Journal of critical care
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Journal of critical care · Apr 2011
Multicenter StudyA prediction survival model for out-of-hospital cardiopulmonary resuscitations.
The aims of this study were to double check old (Resuscitation Predictor Scoring [RPS], Advanced Cardiac Life Support, and Early Prediction Score [EPS]) and form new (Serbian Quality of Life immediately [SR-QOLi], Serbian Quality of Life short-term [SR-QOLs], and Serbian Quality of Life long-term [SR-QOLl]) scores for survival prediction in out-of-hospital cardiopulmonary resuscitation (OHCPR) in Serbia. ⋯ In the course of the research, SR-QOL models were created for prediction of the immediate (SR-QOLi), short-term (SR-QOLs), and long-term (SR-QOLl) survival after the OHCPR, better predictions in our environment.
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Journal of critical care · Apr 2011
Procalcitonin levels are lower in intensive care unit patients with H1N1 influenza A virus pneumonia than in those with community-acquired bacterial pneumonia. A pilot study.
The purpose of the study was to know the kinetics of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) in critically ill patients with H1N1 influenza A virus pneumonia and to compare levels of these inflammatory mediators with patients with acute community-acquired bacterial pneumonia. ⋯ Among patients admitted to the ICU with pneumonia, the PCT level could help identify H1N1 influenza A virus pneumonia and thus enable earlier antiviral therapy.
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Journal of critical care · Apr 2011
PROphylaxis for ThromboEmbolism in Critical Care Trial protocol and analysis plan.
This article reports the preparatory studies as well as the design, implementation, and a priori analysis plans of PROphylaxis for ThromboEmbolism in Critical Care Trial (PROTECT) before dissemination of results. PROphylaxis for ThromboEmbolism in Critical Care Trial (NCT00182143) is a randomized, stratified, concealed international trial comparing subcutaneous injection of unfractionated heparin (UFH) 5000 IU or the low-molecular weight heparin (LMWH) dalteparin 5000 IU once daily plus once-daily placebo for the duration of the intensive care unit stay. ⋯ If PROTECT shows that LMWH is more effective than UFH, this trial will change practice in that LMWH may be the anticoagulant thromboprophylaxis of choice for this population. If the results show that UFH is as effective or more effective than LMWH, intensivists in many parts of the world may continue to use UFH, whereas those currently using LMWH may reconsider and change to use UFH. Unfavorable consequences such as major bleeding, ease of use, and the costs of complications will also factor into such decisions.
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Journal of critical care · Apr 2011
Serum adiponectin upon admission to the intensive care unit may predict mortality in critically ill patients.
Adiponectin has been proposed as an important regulator of glucose metabolism influencing obesity and insulin resistance, which are important risk factors for the outcome of critically ill patients. Moreover, experimental models of inflammation suggest protective anti-inflammatory properties of adiponectin. We therefore investigated the potential pathogenic role and prognostic value of circulating adiponectin levels in critical illness. ⋯ Although serum concentrations did not differ in critically ill patients from controls, low adiponectin levels at admission to ICU have been identified as an independent predictor of survival.
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Journal of critical care · Apr 2011
Global end-diastolic volume, serum osmolarity, and albumin are risk factors for increased extravascular lung water.
The transpulmonary thermodilution technique allows the determination of cardiac preload (global end-diastolic volume index) and quantification of pulmonary edema (extravascular lung water index [EVLWI]). Pulmonary edema commonly develops in critically ill patients; however, the underlying pathophysiology, that is, hydrostatic (cardiac) or permeability-induced (noncardiac), often remains unclear. In this study, hemodynamic and serum parameters of osmolarity and oncotic pressure were analyzed to identify risk factors for increased EVLWI. ⋯ Hypervolemia, hypoalbuminemia, and high plasma osmolarity are associated with increased EVLWI.