Journal of critical care
-
Journal of critical care · Dec 2015
Multicenter Study Observational StudyPediatric Index of Mortality 2 as a predictor of death risk in children admitted to pediatric intensive care units in Latin America: A prospective, multicenter study.
The purpose of this study is to asses the performance of the Pediatric Index of Mortality 2 (PIM2) score in pediatric intensive care units (PICUs) in Latin America. ⋯ Pediatric Index of Mortality 2 showed good discrimination, but calibration was inadequate. To use PIM2 for monitoring PICU performance in Latin America, it might be necessary to recalibrate the score locally.
-
Journal of critical care · Dec 2015
Multicenter Study Observational StudyAssociation between blood alcohol concentration and mortality in critical illness.
In animal models of renal, intestinal, liver, cardiac, and cerebral ischemia, alcohol exposure is shown to reduce ischemia-reperfusion injury. Inpatient mortality of trauma patients is shown to be decreased in a dose-dependent fashion relative to blood alcohol concentration (BAC) at hospital admission. In this study, we examined the association between BAC at hospital admission and risk of 30-day mortality in critically ill patients. ⋯ Analysis of 11850 adult patients showed that having a detectable BAC at hospitalization was associated with significantly decreased odds of 30-day mortality after critical care. Furthermore, BAC greater than 160 mg/dL is associated with significantly decreased odds of developing sepsis and bloodstream infection.
-
Journal of critical care · Dec 2015
Feasibility and safety of in-bed cycling for physical rehabilitation in the intensive care unit.
The purpose was to evaluate the feasibility and safety of in-bed cycle ergometry as part of routine intensive care unit (ICU) physical therapist (PT) practice. ⋯ Use of in-bed cycling as part of routine PT interventions in ICU patients is feasible and appears safe. Further study of the potential benefits of early in-bed cycling is needed.
-
Journal of critical care · Dec 2015
Observational StudySepsis-associated pulmonary complications in emergency department patients monitored with serial lactate: An observational cohort study.
Patients with severe sepsis and septic shock are at high risk for development of pulmonary complications, including acute respiratory distress syndrome (ARDS). Serial lactate monitoring is a useful tool to gauge global tissue hypoxia in emergency department (ED) patients with sepsis. We hypothesized that patients undergoing serial lactate monitoring (SL) would demonstrate a decreased incidence of pulmonary complications. ⋯ Serial lactate monitoring is associated with a decrease in major pulmonary complications in severe sepsis and septic shock. Acute respiratory distress syndrome incidence is also influenced by ED-based mechanical ventilation. These results provide 2 potentially modifiable variables to be targeted in future studies to prevent pulmonary complications in this patient subset.
-
Journal of critical care · Dec 2015
Time for critically ill patients to regain mobility after early mobilization in the intensive care unit and transition to a general inpatient floor.
The purpose of this study is to determine if patient mobility achievements in an intensive care unit (ICU) setting are sustained during subsequent phases of hospitalization, specifically after transferring to inpatient floors and on the day of hospital discharge. ⋯ Mobility progression through the hospital course is imperative to improving patient outcomes. Study findings show the need for improvement in maintaining early ICU mobilization achievement during the crucial phase between ICU stay and hospital discharge.