Journal of critical care
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Journal of critical care · Aug 2012
Review Meta AnalysisPrognostic value of extravascular lung water index in critically ill patients: a systematic review of the literature.
The prognostic value of extravascular lung water (EVLW) has been widely investigated; however, a wide range of its predictive accuracy has been reported. ⋯ The EVLWI appears to be a good predictor of mortality in critically ill patients.
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Journal of critical care · Aug 2012
ReviewLiberation of neurosurgical patients from mechanical ventilation and tracheostomy in neurocritical care.
Neurosurgical patients commonly require mechanical ventilation and monitoring in a neurocritical care unit. There are only few studies that specifically address the process of liberation from mechanical ventilation in this population. Patients who remain ventilator or artificial airway dependent receive a tracheostomy. ⋯ In this article, we review the general principles of liberation and the current literature as it pertains to neurosurgical patients with primary brain injury. The criteria for "readiness of extubation" include a combination of neurologic assessment, hemodynamic, and respiratory parameters. Future studies are required to better assess indicators for extubation readiness, evaluate the predictors of extubation failure in brain-injured patients, and define the most appropriate timing for a tracheostomy.
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Journal of critical care · Aug 2012
Early bacterial genome detection in body fluids from patients with severe sepsis: a pilot study.
The purpose of this study is to evaluate the feasibility and interest of real-time polymerase chain reaction (RT-PCR) testing for bacterial genomes in body fluids other than blood in patients with acute severe sepsis. ⋯ Our results indicate that direct PCR testing may improve the detection of bacteria in body fluids other than blood in patients with acute severe sepsis.
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Journal of critical care · Aug 2012
Multicenter StudyUS practitioner opinions and prescribing practices regarding corticosteroid therapy for severe sepsis and septic shock.
The aim of this study was to examine opinions and practices of US critical care practitioners (USCCPs) toward corticosteroid therapy in adult patients with severe sepsis or septic shock. ⋯ Corticosteroids are commonly used by USCCPs in adult patients with septic shock; however, criteria used to initiate therapy and opinions regarding their impact vary.
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Journal of critical care · Aug 2012
Comparative StudyComparison of physician prediction with 2 prognostic scoring systems in predicting 2-year mortality after intensive care admission: a linked-data cohort study.
Patients who survive an episode of critical illness continue to experience significant mortality after hospital discharge. This study assessed the accuracy of physician prediction of 2-year mortality and compared it with 2 objective prognostic models. ⋯ Physicians tended to overpredict the risk of 2-year mortality of critically ill patients, but accuracy was comparable with 2 objective prognostic models.