Intensive care medicine
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Intensive care medicine · Sep 2021
Serum markers of brain injury can predict good neurological outcome after out-of-hospital cardiac arrest.
The majority of unconscious patients after cardiac arrest (CA) do not fulfill guideline criteria for a likely poor outcome, their prognosis is considered "indeterminate". We compared brain injury markers in blood for prediction of good outcome and for identifying false positive predictions of poor outcome as recommended by guidelines. ⋯ Low levels of brain injury markers in blood are associated with good neurological outcome after CA. Incorporating biomarkers into neuroprognostication may help prevent premature withdrawal of life-sustaining therapy.
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Intensive care medicine · Sep 2021
Randomized Controlled TrialThe relationship between adrenocortical candidate gene expression and clinical response to hydrocortisone in patients with septic shock.
To determine if adrenocortical gene expression is associated with clinical outcomes or response to corticosteroid treatment in septic shock. ⋯ In patients with septic shock, there is no association between adrenocortical candidate gene expression and mortality. Patients with higher expression of GLCCI1 who received hydrocortisone achieved shock resolution faster than those receiving placebo; conversely, patients who had higher expression of BHSD1 who received hydrocortisone achieved shock resolution slower than those who received placebo. Variation in gene expression may be a mechanism for heterogeneity of treatment response to corticosteroids in septic shock.