Journal of critical care
-
Journal of critical care · Dec 2011
Multicenter StudyImpact of different types of organ failure on outcome in intensive care unit patients with acute kidney injury.
The aim of this study was to explore the impact of different types of associated organ failure in patients with acute kidney injury (AKI). ⋯ The prognosis of ICU patients with AKI depended on the total number and types of associated failed organ systems. Respiratory failure was the most common associated organ failure, but neurologic and hepatic failures were associated with the worst prognosis.
-
Journal of critical care · Dec 2011
Subtle change of cystatin C, with or without acute kidney injury, associated with increased mortality in the intensive care unit.
Recent epidemiologic studies suggest a significant association between small increases in serum creatinine (sCr) and adverse outcomes. The Acute Kidney Injury Network (AKIN) sought to increase the sensitivity of the AKIN criteria for acute kidney injury (AKI) by recommending the use of small changes in sCr for the diagnosis of AKI. Several recent studies have reported that serum cystatin C (cysC) is more accurate than sCr as a surrogate for the glomerular filtration rate. This study was performed to determine whether small increases in cysC (≥0.3 mg/L within 48 hours) are associated with clinical outcomes in critically ill patients. ⋯ Small increases of cysC were associated with increased mortality in intensive care unit patients independent of diagnosis of AKI by AKIN criteria.
-
Journal of critical care · Dec 2011
Randomized Controlled Trial Multicenter StudySevere protein C deficiency is associated with organ dysfunction in patients with severe sepsis.
The aim of this study was to assess the relationship between protein C levels and temporal changes in organ dysfunction. ⋯ Severe protein C deficiency in patients with severe sepsis is associated with both the incidence and severity of organ dysfunction and subsequent worsening of organ function and may be a useful predictor of organ failure in severe sepsis.
-
The purpose of the study was to evaluate the time taken for delivery of each component of care following patient deterioration and to assess the effect on response times of strategies implemented to improve the system. ⋯ Significant delays in responding to acute deterioration persist despite strategies to facilitate the functioning of the RRT system. Simple strategies such as policy directives are not sufficient to effect change in complex health care systems.
-
Journal of critical care · Dec 2011
The use of an electronic medical record based automatic calculation tool to quantify risk of unplanned readmission to the intensive care unit: a validation study.
The aim of this study was to refine and validate an automatic risk of unplanned readmission (Stability and Workload Index for Transfer, or SWIFT) calculator in a prospective cohort of consecutive medical intensive care unit (ICU) patients in a teaching hospital with comprehensive electronic medical records (EMRs). ⋯ The EMR-based automatic tool accurately calculates SWIFT score and can facilitate ICU discharge decisions without the need for manual data collection.