Journal of critical care
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Journal of critical care · Aug 2014
Renal outcome after vancomycin treatment and renal replacement therapy in patients with severe sepsis and septic shock: A retrospective study.
Acute kidney injury during systemic infections is common; however, renal outcome is poorly investigated. The increase of multiresistant pathogens leads to the use of potential nephrotoxic antibiotics as vancomycin. We investigated the impact of vancomycin and renal replacement therapy (RRT) for renal recovery during sepsis. ⋯ Estimated GFR at ICU admission predicts renal outcome, whereas the use of vancomycin increases the probability of a prolonged need for RRT at discharge from ICU. The use of alternative antibiotics for certain patients, indicated by eGFR at admission, might be considered.
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Journal of critical care · Aug 2014
Observational StudyCorrelation of corrected flow time in the carotid artery with changes in intravascular volume status.
Assessment of volume status remains a challenge in critical care. Our purpose was to determine if Doppler waveform analysis of carotid artery blood flow correlates with changes in volume status. ⋯ Intravenous fluid administration in dehydrated patients resulted in significant changes in FTc in the carotid artery despite no change in vital signs. Corrected flow time measured from carotid arterial blood flow may be a useful means of assessing volume status in volume-depleted patients.
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Journal of critical care · Aug 2014
Value of clinical pulmonary infection score in critically ill children as a surrogate for diagnosis of ventilator-associated pneumonia.
Although the modified clinical pulmonary infection score (mCPIS) has been endorsed by national organizations, only a very few pediatric studies have assessed it for the diagnosis of ventilator-associated pneumonia (VAP). ⋯ The mCPIS had a clinically acceptable performance, and it can be a helpful screening tool for VAP diagnosis. An mCPIS lower than 6 was highly able in distinguishing patients without VAP. Despite its high sensitivity and negative predictive value of this score, further studies are required to assess the use of mCPIS in guiding therapeutic decisions.
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Journal of critical care · Aug 2014
Observational StudyFunctional electrical stimulation with cycling in the critically ill: A pilot case-matched control study.
The purpose was to determine (a) safety and feasibility of functional electrical stimulation (FES)-cycling and (b) compare FES-cycling to case-matched controls in terms of functional recovery and delirium outcomes. ⋯ The delivery of FES-cycling is both safe and feasible. The preliminary findings suggest that FES-cycling may improve function and reduce delirium. Further research is required to confirm the findings of this study and evaluate the efficacy of FES-cycling.
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Journal of critical care · Aug 2014
Observational StudyIncidence and predictors of new-onset atrial fibrillation in noncardiac intensive care unit patients.
Atrial fibrillation (AF) is thought to be a relatively common arrhythmia in the setting of noncardiac intensive care unit (ICU). However, data concerning AF deriving from such populations are scarce. In addition, it is unclear which of the wide spectrum of AF predictors are relevant to the ICU setting. ⋯ A significant fraction of ICU patients manifest AF. The predictors of interest for the ICU patients might be considerably different than those of the general population and other subgroups with systemic inflammation possibly having a pivotal role.