Abstract:
PURPOSE:Cervical spine (CS) injury in blunt trauma is a prevalent and devastating complication. Clearing CS injuries in obtunded patients is fraught with challenges, and no single imaging modality or algorithm is both safe and effective. Increased time in c-spine precautions is associated with greater patient morbidity including increased ventilator associated pneumonia, delirium and ulceration. We systemically reviewed the literature to assess the effectiveness of 64-slice computed tomographic (CT) scanners in clearing traumatic CS injuries. MATERIALS AND METHODS:Studies were identified using MEDLINE and Embase, the references of identified studies, international experts on CS clearance and authors of primary studies. Three reviewers independently selected and extracted data from studies that reported on both CT and MRI in traumatic CS injury. RESULTS:We included five studies involving a total of 3443 patients; however, heterogeneity and lack of sample size precluded quantitative summation of the results. Qualitative assessment showed that 64-Slice CT scan, when applied within a set protocol, performed favourably in clearing injury. CONCLUSIONS:Data suggests that using 64-slice CT scans on obtunded trauma patients with grossly intact motor function, in the context of a defined clearance protocol with interpretation by an experienced radiologist, may be sufficient to safely clear significant CS injury. A prospective study comparing MRI and 64-slice CT scan clearance in this population is necessary to corroborate these conclusions.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Kanji HD,Neitzel A,Sekhon M,McCallum J,Griesdale DEdoi
10.1016/j.jcrc.2013.10.022subject
Has Abstractpub_date
2014-04-01 00:00:00pages
314.e9-13issue
2eissn
0883-9441issn
1557-8615pii
S0883-9441(13)00402-4journal_volume
29pub_type
杂志文章,评审abstract:OBJECTIVE:To describe perceptions of the administrative procedures for seasonal bed closures and their consequences in the intensive care unit (ICU), and to critique this example of health care priority setting for legitimacy and fairness. DESIGN:A qualitative study using case study methods and interviews with key par...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2003.YJCRC6
更新日期:2003-03-01 00:00:00
abstract:PURPOSE:To compare the rate of therapeutic failure in critically ill patients treated by third-generation cephalosporins (3GCs) or piperacillin-tazobactam (PTZ) for wild-type AmpC-producing Enterobacterales pulmonary infections. METHODS:Over a 4-year period, all adult patients treated for a wild-type AmpC-producing En...
journal_title:Journal of critical care
pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
abstract:PURPOSE:To assess the clinical significance of serial troponin I levels (measured in the first 72 hours from admission) in 42 consecutive patients with moderate-to-severe acute respiratory distress syndrome (ARDS). Echocardiography and electrocardiogram testings were serially performed in the time window. MATERIALS AN...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.01.004
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:To assess the effect on healthcare professional emergency response time and safety of small compared to large clog size. DESIGN:Randomized controlled trial. SETTING:The intensive care unit of a single university medical centre in The Netherlands. PARTICIPANTS:Intensive care medicine professionals. INTERV...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
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更新日期:2020-12-01 00:00:00
abstract:PURPOSE:Hypoxia is one of the leading causes of anesthesia-related injury. In response to the limitations of conventional preoxygenation, Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) has been used as a method of providing both preoxygenation and apneic oxygenation during intubation. MATERIALS...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.06.011
更新日期:2016-12-01 00:00:00
abstract:PURPOSE:Although gastrointestinal motility disorders are common in critically ill patients, constipation and its implications have received very little attention. We aimed to determine the incidence of constipation to find risk factors and its implications in critically ill patients MATERIALS AND METHODS:During a 6-mo...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2009.03.007
更新日期:2009-12-01 00:00:00
abstract:PURPOSE:To evaluate the impact of slow-tempo music listening periods in mechanically ventilated intensive care unit patients. METHODS:A randomized crossover study was performed in a 16-bed, adult critical care unit at a tertiary care hospital. Still-sedated patients, mandating at least 3 more days of mechanical ventil...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2013.01.007
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Changes in mean perfusion pressure (MPP) from premorbid resting values may contribute to the progression of septic acute kidney injury (AKI). OBJECTIVES:In patients with septic shock, we aimed to investigate the association of changes from premorbid values with AKI severity and progression. METHODS:We obta...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.05.003
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:Transesophageal probe insertion in the ventilated patients often is difficult. Different complex techniques were suggested for easier placement of the transesophageal probe. In this work, we describe a simple technique of TEE probe insertion in ventilated patients. METHODS AND RESULTS:In the period 2015-2018, ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.11.020
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:Optimal dosing of antibiotics is important for efficacy and avoidance of resistance. Fluoroquinolones are frequently used to treat severe infections in critically ill patients. We studied ciprofloxacin pharmacokinetics after administration of 400 mg twice a day (bid) intravenously (IV). MATERIAL AND METHODS:Se...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2007.11.011
更新日期:2008-09-01 00:00:00
abstract::Hypernatremia is common in intensive care units. It has detrimental effects on various physiologic functions and was shown to be an independent risk factor for increased mortality in critically ill patients. Mechanisms of hypernatremia include sodium gain and/or loss of free water and can be discriminated by clinical ...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2012.05.001
更新日期:2013-04-01 00:00:00
abstract:PURPOSE:Thoracocardiography noninvasively monitors global stroke volume by inductive plethysmographic recording of ventricular volume curves as previously validated by thermodilution. Our purpose was to investigate the potential of thoracocardiography to individually assess stroke volume of the left ventricle. We hypot...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/s0883-9441(98)90019-3
更新日期:1998-09-01 00:00:00
abstract:PURPOSE:To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. METHODS:31 patients that had been admitted to the intensive care unit (ICU) of a center on oncology were evaluated. Their PA was obtained from their bioelectrica...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.01.006
