Journal of critical care
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Journal of critical care · Dec 2015
ReviewMagnesium status and magnesium therapy in critically ill patients: A systematic review.
Magnesium is frequently measured and administered in general intensive care unit patients. However, magnesium status, its association with outcomes, and therapeutic utility in such patients are unclear. We performed a systematic review of the relevant literature to define current knowledge in this field. ⋯ Total serum magnesium levels are generally used to estimate magnesium status in critical illness. Hypomagnesemia appears associated with greater risk of mortality, but the efficacy of magnesium administration is open to challenge.
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Journal of critical care · Dec 2015
Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure: a retrospective study.
Prone positioning (PP) improves oxygenation and outcome of patients with acute respiratory distress syndrome undergoing invasive ventilation. We evaluated feasibility and efficacy of PP in awake, non-intubated, spontaneously breathing patients with hypoxemic acute respiratory failure (ARF). ⋯ PP was feasible and improved oxygenation in non-intubated, spontaneously breathing patients with ARF.
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Journal of critical care · Dec 2015
ReviewPANCREATITIS OR NOT? - Elevated lipase and amylase in ICU patients.
Elevation in serum levels of pancreatic enzymes (Hyperamylasemia and/or Hyperlipasemia) can occur in any Intensive Care Unit (ICU) patient either as a result of true acute pancreatitis (AP) or as a reflection of a non-pancreatic disease. Although most patients may not have clinical pancreatitis, identifying true acute pancreatitis in the ICU setting may be critical in the presence of associated co-morbid conditions of the disease for which the patient is being managed. With neither amylase nor lipase being specific for pancreatitis, it is important for the clinician to be aware of different causes of hyperamylasemia and hyperlipasemia, especially when clinical diagnosis of pancreatitis is unclear. This review will focus on understanding different non-pancreatic conditions where there is elevation of pancreatitis enzymes and to identify true acute pancreatitis in critically ill patients without typical symptoms.
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Journal of critical care · Dec 2015
Admission hyperglycemia is associated with poor outcome after emergent coronary bypass grafting surgery.
Hyperglycemia during or after cardiac surgery is a common finding that is associated with poor outcome. Very few data, however, are available regarding a correlation between admission blood glucose and outcomes after coronary artery bypass grafting (CABG). Thus, the goal of the current study was to examine the relationship between admission blood glucose and outcome after emergency CABG surgery. ⋯ Our study shows for the first time that admission blood glucose is correlated with increased morbidity and mortality among patients undergoing emergency CABG surgery.
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Journal of critical care · Dec 2015
Impact of late fluid balance on clinical outcomes in the critically ill surgical and trauma population.
Management of fluid status in critically ill patients poses a significant challenge due to limited literature. This study aimed to determine the impact of late fluid balance management after initial adequate fluid resuscitation on in-hospital mortality for critically ill surgical and trauma patients. ⋯ Consistent with previous literature, high fluid balance on postoperative day 7 was associated with increased in-hospital mortality. Patients who received and responded to diuretic therapy did not demonstrate improved clinical outcomes, which questions their use in the postoperative period.