Journal of critical care
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Journal of critical care · Dec 2011
Dynamic changes of matrix metalloproteinases and their tissue inhibitors in severe sepsis.
Little is known about the dynamic changes of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) in sepsis. Our aim was therefore to investigate the time course of MMPs and their inhibitors in patients experiencing severe sepsis. ⋯ Our research is the first follow-up study dealing with MMPs, TIMPs, and their ratios in severe sepsis. Our results indicate that MMPs and TIMPs may play a crucial role in severe sepsis, especially TIMP-1, MMP-9, and possibly TIMP-2, after an extensive study.
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Journal of critical care · Dec 2011
Acute kidney injury on ventilator initiation day independently predicts prolonged mechanical ventilation in intensive care unit patients.
The purpose of this study is to identify the predictors for prolonged mechanical ventilation (PMV) of more than 21 days among intensive care unit (ICU) patients. ⋯ Acute kidney injury on MV initiation day is an independent risk factor for PMV of more than 21 days, which may be helpful for clinicians to refine their management of these ICU patients early.
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Journal of critical care · Dec 2011
Acute Kidney Injury Network definition of contrast-induced nephropathy in the critically ill: incidence and outcome.
Contrast-induced nephropathy (CIN) has been extensively studied in the ward but only scarcely in intensive care unit (ICU) patients, even if they may be particularly prone to develop or to worsen acute kidney insufficiency. We aimed to measure the incidence of CIN in a large ICU population using the Acute Kidney Injury Network (AKIN) definition and to investigate its impact on patients' outcome. ⋯ Even if incidence varied greatly depending on the definition, CIN appeared frequent in our critically ill patients. The AKIN definition, independently associated with ICU mortality, may allow unifying diagnostic criteria to further evaluate this condition that impacts morbidity and mortality.
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Journal of critical care · Dec 2011
Renal replacement therapy in prolonged mechanical ventilation patients with renal failure in Taiwan.
Renal failure requiring renal replacement therapy (RRT) is associated with a high mortality rate in intensive care unit (ICU) patients. Little information is available on the outcomes of patients having prolonged mechanical ventilation (PMV) in addition to RRT. The purpose of this study was to investigate the impact of RRT in PMV patients. ⋯ The present study demonstrates that the need for RRT had a negative impact on weaning and mortality in PMV patients compared with patients without RRT. Patients who had RRT initiated at the RCC had a significantly lower weaning rate compared with ESRD patients.
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Journal of critical care · Dec 2011
Variability of preference toward mechanical ventilator settings: a model-based behavioral analysis.
The purpose of this study was to evaluate Danish clinicians' opinions toward ventilator settings using standardized model-simulated patients. The models ensured that all clinicians received identical presentations of data and anticipated responses to changes in patient state, enabling opinions on the same patient cases to be obtained from different clinicians. ⋯ The present study shows significant difference in opinion on appropriate settings of f, Vt, and Fio(2) in the same computerized decision support system model-simulated patient cases.