Journal of critical care
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Journal of critical care · Oct 2013
Serum concentrations of A Proliferation-Inducing Ligand (APRIL) are elevated in sepsis and predict mortality in critically ill patients.
Inflammatory and autoimmune diseases have been associated with the tumor necrosis factor superfamily member "A PRoliferation Inducing Ligand" (APRIL). However, up to now, APRIL has not been investigated in critical illness or sepsis. We therefore analyzed APRIL serum concentrations in a large cohort of well-characterized intensive care unit patients. ⋯ Serum levels of APRIL were significantly elevated in intensive care unit patients, with the highest concentrations in septic patients, and associated with unfavorable outcome. Besides being used as a single marker, APRIL may be implemented into established scoring systems to further improve their sensitivity and specificity in predicting patient's prognosis.
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Journal of critical care · Oct 2013
Predicting laryngeal edema in intubated patients by portable intensive care unit ultrasound.
The purpose of this study is to determine the diagnostic accuracy of portable ultrasound for detection of laryngeal edema (LE) in intubated patients. ⋯ Portable intensive care unit ultrasound visualizing ACWD between predeflation and postdeflation cuff balloon is a promising objective tool, which aids in prediction of successful extubation regarding LE.
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Journal of critical care · Oct 2013
Endotoxin activity levels as a prediction tool for risk of deterioration in patients with sepsis not admitted to the intensive care unit: A pilot observational study.
The aim of this prospective observational study was to evaluate in patients with sepsis not requiring intensive care unit admission the relationship between the levels of endotoxin activity assay (EAA) early after sepsis recognition and the risk of development of organ dysfunction (OD). ⋯ Endotoxin activity assay levels 0.60 or greater early after sepsis diagnosis in patients not requiring intensive care unit admission predict risk of development of new organ dysfunction. High EAA levels in the first 48 hours of recognition of sepsis are also predictive of risk of deterioration.
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Journal of critical care · Oct 2013
Intra-abdominal hypertension in the critically ill: Interrater reliability of bladder pressure measurement.
Intra-abdominal hypertension is frequently underdiagnosed and defined by intra-abdominal pressure (IAP) 12 mm Hg or higher. Increasing IAP may compromise organ viability and culminate in abdominal compartment syndrome. Bladder pressure measurement is a surrogate for IAP, but measurement properties are unknown in the intensive care unit. Our primary objective was to assess the agreement of bladder pressure measurements in critically ill patients. ⋯ Agreement on bladder pressure was high among 4 clinicians and were not significantly different between physicians and nurses. Given that medical/surgical treatments are considered on bladder pressure values, understanding their reliability is essential to monitor critically ill patients.
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Journal of critical care · Oct 2013
Procollagen type III aminoterminal propeptide as biomarker of host response in severe sepsis.
The purpose of this study is to test the hypothesis that procollagen type III aminoterminal propeptide (PIIINP) is early elevated in septic episodes and can indicate the acute organ dysfunction/failure characterizing severe sepsis. ⋯ Increased serum PIIINP can signify severe sepsis/septic shock and predict which patients with sepsis will eventually develop severe sepsis/septic shock, thus representing a biomarker of risk stratification of patients with sepsis.