Comparing Bispectral Index Monitoring vs Clinical Assessment for Deep Sedation in the ICU: Effects on Delirium Reduction and Sedative Drug Doses-A Randomized Trial.

Background: Sedative overdoses pose a risk of delirium among patients in the ICU, with potential mitigation through the use of a processed EEG monitor (the bispectral index [BIS]) to guide depth of sedation.

Research Question: Can BIS-guided deep sedation (Richmond Agitation Sedation Scale [RASS] score, -4 or -5) reduce sedative dosage and increase delirium-free and coma-free (DFCF) days?

Study Design And Methods: A randomized controlled trial was conducted in a tertiary mixed ICU, enrolling patients requiring deep sedation for > 8 h. Patients were assigned randomly to either the clinical assessment (CA) or BIS groups (BIS range, 40-60).

Fractional excretion of sodium and potassium and urinary strong ion difference in the evaluation of persistent AKI in sepsis.

Objective: To evaluate the diagnostic performance of FENa (Fractional excretion of sodium), FEK (fractional excretion of potassium) and uSID (urinary strong ion difference) in predicting pAKI in sepsis and septic shock.

Design: Retrospective cohort study.

Setting: Two intensive care units in Argentina.

Acute ischemic stroke in a patient with Cogan's syndrome.

Cogan's syndrome is a rare disorder characterized by inflammatory eye and inner ear/vestibular disease. In some cases patients may present medium and large vessel vasculitis which may produce neurological manifestations. We present the case of a patient who was admitted with clinical manifestations of stroke.

Cryoprobe biopsy for the diagnosis of acute hypoxemic respiratory failure of undetermined origin.

Rationale: Acute hypoxemic respiratory failure is a condition that comprises a wide array of entities. Obtaining a histological lung sample might help reach a diagnosis and direct an appropriate treatment in a select group of patients.

Objective: To describe our experience in the use of cryobiopsy for the diagnosis of acute hypoxemic respiratory failure of undetermined origin.

[Transcultural validation of the Maastricht Clinical Teaching Questionnaire].

The evaluation of the clinical teacher's performance provides feedback to motivate them to improve their teaching skills. To perform the cross-cultural adaptation of the Maastricht Clinical Teaching Questionnaire, the International Guide for the Adaptation of the Questionnaires was followed. The validity of content, response process, construct and reliability were investigated.

Dead space analysis at different levels of positive end-expiratory pressure in acute respiratory distress syndrome patients.

Purpose: To analyze the effects of positive end-expiratory pressure (PEEP) on Bohr's dead space (VD/VT) in patients with acute respiratory distress syndrome (ARDS).

Material And Methods: Fourteen ARDS patients under lung protective ventilation settings were submitted to 4 different levels of PEEP (0, 6, 10, 16 cmHO). Respiratory mechanics, hemodynamics and volumetric capnography were recorded at each protocol step.

Implementation and results of a new ECMO program for lung transplantation and acute respiratory distress.

Objective: The development of the extracorporeal membrane oxygenation in Latin America represents a challenge in this specialty field. The objective of this article was to describe the results of a new extracorporeal membrane oxygenation program in an intensive care unit.

Methods: This retrospective cohort study included 22 patients who required extracorporeal membrane oxygenation and were treated from January 2011 to June 2014.

Reference values for volumetric capnography-derived non-invasive parameters in healthy individuals.

The aim of this study was to determine typical values for non-invasive volumetric capnography (VCap) parameters for healthy volunteers and anesthetized individuals. VCap was obtained by a capnograph connected to the airway opening. We prospectively studied 33 healthy volunteers 32 ± 6 years of age weighing 70 ± 13 kg at a height of 171 ± 11 cm in the supine position.

Factors determining a low dose of haemodialysis as measured by ionic dialysance in critical patients with acute kidney injury.

Background: Estimating the dialysis dose is a requirement commonly used to assess the quality of renal replacement therapy (RRT) in patients with chronic kidney disease (CKD). In patients with acute kidney injury (AKI), this value is not always evaluated and it has been estimated that the prescribed dose is seldom obtained. Reports addressing this issue in AKI individuals are scarce and most have not included an adequate number of patients or treatments, nor were patients treated with extended therapies.

H1N1 infection and the kidney in critically ill patients.

Background: Acute renal failure due to viral infections is rare. We assessed the development of acute kidney injury (AKI) in critically compromised patients due to the H1N1 influenza virus.

Methods: All patients with a PCR -confirmed diagnosis of H1N1 influenza infection admitted to the intensive care unit between May and July 2009 were retrospectively studied.