Journal of critical care
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Journal of critical care · Oct 2013
Ionized hypocalcemia is an early event and is associated with organ dysfunction in children admitted to the intensive care unit.
The purpose was to determine the frequency and risk factors of ionized hypocalcemia and to evaluate this disturbance as a predictor of mortality in a pediatric intensive care unit (ICU). ⋯ Ionized hypocalcemia is common during the ICU stay, particularly in the first 3 days of admission. This disturbance was not found to be a predictor of mortality, but it is independently associated with more severe organ dysfunction.
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Journal of critical care · Oct 2013
Ischemia-modified albumin and adenosine plasma concentrations are associated with severe systemic inflammatory response syndrome after cardiopulmonary bypass.
Severe systemic inflammatory response syndrome (SIRS) occurring after cardiopulmonary bypass (CPB) is a common cause of mortality during cardiac surgery. These syndromes are characterized by vasoplegia and ischemia-reperfusion phenomenom. Adenosine is a strong endogenous vasodilating agent, which may be involved in blood pressure failure during CPB induced by severe SIRS. Ischemia-modified albumin (IMA) is considered as a sensitive marker of tissue ischemia. We examined whether the IMA or adenosine plasma concentrations (APCs) change during a severe SIRS-induced blood pressure failure during CPB. ⋯ Adenosine plasma concentration and IMA concentration are associated with postoperative severe SIRS after CPB.
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Journal of critical care · Oct 2013
Comparative StudyIntroducing a new generation indirect calorimeter for estimating energy requirements in adult intensive care unit patients: Feasibility, practical considerations, and comparison with a mathematical equation.
Indirect calorimetry (IC) is increasingly advocated for individualizing nutritional therapy in critically ill adult patients, but questions remain regarding its practical implementation. ⋯ Indirect calorimetry is increasingly advocated for individualizing nutritional therapy in critically ill adult patients. Practical feasibility is tested in this study. Large differences between measured and calculated energy expenditure are observed. Together with patients' characteristics, feasibility results can guide clinicians or institutes in using IC in their daily clinical practice.
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Journal of critical care · Oct 2013
Augmented renal clearance is a common finding with worse clinical outcome in critically ill patients receiving antimicrobial therapy.
We describe incidence and patient factors associated with augmented renal clearance (ARC) in adult intensive care unit (ICU) patients. ⋯ ARC was documented in approximately 52% of a mixed ICU patient population receiving antibiotic treatment with worse clinical outcome. Young age and male gender were independently associated with ARC presence.
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Journal of critical care · Oct 2013
New biomarker panel of plasma neutrophil gelatinase-associated lipocalin and endotoxin activity assay for detecting sepsis in acute kidney injury.
Septic acute kidney injury (AKI) shows an unacceptably high mortality rate. Detection of sepsis is important for the clinical management of AKI patients. This study was undertaken to evaluate 2 biomarkers of neutrophil gelatinase-associated lipocalin (NGAL) and endotoxin activity (EA) assay and their combination for detecting sepsis in AKI. ⋯ Combinations of plasma NGAL and EA, which are operating via different pathological pathways, significantly improved their detection performance in complicated conditions of septic AKI.