Abstract:
INTRODUCTION:Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related complications. OBJECTIVE:To investigate whether the ultrasound-guided PDT is equivalent or superior to the bronchoscopy-guided or anatomical landmarks-guided PDT with regard to procedural-related and clinical complications. METHODS:A systematic review of randomized clinical trials was conducted comparing an ultrasound-guided PDT to the control groups (either a bronchoscopy-guided PDT or an anatomical landmark-guided PDT) in patients undergoing a PDT in the ICU. The primary outcome was the incidence of major procedural-related and clinical complication rates. The secondary outcome was the incidence of minor complication rates. Random-effect meta-analyzes were used to pool the results. RESULTS:Four studies fulfilled the inclusion criteria and they were analyzed. The studies included 588 participants. There were no differences in the major complication rates between the patients who were assigned to the ultrasound-guided PDT when compared to the control groups (pooled risk ratio [RR]: 0.48; 95% confidence interval [CI]: 0.13-1.71, I2 = 0%). The minor complication rates were not different between the groups, but they had a high heterogeneity (pooled RR: 0.49; 95% CI 0.16-1.50; I2 = 85%). The sensitivity analyzes that only included the randomized controlled trials that used a landmark-guided PDT as the control group showed lower rates of minor complications in the ultrasound-guided PDT group (pooled RR: 0.55; 95% CI: 0.31-0.98, I2 = 0%). CONCLUSION:The ultrasound-guided PDT seems to be safe and it is comparable to the bronchoscopy-guided PDT regarding the major and minor procedural-related or clinical complications. It also seems to reduce the minor complications when compared to the anatomical landmark-guided PDT.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Gobatto ALN,Besen BAMP,Cestari M,Pelosi P,Malbouisson LMSdoi
10.1177/0885066618755334subject
Has Abstractpub_date
2020-05-01 00:00:00pages
445-452issue
5eissn
0885-0666issn
1525-1489journal_volume
35pub_type
杂志文章,meta分析abstract::Thyroid storm, an endocrine emergency first described in 1926, remains a diagnostic and therapeutic challenge. No laboratory abnormalities are specific to thyroid storm, and the available scoring system is based on the clinical criteria. The exact mechanisms underlying the development of thyroid storm from uncomplicat...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613498053
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND::The diagnosis of sepsis is challenging in the absence of a gold standard test. Recent studies have explored the role of neutrophil and monocyte volume, conductivity, and scatter (VCS), derived from automated hematology analyzers, in diagnosing sepsis. We assessed the diagnostic accuracy of VCS parameters in...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066616682940
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:At this time, there are no studies evaluating the risk of delirium or coma with the use of ketamine in mechanically ventilated adult patients, compared to conventional therapies such as propofol or dexmedetomidine. OBJECTIVE:The objective of this study was to evaluate the number of days alive without deliri...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618767619
更新日期:2020-06-01 00:00:00
abstract::Decision-making for the hospitalized dying and critically ill is often characterized by an understanding of autonomy that leads to clinical care and outcomes that are antithetical to patients' preferences around suffering and quality of life. A better understanding of autonomy will facilitate the ultimate goal of a pa...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619870458
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:A 25-hydroxyvitamin D, 25(OH)D, deficiency is common among critically ill patients and correlated with increased mortality. Furthermore, deficiency is associated with advanced liver disease. However, there are no studies available comparing the dimensions and consequences of a 25(OH)D deficiency between pa...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618803844
更新日期:2020-10-01 00:00:00
abstract::The whole-brain criterion of death provides that a person who has irreversibly lost all clinical functions of the brain is dead. Bedside brain death (BD) tests permit physicians to determine BD by showing that the whole-brain criterion of death has been fulfilled. In a nonsystematic literature review, we identified an...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618784268
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Lactate clearance has become important in the management of sepsis. However, factors unrelated to sepsis-induced hyperlactatemia, including β-2 adrenergic agonists, can interfere with lactate clearance. OBJECTIVES:To investigate the association of inhaled albuterol with lactate clearance in patients with se...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619901095
更新日期:2020-01-22 00:00:00
abstract::Brain blood flow tests with diffusible radiopharmaceuticals are often done as an ancillary test in brain death (BD). We report a case of an infant with absent brain blood flow on an anterior planar image despite persistent breathing and extensor posturing. We reviewed the literature from 1980 to 2008 using MEDLINE and...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066609355388
更新日期:2010-01-01 00:00:00
abstract::Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous develop...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613485215
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Intracerebral hemorrhage (ICH) is a devastating and costly condition. Although the American Heart Association/American Stroke Association recommends admitting patients with ICH to a neurocritical care unit (NCCU), this strategy may accrue unnecessary cost for patients with relatively milder presentation. We ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066615578113
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:The management of refractory septic shock remains a major challenge in critical care and its early indicators are not fully understood. We hypothesized that the maximum norepinephrine dosage within 24 hours of intensive care unit (ICU) admission may be a useful indicator of early mortality in patients with s...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619860736
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Pharmacogenomic (PGx) testing has the potential to provide information on specific drug-metabolizing enzymes that may lead to an absence, reduction, or increase in medication effect in patients. There is a paucity of prospective studies examining PGx testing in the intensive care unit (ICU) setting. RESEARC...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620946303
更新日期:2020-07-31 00:00:00
abstract::Although the number of available donor hearts severely limits the epidemiologic impact of heart transplantation on patients with heart failure, patients with end-stage heart failure unresponsive to medical management currently have no other viable alternatives. Destination therapy with a ventricular assist device is t...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066603259012
