Journal of critical care
-
Journal of critical care · Oct 2013
Comparative StudySimple translational equations to compare illness severity scores in intensive care trials.
Comparison of illness severity for intensive care unit populations assessed according to different scoring systems should increase our ability to compare and meta-analyze past and future trials but is currently not possible. Accordingly, we aimed to establish a methodology to translate illness severity scores obtained from one system into another. ⋯ Simple and robust translational formulas can be developed to allow clinicians to compare illness severity between studies involving critically ill patients. Further studies in other countries and health care systems are needed to confirm the generalizability of these results.
-
Journal of critical care · Oct 2013
Improving risk classification of critical illness with biomarkers: A simulation study.
Optimal triage of patients at risk for critical illness requires accurate risk prediction, yet few data on the performance criteria required of a potential biomarker to be clinically useful exists. ⋯ Clinical models for triage of critical illness could be significantly improved by incorporating biomarkers, yet substantial sample sizes and biomarker strength may be required.
-
Journal of critical care · Oct 2013
Critical illness is associated with decreased plasma levels of coenzyme Q10: A cross-sectional study.
Plasma coenzyme Q10 (CoQ10) levels are lower in patients with septic shock (SS) than in healthy controls (HCs). However, CoQ10 status in critically ill patients without SS is unknown. Here, we investigated CoQ10 concentrations in patients with SS and without SS as compared with HCs. ⋯ Decreased plasma CoQ10 levels are not specific to patients with SS, but rather observed in a broad range of critically ill patients. In critically ill patients, CoQ10 insufficiency may be associated with various conditions; age may be a risk factor.
-
Journal of critical care · Oct 2013
Unplanned pediatric intensive care unit readmissions: A single-center experience.
The purpose of the study was to compare patients readmitted to the pediatric intensive care unit (PICU) unexpectedly within 48 hours (early), more than 48 hours from transfer (late), or not readmitted during the same hospitalization. ⋯ Patients requiring an unplanned PICU readmission had worse outcomes than those without a readmission. Future studies should focus on identifying modifiable risk factors for targeted interventions.
-
Journal of critical care · Oct 2013
Development and validation of a novel fusion algorithm for continuous, accurate, and automated R-wave detection and calculation of signal-derived metrics.
Previous studies have shown that heart rate complexity may be a useful indicator of patient status in the critical care environment but will require continuous, accurate, and automated R-wave detection (RWD) in the electrocardiogram (ECG). Although numerous RWD algorithms exist, accurate detection remains a challenge. The purpose of this study was to develop and validate a novel fusion algorithm (Automated Electrocardiogram Selection of Peaks, or AESOP) that combines the strengths of several well-known algorithms to provide a more reliable real-time solution to the RWD problem. ⋯ By fusing several best algorithms, AESOP uses the strengths of each algorithm to perform more robustly and reliably in real time. The AESOP algorithm will be integrated into a real-time heart rate complexity software program for decision support and triage in critically ill patients.