Journal of critical care
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Journal of critical care · Jun 2014
Assessment of a modified 4T scoring system for heparin-induced thrombocytopenia in critically ill patients.
The purpose of the study is to determine if a modified 4T (m4T) scoring system, which omits clinical evaluation of other thrombocytopenic etiologies, is different from the 4T scoring system's probability to predict a positive heparin-induced thrombocytopenia (HIT) laboratory test in the intensive care unit. ⋯ This study does not show a difference in the probability of the m4T and 4T scoring systems to predict a positive ELISA anti-PF4 Ab test in the critically ill patient population. Further prospective studies are needed to validate the m4T scoring system.
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Journal of critical care · Jun 2014
Critically ill elderly patients in a developing world-mortality and functional outcome at 1 year: A prospective single-center study.
To study the mortality and outcome of critically ill elderly patients in a developing country with focus on nutritional and socioeconomic status. ⋯ Malnutrition, delirium, and APACHEII were risk factors for long-term mortality. Survivors had a good functional outcome. Appropriate quality of life tools for this population need to be developed.
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Journal of critical care · Jun 2014
Randomized Controlled Trial Multicenter StudyDoes the achievement of an intermediate glycemic target reduce organ failure and mortality? A post hoc analysis of the Glucontrol trial.
This research evaluates the impact of the achievement of an intermediate target glycemic band on the severity of organ failure and mortality. ⋯ There was no difference in organ failure in the Glucontrol study based on intention to treat to different glycemic targets. Actual outcomes and significant crossover indicate that this result may not be due to the difference in target or treatment. Odds ratios-associated achieving an intermediate 4.0 to 7.0 mmol/L range improved outcome.
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Journal of critical care · Jun 2014
Randomized Controlled Trial Multicenter StudyRelative adrenal insufficiency in critically ill patient after rapid sequence intubation: KETASED ancillary study.
Relative adrenal insufficiency (RAI) has been reported as a predictor of mortality in septic patient; however, its effects on mortality and outcomes for critically ill patients remain debatable. The objective of this study was to assess the effect of RAI on prognostic outcomes in patients after out-of-hospital rapid sequence intubation (RSI) and factors associated with the onset of RAI. ⋯ In critically ill patients who require RSI, RAI is common and is not associated with worsened outcomes in our cohort.
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Journal of critical care · Jun 2014
ReviewEfficacy and safety of fibrinogen concentrate in trauma patients-a systematic review.
Uncontrolled bleeding is the main preventable cause of death in severe trauma patients. Fibrinogen is the first coagulation factor to decrease during trauma-induced coagulopathy, suggesting that pharmacological replacement might assist early hemorrhage control. Several sources of fibrinogen are available; however, fibrinogen concentrate (FC) is not routinely used in trauma settings in most countries. The aim of this review is to summarize the available literature evaluating the use of FC in the management of severe trauma. ⋯ Despite methodological flaws, some of the available studies suggested that FC administration may be associated with a reduced blood product requirement. Randomized trials are warranted to determine whether FC improves outcomes in prehospital management of trauma patients or whether FC is superior to another source of fibrinogen in early hospital management of trauma patients.