Journal of critical care
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Journal of critical care · Oct 2014
Low serum creatine kinase activity is associated with worse outcome in critically ill patients.
To investigate the prognostic significance of low serum creatine kinase (CK) activity in intensive care unit patients. ⋯ Low serum CK activities are associated with a higher severity of illness and higher mortality rates.
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Journal of critical care · Oct 2014
Model for End-Stage Liver Disease score predicts mortality in critically ill cirrhotic patients.
Cirrhosis is a common condition that complicates the management of patients who require critical care. There is interest in identifying scoring systems that may be used to predict outcome because of the poor odds for recovery despite high-intensity care. We sought to evaluate how Model for End-Stage Liver Disease (MELD), an organ-specific scoring system, compares with other severity of illness scoring systems in predicting short- and long-term mortality for critically ill cirrhotic patients. ⋯ Our results demonstrate that the prognostic ability of a variety of scoring systems strongly depends on the patient population. In the MICU population, each model (MELD + SOFA, MELD, and SOFA) demonstrates excellent discrimination for 28-day and 1-year mortality. However, these scoring systems did not predict 28-day mortality in the surgical ICU group but were significant for 1-year mortality. This suggests that patients admitted to a surgical ICU will behave similarly to their MICU cohort if they survive the perioperative period.
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Journal of critical care · Oct 2014
Observational StudyFactors affecting sleep in the critically ill: An observational study.
The aims of the current study were to describe the extrinsic and intrinsic factors affecting sleep in critically ill patients and to examine potential relationships with sleep quality. ⋯ The presence of an artificial airway during sleep monitoring was the only significant predictor in the regression model and may suggest that although potentially uncomfortable, an artificial airway may actually promote sleep. This requires further investigation.
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Journal of critical care · Oct 2014
Observational StudyAssociation between early glycemic control and improvements in markers of coagulation and fibrinolysis in patients with septic shock-induced stress hyperglycemia.
The purpose of this study is to evaluate the coagulation and inflammatory profiles in septic shock patients with baseline hyperglycemia under glycemic control. ⋯ Glycemic control during septic shock is associated with improvements in coagulation and fibrinolysis parameters compared with baseline and normoglycemic patients.
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Journal of critical care · Oct 2014
Serum lipid profile, cytokine production, and clinical outcome in patients with severe sepsis.
The purpose of the study is to evaluate the prevalence and clinical significance of hypolipidemia and the relationship to cytokine concentrations and outcomes in septic patients. ⋯ Low cholesterol and lipoprotein concentrations are detected in septic patients, especially in individuals with poor outcome. High-density lipoprotein cholesterol concentration seems to be an early independent predictive marker of survival in severe sepsis.