Journal of critical care
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Journal of critical care · Apr 2015
Observational StudyPredictive value of the complement system for sepsis-induced disseminated intravascular coagulation in septic patients in emergency department.
To investigate changes in circulating complement component C3, membrane attack complex (MAC), and mannose-binding lectin (MBL) in patients with sepsis-induced disseminated intravascular coagulation (DIC). ⋯ Complement 3, MAC, and MBL were significantly increased in septic patients with DIC. Membrane attack complex independently predicted sepsis-induced DIC and development of DIC after ED admission.
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Journal of critical care · Apr 2015
The effect of early quantitative resuscitation on organ function in survivors of septic shock.
The objective of this study is to determine if early quantitative resuscitation (QR) attenuates organ dysfunction in survivors of septic shock. ⋯ In survivors of septic shock, we found no difference in maximal organ dysfunction during hospitalization between patients who received QR vs NPC.
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Journal of critical care · Apr 2015
The utility of remote supervision with feedback as a method to deliver high-volume critical care ultrasound training.
Despite international agreement that critical care ultrasound (CCUS) is an essential skill for intensive care providers, CCUS training and dissemination is complicated by a shortage of educators. Newer technology now permits remote, offline supervision as a method of overseeing trainees undergoing CCUS instruction. ⋯ This study suggests that the use of wireless archiving and offline oversight in a CCUS curriculum is a feasible and highly-efficient strategy permitting a small number of faculty to supervise a large number of trainees. This approach provides an efficient method to address unmet demand for CCUS education.
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Journal of critical care · Apr 2015
Editorial Comment LetterThe unplanned intensive care unit admission.
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Journal of critical care · Apr 2015
Randomized Controlled Trial Multicenter StudyInsulin infusion therapy in critical care patients: Regular insulin vs short-acting insulin. A prospective, crossover, randomized, multicenter blind study.
The aim of this multicenter, prospective, randomized, crossover trial is to compare, in critical care patients receiving insulin infusion therapy (IIT), the pharmacodynamic of Humulin insulin (Hlin), currently used as "standard of care," and Humalog insulin (Hlog), a shorter acting insulin formulation. This was measured as extent and duration of the carryover effect of insulin treatment, with the latter calculated as ratio between blood glucose concentration (BGC) reduction during and after IIT. ⋯ The use of constant Hlog infusion for IIT, when compared with Hlin at the same dose, is associated with a less profound carryover effect on BGC after discontinuation of IIT, a briefer duration of carryover, a faster BGC drop during infusion, and a quicker BGC rise after discontinuation. These characteristics suggest that Hlog IIT may be preferable for use in critically ill patients.