Journal of intensive care medicine
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J Intensive Care Med · Nov 2020
Serum Lactate as an Independent Predictor of In-Hospital Mortality in Intensive Care Patients.
The aim of this study was to check if serum lactate was independently associated with mortality among critically ill patients. ⋯ Intensive care unit serum lactate is associated with increased ICU and hospital mortality, independent of comorbidities, organ dysfunction, or hemodynamic status.
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J Intensive Care Med · Nov 2020
Evaluation of qSOFA as a Predictor of Mortality Among ICU Patients With Positive Clinical Cultures-A Retrospective Cohort Study.
To compare the discriminative value of the quick-sequential organ failure assessment score (qSOFA) to SOFA in a critically ill population, in which a microbial pathogen was isolated within 48 hours of admission to intensive care. ⋯ Quick-sequential organ failure assessment score at admission was not superior to SOFA in predicting in-hospital mortality in patients with positive clinical cultures within 48 hours of admission to ICU. Quick-sequential organ failure assessment score at admission to the ICU was associated with mortality and showed reasonable calibration and discrimination. When the analysis was focused on patients with pathogenic bacteremia or positive CSF cultures, qSOFA performed similarly to SOFA in discriminatory those who will die from sepsis.
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J Intensive Care Med · Nov 2020
Ascorbic Acid, Thiamine, and Steroids in Septic Shock: Propensity Matched Analysis.
We aimed to study the use of ascorbic acid, thiamine, and steroids (ATS) in patients with septic shock (SS). ⋯ The use of IV ascorbic acid, thiamine, and hydrocortisone might be beneficial in patients with SS.
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J Intensive Care Med · Nov 2020
Assessing Extravascular Lung Water With Ultrasound: A Tool to Individualize Fluid Management?
Aggressive fluid resuscitation has become standard of care for hypotensive patients with sepsis. However, sepsis is a syndrome that occurs in patients with diverse underlying physiology and a one-size-fits-all approach to fluid administration seems misguided. To individualize fluid management, several methods to assess fluid responsiveness have been validated, but even in fluid responsive patients, fluid administration may still be harmful and lead to pulmonary edema. ⋯ The physiology of EVLW and the principles of lung ultrasound are briefly described. Articles examining the correlation between EVLW and lung ultrasound findings in various clinical settings are carefully reviewed. Overall, lung ultrasound has been found to be an excellent tool to detect EVLW, but large outcome studies investigating lung ultrasound-guided fluid management are still lacking.
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J Intensive Care Med · Nov 2020
Observational StudyA Retrospective Analysis of Nonocclusive Mesenteric Ischemia in Medical and Surgical ICU Patients: Clinical Data on Demography, Clinical Signs, and Survival.
To analyze demography, clinical signs, and survival of intensive care patients diagnosed with nonocclusive mesenteric ischemia (NOMI) and to evaluate the effect of a local intra-arterial prostaglandin therapy. ⋯ Our data suggest that NOMI is a detrimental disease associated with progressive organ failure and a high mortality. Local intra-arterial prostaglandin application might hold promise as a rescue treatment strategy. These data encourage future randomized controlled trials are desirable.