Journal of critical care
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Journal of critical care · Oct 2015
Predialysis hypernatremia is a prognostic marker in acute kidney injury in need of renal replacement therapy.
The present study aimed to evaluate the prognostic impact of predialysis dysnatremia in patients with acute kidney injury requiring renal replacement therapy (RRT). ⋯ Almost 50% of patients with acute kidney injury in need of RRT in the ICU had mild or severe dysnatremia before dialysis initiation. Hypernatremia was the main sodium disturbance and independently associated with poor outcome in the study population.
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Journal of critical care · Oct 2015
Patterns of treatment and correction of hyponatremia in intensive care unit patients.
The goal of this study was to examine the real-world patterns of care and interventions among intensive care unit (ICU) patients with hypervolemic and euvolemic hyponatremia using a large clinical database. ⋯ A significant proportion of hyponatremia is not corrected during an ICU stay. Critically ill patients with hyponatremia who have their serum sodium corrected have lower mortality and longer survival, highlighting the need for more attention to hyponatremia and its correction in critically ill patients.
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Journal of critical care · Oct 2015
Risk factors and outcomes associated with new-onset atrial fibrillation during acute respiratory distress syndrome.
Outcomes and risk factors associated with new-onset atrial fibrillation (AF) during acute respiratory distress syndrome (ARDS) are unclear. We investigated mortality and risk factors associated with new-onset AF during ARDS. ⋯ New-onset AF during ARDS is associated with increased mortality; however, its mechanisms require further study.
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Journal of critical care · Oct 2015
Prospective analysis of cardiac collapsibility of inferior vena cava using ultrasonography.
The inferior vena cava (IVC) diameter and its respiratory change (respiratory variation) reportedly correlate well with the central venous pressure and response to fluid. However, changes in the IVC diameter are related to the cardiac rhythm (cardiac variation), which can be useful as an indicator for intravascular volume but can affect respiratory variation. We conducted a prospective analysis of this cardiac variation in adult emergency department patients. ⋯ The IVC cardiac variation affects our interpretation of ultrasonography IVC imaging. The IVC cardiac variation provides several advantages over other parameters of intravascular volume. Therefore, it can be a novel tool to assess the intravascular volume of the patients.
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Journal of critical care · Oct 2015
Factors associated with interhospital transfer of children with respiratory failure from level II to level I pediatric intensive care units.
Of all sources of admission to level I pediatric intensive care units (PICUs), interhospital transfer admissions from level II PICUs carry the highest mortality and resource use burden. We sought to investigate factors associated with transfer of children with respiratory failure from level II to level I PICUs. ⋯ The study identified patient-level and process-of-care factors associated with transfer from level II to level I PICUs. These findings highlight the influence of escalated care on transfer decision making for critically ill children in respiratory failure.