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:We identified risk factors for noninvasive ventilation (NIV) failure in patients with acute cardiogenic pulmonary edema (ACPE). MATERIALS AND METHODS:We conducted an observational cohort study over a 3-year period in a 28-bed emergency intensive care unit (EICU) and prospectively included all consecutive patie...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.01.001
更新日期:2017-06-01 00:00:00
abstract:PURPOSE:The prognostic value of hyperlactatemia in septic shock is unquestionable. However, as current definitions do not include hyperlactatemia as a mandatory criterion, some hypotensive patients may be diagnosed as having septic shock despite exhibiting normolactatemia. The significance of persistent sepsis-induced ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.09.007
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:The primary objective of this survey was to describe pharmacists' attitudes regarding probiotic use in the intensive care unit (ICU); secondary objectives were to evaluate pharmacists' knowledge and use of probiotics for critically ill patients. METHODS:The survey instrument was rigorously designed and pretest...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.10.016
更新日期:2016-02-01 00:00:00
abstract:PURPOSE:Medication-related problems (MRPs) frequently occur at the interfaces of care settings. We examined this further because little has been published about MRPs experienced by patients/carers after discharge from the intensive care unit (ICU). METHODS AND MATERIALS:Medication history data were collected before, d...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.06.002
更新日期:2013-02-01 00:00:00
abstract:PURPOSE:The purpose of this study is to determine if monitoring urinary bladder PCO2, PO2, and calculated intramucosal pH would be a reliable index of tissue perfusion. MATERIALS AND METHODS:This nonrandomized controlled study was conducted in a laboratory at a university medical center. Eight immature female Yorkshir...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/s0883-9441(99)90020-5
更新日期:1999-06-01 00:00:00
abstract:PURPOSE:Closed endotracheal suctioning (CES) may impact ventilator-associated pneumonia (VAP) risk by reducing environmental contamination. In developing countries where resource limitations constrain the provision of optimal bed space for critically ill patients, CES assumes greater importance. MATERIALS AND METHODS:...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2010.10.002
更新日期:2011-10-01 00:00:00
abstract:PURPOSE:Bacterial ventriculitis (BV) may develop in patients requiring external ventricular drains (EVDs). The purpose of this study was to determine predictors of EVD-associated BV onset. MATERIALS AND METHODS:A retrospective review of Duke University Hospital patients with EVD device placement between January 2005 a...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.08.012
更新日期:2014-02-01 00:00:00
abstract:PURPOSE:The purpose of this study is to assess lipid metabolism at the tissue level in critically ill subjects. MATERIALS AND METHODS:We studied 182 patients with systemic inflammatory response syndrome/severe sepsis or shock during the acute (day 1) and subacute phase of critical illness (day 6). All subjects had a t...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.06.003
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate the causes, incidence, and impact on outcome of admission hyperlactatemia in patients admitted to a general medical intensive care unit (ICU). METHODS:A retrospective cohort study was done in an 8-bed general ICU of tertiary care hospital over 15 months. Data regarding pat...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.11.009
更新日期:2011-06-01 00:00:00
abstract:PURPOSE:To assess the feasibility of a trial evaluating whether hyperoncotic albumin, in addition to diuretics, improves diuresis and facilitates liberation from mechanical ventilation in critically ill adults. MATERIALS AND METHODS:We randomized 46 hemodynamically stable patients with hypoalbuminemia, prescribed diur...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2018.07.020
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Thoracic surgery patients are at high-risk for adverse pulmonary outcomes. Heated humidified high-flow nasal cannula oxygen (HHFNC O2) may decrease such events. We hypothesized that patients randomized to prophylactic HHFNC O2 would develop fewer pulmonary complications compared to conventional O2 therapy. ...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2017.04.023
更新日期:2017-08-01 00:00:00
abstract:PURPOSE:Using administrative codes and minimal physiologic and laboratory data, we sought a high-specificity identification strategy for patients whose sepsis initially appeared during their ICU stay. MATERIALS AND METHODS:We studied all patients discharged from an academic hospital between September 1, 2013 and Octob...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.01.012
更新日期:2017-06-01 00:00:00
abstract:PURPOSE:Utilization of renal replacement therapy (RRT) in cirrhotic patients has been controversial and is typically dependent on the status of transplantation. A better understanding of the central role for arterial vasodilatation in the pathogenesis of hepatorenal syndrome (HRS) has led to routine use of vasoconstric...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.05.006
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:The study aimed to compare hemoglobin (Hb) values determined using the portable HemoCue system (HemoCue Hb 201+; HemoCue AB, Ängelholm, Sweden) with laboratory Hb level determination. MATERIALS AND METHODS:Adult patients hospitalized in our surgical intensive care unit who required an Hb level determination we...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.08.012
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:To examine relationships between self-report and performance-based measures of physical function in ICU patients randomized to standardized rehabilitation therapy (SRT) or usual care (UC). METHODS:Physical function was assessed in 257 ICU patients using self-report (physical functioning scale of the SF-36 (SF-...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.01.020
更新日期:2019-06-01 00:00:00
abstract:PURPOSE:The purpose of this study is to determine the effect of postoperative fluid balance (FB) on subsequent outcomes in acute care surgery (ACS) patients admitted to the surgical intensive care unit (ICU). MATERIAL AND METHODS:Acute care surgery patients admitted to the surgical ICU from 06/2012 to 01/2013 were fol...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.06.023
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:It is uncertain whether, in critical care medicine, non-blinded trials are associated with a bias toward a different effect size. The aim of our study was to assess if conducting non-blinded/open label studies leads to greater effect size than blinded studies, and to provide an estimate of the weight of this di...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.09.031
更新日期:2018-12-01 00:00:00