Journal of critical care
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Journal of critical care · Jun 2013
Cerebral desaturation events in the intensive care unit following cardiac surgery.
Patients may be at high risk for hemodynamic instability in the early postoperative period, with subsequent poor cerebral perfusion and the development of postoperative cerebral oxygen desaturation events (CDEs). Intraoperative CDEs have been associated with postoperative adverse events. However, none of these studies examined the incidence of early postoperative cerebral desaturations. This study was designed to identify the incidence of CDEs (defined as a decrease in SctO2 to less than 60% for at least 60 seconds) in the immediate postoperative period following cardiac surgery. ⋯ A high incidence of CDEs (53%) was found in the early post-cardiac surgery period. Larger studies are needed to determine whether postoperative CDEs are correlated with various physiologic events or are associated with adverse patient outcomes.
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Journal of critical care · Jun 2013
Impact of serum C-reactive protein measurements in the first 2 days on the 30-day mortality in hospitalized patients with severe community-acquired pneumonia: a cohort study.
The purpose of the study is to evaluate the impact of daily consecutive measurements of C-reactive protein (CRP) in the initial 2 days of hospitalization on the 30-day all-cause mortality in patients with severe community-acquired pneumonia (CAP). ⋯ Fractional decrease less than 25% in CRP levels at the second day was significantly associated with 30-day all-cause mortality in hospitalized patients with severe CAP.
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Journal of critical care · Jun 2013
Risk of in-hospital mortality identified according to the typology of patients with acute heart failure: classification tree analysis on data from the Acute Heart Failure Database-Main registry.
The purposes of this study are to identify the strongest clinical parameters in relation to in-hospital mortality, which are available in the earliest phase of the hospitalization of patients, and to create an easy tool for the early identification of patients at risk. ⋯ The presented classification model effectively stratified patients with all syndromes of acute heart failure into in-hospital mortality risk groups and might be of advantage for clinical practice.
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Journal of critical care · Jun 2013
Drug-drug interactions contributing to QT prolongation in cardiac intensive care units.
To determine the most common drug-drug interaction (DDI) pairs contributing to QTc prolongation in cardiac intensive care units (ICUs). ⋯ DDIs may be a significant cause of QT prolongation in cardiac ICUs. These data can be used to educate clinicians on safe medication use. Computerized clinical decision support could be applied to aid in the detection of these events.
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Journal of critical care · Jun 2013
Clinical epidemiology of central venous catheter-related bloodstream infections in an intensive care unit in China.
Central venous catheters (CVCs) are universally used during the treatment of critically ill patients. Their use, however, is associated with a substantial infection risk. At present, there are few studies on catheter-related bloodstream infections (CRBSIs) that are comparable with international similar research. The aim of this study was to determine the rate, risk factors, and outcomes of CRBSIs in patients of an intensive care unit (ICU) in China. ⋯ The CRBSI rate in our ICU is higher compared with that reported by the National Nosocomial Infection Surveillance and was associated with the applications of antibiotics before CRBSI and with the number of placed CVCs. Catheter-related bloodstream infections may be associated with a higher mortality rate and a higher incidence of ventilator-associated pulmonitis, which might lead to an increase in the total costs and medicine expenditures.