Journal of critical care
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Journal of critical care · Dec 2010
Effect of early achievement of physiologic resuscitation goals in septic patients admitted from the ward on the kidneys.
The aim of the study was to evaluate if early achievement of physiologic goals of resuscitation in critically ill septic patients admitted from the ward may prevent acute kidney injury (AKI). ⋯ Although most of AKI occurred before ICU consultation, early physiologic resuscitation and achievement of hemodynamic goals on the ICU is associated with a decrease in development of AKI of septic patients admitted from the ward.
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Journal of critical care · Dec 2010
A survey of clinicians addressing the approach to the management of severe sepsis and septic shock in the United States.
Mortality in severe sepsis and septic shock (SS/SS) remains high. Surviving Sepsis Campaign (SSC) guidelines were published in 2004 with the goal of improving outcomes in SS/SS. We tested the hypothesis that adherence to SSC guidelines and management of patients with SS/SS were influenced by physician specialty. ⋯ We observe that adherence with SSC guidelines continues to be a challenge for CCM, IM, and EM physicians. Significant differences in management of SS/SS exist for the 3 specialties. Because guideline implementation impacts patient outcomes, further evaluation of these differences is warranted.
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Journal of critical care · Dec 2010
Peak value of blood myoglobin predicts acute renal failure induced by rhabdomyolysis.
Acute renal failure (ARF) is the most important complication of rhabdomyolysis. Serial measurements of blood myoglobin might be useful for predicting rhabdomyolysis-induced ARF. ⋯ The peak value for blood myoglobin might be a good predictor of rhabdomyolysis-induced ARF. Early renal protective therapies should be considered for patients with rhabdomyolysis at high risk of ARF.