Journal of critical care
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Journal of critical care · Aug 2015
Evaluation of preintubation shock index and modified shock index as predictors of postintubation hypotension and other short-term outcomes.
Preintubation shock index (SI) and modified shock index (MSI) have demonstrated predictive capability for postintubation hypotension in emergency department. The primary aim was to explore this relationship in the critical care environment. The secondary aims were to evaluate the relationship of shock indices with other short-term outcomes like mortality and length of stay in intensive care unit. ⋯ Our findings indicate that preintubation SI greater than or equal to 0.90 is a predictor of postintubation hypotension (systolic blood pressure <90 mm Hg) and ICU mortality in emergently intubated adult patients in intensive care units.
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Journal of critical care · Aug 2015
Observational StudyProspective observation of physical activity in critically ill patients who were intubated for more than 48 hours.
Critical illness can result in impaired physical function. Increased physical activity, additional to rehabilitation, has demonstrated improved functional independence at hospital discharge. The purpose of this study was to measure patterns of physical activity in a group of critically ill patients. ⋯ Outside rehabilitation, patients in ICU are inactive and spend approximately one-third of the 8-hour day alone. Strategies to increase physical activity levels in ICU are required.
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Journal of critical care · Aug 2015
Apolipoprotein A-V is not a major determinant of triglyceride levels during human sepsis.
During critical illnesses, alterations in lipid metabolism occur. We examined levels of apolipoprotein A-V, a novel regulator of triglyceride metabolism, during sepsis in humans. ⋯ During sepsis or acute illnesses, serum apolipoprotein A-V levels were not significantly different from those in controls. Furthermore, apolipoprotein A-V levels were not linearly correlated with triglyceride levels, suggesting that it might not be a major determinant of triglyceride levels during sepsis.
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Journal of critical care · Aug 2015
Early prediction of norepinephrine dependency and refractory septic shock with a multimodal approach of vascular failure.
The purpose of the study is to improve our ability to detect catecholamine dependency and refractory septic shock. ⋯ The intensity of septic shock-induced vascular hyporesponsiveness to vasopressor is tightly linked to septic shock severity and evolution and may potentially be identified early with simple to obtain parameters such as near-infrared spectroscopy value, SOFA score, or norepinephrine dose.
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Journal of critical care · Aug 2015
Observational StudyBalancing care and teaching during clinical activities: 2 contexts, 2 strategies.
The goal of this study was to better understand how clinical supervisors integrate teaching interactions with medical trainees into 2 types of clinical activities in the critical care setting: multidisciplinary rounds and medical crises. ⋯ Modern views of medical apprenticeship and clinical teaching need to take into account the specific clinical context in which learning occurs. Teaching interactions that differ in structure and content in response to changing clinical circumstances could impact learning in unique ways. Learning outcomes resulting from different models of integration of teaching into clinical activities need to be further explored.