Journal of critical care
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Journal of critical care · Oct 2014
Enteral naloxone for the treatment of opioid-induced constipation in the medical intensive care unit.
To determine the safety and efficacy of enteral naloxone for the treatment of opioid-induced constipation in the medical intensive care unit (MICU). ⋯ Enteral naloxone appears safe for the treatment of opioid-induced constipation in the MICU. Enteral naloxone may be effective in treating opioid-induced constipation; however, further studies are warranted.
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Journal of critical care · Oct 2014
Performance of interleukin-27 as a sepsis diagnostic biomarker in critically ill adults.
We recently identified interleukin-27 (IL-27) as a sepsis diagnostic biomarker in children. Here we assess IL-27 as a sepsis diagnostic biomarker in critically ill adults with systemic inflammatory response syndrome and sepsis. ⋯ IL-27 performed overall poorly in this cohort as a sepsis diagnostic biomarker. Combining IL-27, PCT, and age reasonably estimated the risk of sepsis in subjects with a non-pulmonary source of sepsis. IL-27 may be a more reliable sepsis diagnostic biomarker in children than in adults.
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Journal of critical care · Oct 2014
Surveillance cultures in intensive care units: A nationwide survey on current practice providing future perspectives.
To explore the extent of surveillance culture (SC) implementation underlying motives for obtaining SC and decision making based on the results. ⋯ Surveillance culture implementation is common in Dutch ICUs to optimize individual patients' treatment. Consensus is lacking on how to deal with SC results when the focus of infection is not at the sampled site.
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Journal of critical care · Oct 2014
Accelerometer-based devices can be used to monitor sedation/agitation in the intensive care unit.
Monitoring sedation/agitation levels in patients in the intensive care unit (ICU) are important to direct treatment and to improve outcomes. This study was designed to determine the potential use of accelerometer-based sensors/devices to objectively measure sedation/agitation in patients admitted to the ICU. ⋯ Accelerometer data correlate strongly with the sedation/agitation levels of patients in the ICUs, and appropriately designed accelerometer-based sensors/devices have the potential to be used for automating objective and continuous monitoring of sedation/agitation levels in patients in the ICU.
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Journal of critical care · Oct 2014
Observational StudyThe accuracy of Gram stain of respiratory specimens in excluding Staphylococcus aureus in ventilator-associated pneumonia.
To evaluate the Gram stain of deep tracheal aspirate as a tool to direct empiric antibiotic therapy, and more specifically as a tool to exclude the need for empiric antibiotic coverage against Staphylococcus aureus in ventilator-associated pneumonia (VAP). ⋯ Absence of gram-positive bacteria on Gram stain had a high negative predictive value. These data can be used to narrow the initial empiric antibiotic regimen and to avoid unnecessary exposure of patients to vancomycin and other antistaphyloccocal agents.