Journal of critical care
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Journal of critical care · Dec 2013
Observational StudyCan we predict pneumococcal bacteremia in patients with severe community-acquired pneumonia?
This study aimed to evaluate the role of biomarkers as markers of pneumococcal bacteremia in severe community-acquired pneumonia (SCAP). ⋯ In this cohort, significantly higher PCT, BNP, lactate, and CRP levels were found in BPP, and PCT presented the best ability to identify pneumococcal bacteremia. A PCT serum level lower than 17 ng/mL could identify patients with SCAP unlikely to have pneumococcal bacteremia.
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Journal of critical care · Dec 2013
Comparative StudyEvaluation of the radial artery applanation tonometry technology for continuous noninvasive blood pressure monitoring compared with central aortic blood pressure measurements in patients with multiple organ dysfunction syndrome.
We compared blood pressure (BP) measurements obtained using radial artery applanation tonometry with invasive BP measurements using a catheter placed in the abdominal aorta through the femoral artery in patients with multiple organ dysfunction syndrome (MODS). ⋯ In intensive care unit patients with MODS, mean arterial pressure and diastolic arterial pressure can be determined accurately and precisely using radial artery applanation tonometry compared with central aortic values obtained using a catheter placed in the abdominal aorta through the femoral artery. Although systolic arterial pressure could also be derived accurately, wider 95% limits of agreement suggest lower precision for determination of systolic arterial pressure.
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Journal of critical care · Dec 2013
Initial fractal exponent of heart rate variability is associated with success of early resuscitation in patients with severe sepsis or septic shock: a prospective cohort study.
Heart rate variability (HRV) reflects autonomic nervous system tone as well as the overall health of the baroreflex system. We hypothesized that loss of complexity in HRV upon intensive care unit (ICU) admission would be associated with unsuccessful early resuscitation of sepsis. ⋯ Loss of complexity in HRV is associated with worse outcome early in severe sepsis and septic shock. Further work should evaluate whether complexity of HRV could guide treatment in sepsis.
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Journal of critical care · Dec 2013
Multicenter StudyThe association between primary language spoken and all-cause mortality in critically ill patients.
The study objective was to investigate the association between primary language spoken and all-cause mortality in critically ill patients. ⋯ In a regional cohort, not speaking English as a primary language is associated with improved outcomes after critical care. Our observations may have clinical relevance and illustrate the intersection of several factors in critical illness outcome including severity of illness, comorbidity, and social and economic factors.
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Journal of critical care · Dec 2013
The microcirculation image quality score: Development and preliminary evaluation of a proposed approach to grading quality of image acquisition for bedside videomicroscopy.
Side-stream dark-field microscopy is currently used to directly visualize sublingual microcirculation at the bedside. Our experience has found inherent technical challenges in the image acquisition process. This article presents and assesses a quality assurance method to rate image acquisition quality before analysis. ⋯ Our Microcirculation Image Quality Score addresses many of the common areas where video quality can degrade. The criteria introduced are an objective way to assess the quality of image acquisition, with the goal of selecting videos of adequate quality for analysis. The interrater reliability results in our preliminary study suggest that the Microcirculation Image Quality Score is reasonably repeatable between reviewers. Further assessment is warranted.