Intensive care medicine
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Intensive care medicine · Oct 2014
Effect of the use of low and high potency statins and sepsis outcomes.
Although statins have been shown to have cholesterol-lowering effects, their pleiotropic benefits on sepsis remain a matter of debate. In addition, the influence of statin potency on sepsis-related mortality has never been explored. The aim of our study was to determine the sepsis outcomes of low- and high-potency statin users and non-users. ⋯ High-potency statin use is associated with a lower risk of sepsis-related mortality compared with low-potency statin use.
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Intensive care medicine · Oct 2014
Pediatric cancer type predicts infection rate, need for critical care intervention, and mortality in the pediatric intensive care unit.
Up to 38 % of children with cancer require pediatric intensive care unit (PICU) admission within 3 years of diagnosis, with reported PICU mortality of 13-27 % far exceeding that of the general PICU population. PICU outcomes data for individual cancer types are lacking and may help identify patients at risk for poor clinical outcomes. ⋯ Children with cancer account for 4.2 % of PICU admissions and 11.4 % of PICU deaths. Hematologic cancer patients have significantly higher admission illness severity, rates of infections, and PICU mortality than solid cancer patients. These data may be useful in risk stratification for closer monitoring and patient counseling.
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Intensive care medicine · Oct 2014
Secretoneurin as a marker for hypoxic brain injury after cardiopulmonary resuscitation.
The neuropeptide secretoneurin (SN) shows widespread distribution in the brain. We evaluated whether SN is elevated after cardiopulmonary resuscitation (CPR) and could serve as a potential new biomarker for hypoxic brain injury after CPR. ⋯ SN is a promising early biomarker for hypoxic brain injury. Further studies will be required for confirmation of these results.
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Intensive care medicine · Oct 2014
Mortality related to after-hours discharge from intensive care in Australia and New Zealand, 2005-2012.
After-hours discharge from the intensive care unit (ICU) is associated with adverse patient outcomes including increased ICU readmissions and mortality. Since Australian and New Zealand data were last published, overall ICU patient mortality has decreased; however it is unknown whether changes in discharge practices have contributed to these improved outcomes. Our aim was to examine trends over time in discharge timing and the contemporary associations with mortality and ICU readmission. ⋯ After-hours discharge remains an important independent predictor of hospital mortality and readmission to ICU. Despite widespread dissemination this evidence has not translated into fewer after-hours discharges or reduction in risk in Australian and New Zealand hospitals.
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Intensive care medicine · Oct 2014
Prognostic factors and historical trends in the epidemiology of candidemia in critically ill patients: an analysis of five multicenter studies sequentially conducted over a 9-year period.
To describe temporal trends in the epidemiology, clinical management and outcome of candidemia in intensive care unit (ICU) patients. ⋯ We found a clear change in the epidemiology and clinical management of candidemia in ICU patients over the 9-year period of the study. The use of echinocandins as primary therapy for candidemia appears to be associated with better outcomes.