Journal of critical care
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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.
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Journal of critical care · Oct 2013
Hypophosphatemia on the intensive care unit: Individualized phosphate replacement based on serum levels and distribution volume.
Hypophosphatemia occurs in about 25% of patients admitted to the intensive care unit. To date, a safe and validated phosphate replacement protocol is not available. ⋯ This study shows that phosphate replacement with dose calculation based on serum phosphate levels and a Vd of 0.5 L/kg is effective and safe.
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Journal of critical care · Oct 2013
Predictive value of elevated cystatin C in patients undergoing primary angioplasty for ST-elevation myocardial infarction.
The prognostic value of cystatin C (CysC) has been documented in patients with acute coronary syndrome without ST-segment elevation. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the prognostic value of CysC in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). ⋯ These results suggest that a high admission CysC level was associated with increased in-hospital and one-month cardiovascular mortality in patients with STEMI undergoing primary PCI.
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Journal of critical care · Oct 2013
Previous antibiotic exposure and evolution of antibiotic resistance in mechanically ventilated patients with nosocomial infections.
This study aimed to evaluate the impact of previous antibiotic exposure and the influence of time interval since exposure on the evolution of antibiotic-resistant infections. ⋯ Although antibiotic exposure increased resistance rate in nosocomial infections, this association decreased as time interval increased. Antibiotic stewardship should consider the significance of time interval while investigating the evolution of subsequent antibiotic-resistant infections.
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Journal of critical care · Oct 2013
High glucose variability increases cerebral infarction in patients with spontaneous subarachnoid hemorrhage.
High glucose variability is a significant marker for poor outcome in critically ill patients. We evaluated the impact of high glucose variability on cerebral infarction following spontaneous subarachnoid hemorrhage (SAH). ⋯ Glucose variability is a significant predictor of cerebral infarction in patients with severe spontaneous SAH.