Journal of critical care
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Journal of critical care · Dec 2008
Sepsis and organ system failure are major determinants of post-intensive care unit mortality.
The aim of the study was to investigate predictors of post-intensive care unit (ICU) in-hospital mortality with special emphasis on the impact of sepsis and organ system failure. ⋯ This large international study identified not only age, medical admission, and preexisting comorbidities on ICU admission but also sepsis and organ system failure as important independent risk factors for in-hospital post-ICU death.
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Journal of critical care · Dec 2008
Mortality rates under the care of junior and senior surgery residents in a surgical intensive care unit/neurologic intensive care unit: a 5-year retrospective cohort study at Taoyuan Armed Forces General Hospital.
The quality and outcome of health care administered in intensive care units (ICUs) of teaching hospitals are dependent on a myriad of factors; however, few studies have assessed mortality rates and length of stay in surgical intensive care and neurologic intensive care units (SICU/NICU) in relation to the experience of junior and senior surgery residents. ⋯ The quality of care of critically ill patients is improved when more experienced residents are providing care. We suggest that residents rotated into the special units such as SICU/NICU for care of critically ill patients should be at least at third year of training.
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Journal of critical care · Dec 2008
Effect of corticosteroids on arginine vasopressin-containing vasopressor therapy for septic shock: a case control study.
Studies showing corticosteroids decrease time to shock reversal in septic shock did not include arginine vasopressin, which also may reduce the duration of catecholamine therapy. Thus, the effect of corticosteroids on vasopressin-containing vasopressor regimens is unknown. We designed this study to evaluate the effect of corticosteroids on time to vasopressin-containing vasopressor withdrawal and the proportion of patients alive without vasopressors at day 7. ⋯ Although corticosteroids did not improve the time to withdrawal of vasopressin-containing vasopressor therapy they significantly increased the proportion of patients alive without vasopressors at day 7.
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Journal of critical care · Dec 2008
Clinical characteristics and outcomes of septic patients with new-onset atrial fibrillation.
No studies have specifically evaluated the incidence or clinical characteristics of atrial fibrillation (AF) in a mixed medical-surgical population of patients with sepsis. We undertook to determine the incidence and clinical course of critically ill septic patients in the intensive care unit (ICU) who developed new-onset AF. ⋯ Statistically significantly higher mortality was observed in critically ill septic patients with new-onset AF, as were longer duration of mechanical ventilation, ICU, and hospital LOS. Whether the higher incidence of AF in septic patients is a specific risk factor for outcome or an indication of severity of illness remains to be determined.
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Journal of critical care · Dec 2008
Characteristic features and outcomes of severe acute respiratory syndrome found in severe acute respiratory syndrome intensive care unit patients.
The aim of the study was to identify characteristic clinical features and outcomes of critically ill patients with confirmed severe acute respiratory syndrome (SARS). ⋯ In a SARS ICU, patients with a confirmed diagnosis of SARS had significantly different clinical features and timing of mortality from those of the control group.