS) for more than a decade. Observational data, small randomized studies and two recent systematic reviews suggest that lung protective ventilation is both safe and potentially beneficial in patients who do not have ARDS at the onset of mechanical ventilation. Principles of lung-protective ventilation include: a) prevention of volutrauma (tidal volume 4 to 8 ml/kg predicted body weight with plateau pressure<30 cmH2O); b) prevention of atelectasis (positive end-expiratory pressure≥5 cmH2O, as needed recruitment maneuvers); c) adequate ventilation (respiratory rate 20 to 35 breaths per minute); and d) prevention of hyperoxia (titrate inspired oxygen concentration to peripheral oxygen saturation (SpO2) levels of 88 to 95%)...
March 12, 2013: Critical Care: the Official Journal of the Critical Care Forum
Scott D Weingart, Robert L Sherwin, Lillian L Emlet, Isaac Tawil, Julie Mayglothling, Jon C Rittenberger
No abstract text is available yet for this article.
March 2013: American Journal of Emergency Medicine
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