Journal of critical care
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Journal of critical care · Oct 2015
Indexation of cardiac output to biometric parameters in critically ill patients: A systematic analysis of a transpulmonary thermodilution-derived database.
Cardiac output (CO) (liters per minute) is usually normalized (ie, indexed) to the patient's body surface area (BSA) resulting in the hemodynamic variable cardiac index (CI) (liters per minute per square meter). We aimed (1) to evaluate the impact of different body weight-based CO indexations on the resulting CI values and (2) to identify biometric parameters independently associated with CO in critically ill patients. ⋯ The indexation of CO to BSA is highly dependent on the body weight estimation formula used to calculate BSA. Cardiac output is independently associated with the biometric factors age, height, and BWact. These factors might be considered for indexation of CO.
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Journal of critical care · Oct 2015
Observational StudyPatient-ventilator asynchrony affects pulse pressure variation prediction of fluid responsiveness.
During partial ventilatory support, pulse pressure variation (PPV) fails to adequately predict fluid responsiveness. This prospective study aims to investigate whether patient-ventilator asynchrony affects PPV prediction of fluid responsiveness during pressure support ventilation (PSV). ⋯ Patient-ventilator asynchrony affects PPV performance during partial ventilatory support influencing its efficacy in predicting fluid responsiveness.
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Journal of critical care · Oct 2015
Development and validation of electronic surveillance tool for acute kidney injury: A retrospective analysis.
Timely detection of acute kidney injury (AKI) facilitates prevention of its progress and potentially therapeutic interventions. The study objective is to develop and validate an electronic surveillance tool (AKI sniffer) to detect AKI in 2 independent retrospective cohorts of intensive care unit (ICU) patients. The primary aim is to compare the sensitivity, specificity, and positive and negative predictive values of AKI sniffer performance against a reference standard. ⋯ Acute kidney injury can reliably and accurately be detected electronically in ICU patients. The presented method is applicable for both clinical (decision support) and research (enrollment for clinical trials) settings. Prospective validation is required.
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Journal of critical care · Oct 2015
Intraoperative administration of vasopressin during coronary artery bypass surgery is associated with acute postoperative kidney injury.
Severe vasodilatation is commonly seen upon weaning from cardiopulmonary bypass (CPB). We examined the effects of vasopressin (arginine vasopressin [AVP]) on acute kidney injury (AKI) in postoperative period. ⋯ Acute kidney injury is a common complication after cardiac surgery, and vasopressin use increases its incidence; however, this effect may rely on several clinical factors, and its true effect should be examined by large randomized trials.