Journal of critical care
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Journal of critical care · Dec 2014
Adipose tissue lipolysis and circulating lipids in acute and subacute critical illness: Effects of shock and treatment.
The purpose of this study is to assess lipid metabolism at the tissue level in critically ill subjects. ⋯ Subcutaneous tissue lipolysis is only one of the many determinants of plasma FFAs. Routinely applied therapeutic modalities in the ICU interfere with adipose tissue metabolism.
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Journal of critical care · Dec 2014
Observational StudyImpact of positive fluid balance on critically ill surgical patients: A prospective observational study.
The purpose of this study is to determine the effect of postoperative fluid balance (FB) on subsequent outcomes in acute care surgery (ACS) patients admitted to the surgical intensive care unit (ICU). ⋯ In a cohort of critically ill ACS patients, achieving FB (-) status early during surgical ICU admission was associated with a nearly 70% reduction in the risk for mortality.
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Journal of critical care · Dec 2014
The impact of an interdisciplinary electroencephalogram educational initiative for critical care trainees.
The purpose of this study is to evaluate the effectiveness of an interdisciplinary electroencephalogram (EEG) educational module for critical care training. Electroencephalogram is increasingly used for diagnosis, monitoring, and treatment decisions in critically ill patients with neurologic and nonneurologic disorders. Continuous EEG monitoring has an expanded role in the intensive care unit as an additional evaluation tool for critically ill patients with altered mental status. ⋯ An interdisciplinary approach was effective for increasing EEG knowledge in critical care fellows as measured by the assessment tools. As an added potential benefit, the pulmonary fellows also learned about sleep disorder-related EEG. This model can be replicated in other institutions for trainees of other specialties interested in critical care.
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Journal of critical care · Dec 2014
Acute kidney injury in critical care: Experience of a conservative strategy.
Renal replacement therapy (RRT) is a major supportive treatment of acute kidney injury (AKI) in intensive care unit (ICU), but the timing of its initiation remains open to debate. ⋯ A conservative approach of AKI was not associated with increased mortality.
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Journal of critical care · Dec 2014
Observational StudyVolume of fluids administered during resuscitation for severe sepsis and septic shock and the development of the acute respiratory distress syndrome.
The purpose of this study was to examine the association between the volume of intravenous (IV) fluids administered in the resuscitative phase of severe sepsis and septic shock and the development of the acute respiratory distress syndrome (ARDS). ⋯ For patients hospitalized for severe sepsis and septic shock, fluid administration to improve end-organ perfusion should remain the top priority in early resuscitation despite the potential risk of inducing ARDS.