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Ischemic and hypoxic secondary brain insults are common and detrimental in traumatic brain injury (TBI). Treatment aims to maintain an adequate cerebral blood flow with sufficient arterial oxygen content. It has been suggested that arterial hyperoxia may be beneficial to the injured brain to compensate for c...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620944097
更新日期:2020-07-27 00:00:00
abstract::Respiratory complications before and after liver transplant are common, diverse, and potentially have a negative impact on patient outcomes. In this review, we discuss the most frequent respiratory conditions that patients may develop in the perioperative period. Their prevention and/or treatment may help to maximize ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066618781526
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Changes in white blood cell (WBC) counts and/or temperature could have important implications in patients on ventilators, but the frequency of these events is uncertain. METHODS:We reviewed the medical records from 281 ventilation episodes in our medical intensive care unit to determine patient characterist...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066615605036
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Poor communication among health-care providers is cited as the most common cause of sentinel events involving patients. Patient care in the critical care setting is incredibly complex. A consistent care plan is necessary between day/night shift teams and among bedside intensive care unit (ICU) nurses, consul...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066616653947
更新日期:2017-09-01 00:00:00
abstract::Substantial progress has been made to create innovative technology that can monitor the different physiological characteristics that precede the onset of secondary brain injury, with the ultimate goal of intervening prior to the onset of irreversible neurological damage. One of the goals of neurocritical care is to re...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066618788022
更新日期:2019-06-01 00:00:00
abstract::Acute kidney injury (AKI) is common in critically ill patients and associated with increased morbidity and mortality. With the increased use of renal replacement therapy (RRT) for severe AKI, the optimal time for initiation of RRT has become one of the most probed and debated topic in the field of nephrology and criti...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066618774257
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Sepsis coagulopathy or disseminated intravascular coagulation (DIC) mainly due to progressive endothelial disruption and damage. The glycocalyx is expressed on the endothelial cell surface and contributes to anti-thrombogenicity, anti-inflammatory, and regulates vascular permeability. We aimed to evaluate th...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620949131
更新日期:2020-08-17 00:00:00
abstract::Realizing the vast medical benefits of validated protocols, recommendations and practice guidelines requires acceptance and implementation by frontline care providers. Knowledge translation is the science of accelerating the transfer of knowledge to practice by understanding and creatively addressing the barriers that...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,实务指引
doi:10.1177/0885066610387988
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The efficacy of routinely obtained chest radiographs (CXRs) on admission to the intensive care unit (ICU) is largely unknown. The current study investigated the efficacy of routinely obtained admission CXRs and determined whether the value of this diagnostic test was dependent on patient categ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066610366925
更新日期:2010-07-01 00:00:00
abstract::Echodynamics refers to the use of echocardiography as hemodynamic tool mostly in intensive and acute care settings. It implies a smooth drift from the classic cardiology use to a more critical care adjusted use. A more personalized approach is advocated in critical care, and echo is one way to reach such goal. Correct...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066617734151
更新日期:2018-08-01 00:00:00
abstract:PURPOSE:To evaluate the effects of midodrine in addition to intravenous vasopressor therapy on outcomes in adults recovering from shock. MATERIALS AND METHODS:PubMed, Scopus, Clinicaltrials.gov, and published abstracts were searched from inception to November 2018 for studies comparing outcomes in shock after midodrin...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619843279
更新日期:2020-11-01 00:00:00
abstract:UNLABELLED:While clinicians' management of severe sepsis and septic shock has been positively influenced by a number of clinical research studies in the last decade, challenges remain regarding early hemodynamic optimization as envisioned in the Surviving Sepsis Campaign's (SSC) resuscitation bundle (RB). We examined t...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066610392499
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:To use the 2010 to 2011 data collected by structured chart review to provide a detailed up-to-date description of the epidemiology and microbiology of the sepsis syndromes. METHODS:Prospective observational study conducted at a university-affiliated urban teaching hospital and level-1 trauma and burn center. A...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066615592851
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Agitation is common in the intensive care unit (ICU). Although antipsychotics are frequently used as first-line therapy, chlorpromazine has fallen out of favor due to risk of cardiovascular complications and severe hypotension. Although chlorpromazine is used anecdotally, there is a lack of data regarding it...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618818787
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Cancer is associated with significant health-care expenditure, but few studies have examined the cost of patients with cancer in the intensive care unit (ICU). We aimed to describe the costs and outcomes of patients admitted to the ICU with cancer. METHODS:We conducted a retrospective cohort study of pati...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619899653
更新日期:2021-02-01 00:00:00
abstract:INTRODUCTION:Red cell distribution width (RDW) is reflective of systemic inflammation. The objective of this study was to investigate the association between RDW (on day 1 of development of septic shock) and mortality. METHODS:A total of 279 patients with septic shock were included. We categorized the patients into qu...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066612452838
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:The strategy used to improve effective checklist use in intensive care unit (ICU) setting is essential for checklist success. This study aimed to test the hypothesis that an electronic checklist could reduce ICU provider workload, errors, and time to checklist completion, as compared to a paper checklist. METH...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066614558015
更新日期:2016-03-01 00:00:00