BACKGROUND Early-onset ventilator-associated pneumonia (EO-VAP) is the leading cause of morbidity and mortality in comatose patients. However, VAP prevention bundles focus mainly on late-onset VAP and may be less effective in preventing EO-VAP in comatose patients. Systemic antibiotic administration at the time of intubation may have a role in preventing EO-VAP. Therefore, we evaluated the effe...

BACKGROUND AND PURPOSE Anecdotal reports suggest that a loss of distinction between gray (GM) and white matter (WM) as adjudged by CT scan predicts poor outcome in comatose patients after cardiac arrest. To address this, we quantitatively assessed GM and WM intensities at various brain levels in comatose patients after cardiac arrest. METHODS Patients for whom consultation was requested withi...

OBJECTIVES To record N18 in median somatosensory evoked potentials (SEPs) for deeply comatose or brain dead patients and to demonstrate the usefulness of N18 for the diagnosis of brain death in comparison with auditory brain stem responses (ABRs) and P13/14 in median SEPs, which have been conventionally used as complementary tests for the diagnosis of brain death. METHODS Subjects were 19 dee...

Bronchial secretions from 21 patients with moderate to severe chest infections were obtained by transtracheal aspiration. Six seriously ill patients showed greatly increased levels of amylase activity in the bronchial secretions compared with those found in the 15 less ill patients. This amylase was almost certainly derived from oropharyngeal contents and its presence suggests that aspiration m...

Auditory evoked potentials are informative of intact cortical functions of comatose patients. The integrity of auditory functions evaluated using mismatch negativity paradigms has been associated with their chances of survival. However, because auditory discrimination is assessed at various delays after coma onset, it is still unclear whether this impairment depends on the time of the recording...

OBJECTIVE To compare heart rate variability (HRV) and QT dispersion in comatose patients with normal brainstem function and with brain death. STUDY DESIGN Cross-sectional comparative study. PLACE AND DURATION OF STUDY The Intensive Care Unit of Ali-Ebn-Abitaleleb Hopital, Rafsanjan Medical University from September 2007 to June 2009. METHODOLOGY Fourteen brain death patients with clinical...

The relation between serum osmolality, glucose, sodium, bicarbonate, arterial pH, BUN and level of consciousness was studied in 189 patients with diabetic ketoacidosis (DKA). There was much overlap between all laboratory values among various groups, even when there was a statistically significant difference. To find a better predictor, we defined a new factor as serum osmolality/arterial pH...