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Original Research Article  |   Volume 1, Issue 2

High Flow Conditioned Oxygen Therapy for Prevention of Reintubation in Critically Ill Patients: A Preliminary Cohort Study

Gonzalo Hernandez, Concepcion Vaquero Collado, Susana Garcia Plaza, Ana Villasclaras Pacheco, Candido Pardo Rey, Eugenia de la Fuente O'Connor, Rafael Cuena, Paloma Gonzalez Arenas, Rafael Fernandez
Abstract

Oxygen delivery after extubation is the cornerstone treatment to maintain adequate oxygenation and avoid reintubation. Oxygen is usually delivered through low-flow nasal prongs; when necessary, flow is increased or patients are switched to a high-flow face mask. Some other interventions after extubation focus on specific causes of reintubation; for example, high risk patients are administered prophylactic corticosteroids before planned extubation to prevent laryngeal edema and patients with hypercapnia at extubation are administered noninvasive mechanical ventilation. However, to our knowledge, no other intervention has been proven to reduce reintubation rate in a general population of critically ill patients.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510009

Research Article  |   Volume 1, Issue 2

Relationship Between Isolating Multi-Drug Resistant A. Baumannii and K. Pneumoniae in Bronchial Aspirate and Subsequently in Blood Cultures: Evaluation of Colistin Aerosol Therapy in Intensive Care Patients

Distasi Maria Antonietta, Del Gaudio Tito, Malcangi Annarita and Pirronti Angela
Abstract

Klebsiella pneumoniae (K. pneumoniae) and Acinetobacter baumannii (A. baumannii) are multiresistant pathogens most frequently found in patients hospitalized in the Intensive Care of our hospital. We found the highest rate of positivity in the bronchial aspirates, often followed by a similar observation in blood culture. We carried out a study to evaluate the reduction of sepsis that developed after the detection of these microorganisms in bronchial aspirate, following the introduction of treatment with colistin aerosol in combination with conventional therapy. From 2012 to the first half of 2014, 533 patients were admitted to the ICU of our hospital.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510008

Original Research  |   Volume 1, Issue 2

Glycemic Disturbances on Admission as a Predictor of Inpatient Mortality

Daniel Saenz-Abad, Jose Antonio Gimeno-Orna, Maria del Carmen Lahoza-Perez, Elena Rivero-Sanz, Marta Jordan-Domingo, Artur Juan-Arribas, Maria del Mar Becerra-Mayor and Cristina Baquer-Sahun
Abstract

This is a case-control retrospective analytical study. The cases were patients deceased during hospitalization and controls where those discharged in the same time period. Patients were age-matched and the final outcome of the study was hospital mortality. Rapid Emergency Medicine Score (REMS) and Charlson comorbidity index as well as blood analysis (full blood count, glucose, renal function, ions) were determined. Abnormal glucose levels (dysglycemia) were those considered to be < 70 or > 200 mg/dl. We used logistic regression, integrated discrimination improvement (IDI) index and ROC curves to determine the predictive mortality capacity.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510007

Review Article  |   Volume 1, Issue 2

Ventricular Arrhythmias in Acute Coronary Syndrome Patients: Therapy of Electrical Storm

Tobias Willich and Andreas Goette
Abstract

This review provides an overview of the available therapeutic options for acute care and management of malignant ventricular arrhythmias (VA) such as ventricular tachycardia (VT), ventricular fibrillation (VF) and electrical storm (ES). As therapeutic options antiarrhythmic drug (AAD) therapy, implantable cardioverter defibrillator therapy (ICD), radiofrequency catheter ablation (RFA) and neuroaxial modulation like stellate ganglion blockade or renal denervation are available. AAD therapy is limited. Amiodarone and beta-blockers are the only option.

  PDF   |    Full Text | DOI: 10.23937/2474-3674/1510006