Effects of nurse delivered thoracic ultrasound on management of adult intensive care unit patients: A prospective observational study.

Background: Thoracic ultrasound is a valuable tool that helps diagnose cardiopulmonary disorders and guide management in intensive care unit patients. Intensive care unit nurses were trained to perform thoracic ultrasound examinations, after which they were named 'UltraNurses' for clinical recognizability. UltraNurses demonstrated rapid learning trajectories, but the impact on clinical-decision making remained unknown.

Effect of Low-Normal vs High-Normal Oxygenation Targets on Organ Dysfunction in Critically Ill Patients: A Randomized Clinical Trial.

Importance: Hyperoxemia may increase organ dysfunction in critically ill patients, but optimal oxygenation targets are unknown.

Objective: To determine whether a low-normal Pao2 target compared with a high-normal target reduces organ dysfunction in critically ill patients with systemic inflammatory response syndrome (SIRS).

Design, Setting, And Participants: Multicenter randomized clinical trial in 4 intensive care units in the Netherlands.

Hyperoxia does not affect oxygen delivery in healthy volunteers while causing a decrease in sublingual perfusion.

Objective: To determine the human dose-response relationship between a stepwise increase in arterial oxygen tension and its associated changes in DO and sublingual microcirculatory perfusion.

Methods: Fifteen healthy volunteers breathed increasing oxygen fractions for 10 minutes to reach arterial oxygen tensions of baseline (breathing air), 20, 40, 60 kPa, and max kPa (breathing oxygen). Systemic hemodynamics were measured continuously by the volume-clamp method.

PReVENT--protective ventilation in patients without ARDS at start of ventilation: study protocol for a randomized controlled trial.

Background: It is uncertain whether lung-protective mechanical ventilation using low tidal volumes should be used in all critically ill patients, irrespective of the presence of the acute respiratory distress syndrome (ARDS). A low tidal volume strategy includes use of higher respiratory rates, which could be associated with increased sedation needs, a higher incidence of delirium, and an increased risk of patient-ventilator asynchrony and ICU-acquired weakness. Another alleged side-effect of low tidal volume ventilation is the risk of atelectasis.

Season of sampling and season of birth influence serotonin metabolite levels in human cerebrospinal fluid.

Background: Animal studies have revealed seasonal patterns in cerebrospinal fluid (CSF) monoamine (MA) turnover. In humans, no study had systematically assessed seasonal patterns in CSF MA turnover in a large set of healthy adults.

Methodology/principal Findings: Standardized amounts of CSF were prospectively collected from 223 healthy individuals undergoing spinal anesthesia for minor surgical procedures.

Percutaneous dilatational tracheostomy in the ICU: optimal organization, low complication rates, and description of a new complication.

Study Objectives: To assess short-term and long-term complications of bronchoscopy-guided, percutaneous dilatational tracheostomy (PDT) and surgical tracheostomy (ST) and to report a complication of PDT that has not been described previously.

Design: Prospective survey.

Setting: University teaching hospital.

Drowning.

Recent epidemiologic data have shown that the burden of drowning is much greater than expected. Prevention and timely rescue are the most effective means of reducing the number of persons at risk. Early bystander cardiopulmonary resuscitation is the most important factor for survival after submersion.