Journal of critical care
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Journal of critical care · Jun 2011
Ventilator-associated pneumonia in critically ill stroke patients: frequency, risk factors, and outcomes.
Our main objective was to assess incidence, risk factors, and outcomes of ventilator-associated pneumonia (VAP) in stroke patients. ⋯ Pneumonia appears as a frequent problem in mechanically ventilated stroke patients. Chronic lung disease history, severity of stroke level at admission, and hemorrhagic transformation of stroke set the stage for developing VAP. The duration of both mechanical ventilation and intensive care unit stay gets significantly prolonged by VAP, but it does not affect mortality.
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Journal of critical care · Jun 2011
Failure to achieve euglycemia despite aggressive insulin control signals abnormal physiologic response to trauma.
We hypothesize that a failure to normalize a patient's glucose on an automated euglycemia protocol signals an adverse response after trauma and that this response can identify patients with an increased mortality. ⋯ A posttraumatic patient's response to tight glycemic control revealed important prognostic information about the patients' physiologic status. Patients who failed to reach euglycemia in the first 6 hours of admission had an increased hospital mortality. The time to normalization is significantly longer in those patients who died. Patients who did not correct rapidly required significantly higher insulin doses, suggesting insulin resistance.
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Journal of critical care · Jun 2011
Protein C as an early biomarker to distinguish pneumonia from sepsis.
Patients with pneumonia often are unrecognized as also having sepsis. We evaluated protein C, as a potential biomarker, to differentiate between patients with pneumonia and sepsis. ⋯ In this study, protein C levels performed well in differentiating between patients with sepsis or pneumonia in the early period after diagnosis.
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Journal of critical care · Jun 2011
A polyurethane cuffed endotracheal tube is associated with decreased rates of ventilator-associated pneumonia.
The aim of this study was to determine whether the use of a polyurethane-cuffed endotracheal tube would result in a decrease in ventilator-associated pneumonia rate. ⋯ Use of a polyurethane-cuffed endotracheal tube was associated with a significant decrease in the rate of ventilator-associated pneumonia in our study.
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Journal of critical care · Jun 2011
N-terminal pro-brain natriuretic peptide as a marker of right ventricular dysfunction after open-lung approach in patients with acute lung injury/acute respiratory distress syndrome.
The purpose of the study was to evaluate the utility of N-terminal pro-brain natriuretic peptide (NT-proBNP) as a marker of right ventricular (RV) dysfunction after open-lung approach (OLA) in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). ⋯ In patients with ALI/ARDS, intraindividual NT-proBNP changes correlated with RV afterload following OLA, thereby serving as a potential marker for RV dysfunction after OLA.