Journal of critical care
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Journal of critical care · Oct 2016
Observational StudyIgG2 as an independent risk factor for mortality in patients with community-acquired pneumonia.
Mortality in patients with community-acquired pneumonia (CAP) remains high despite improvements in treatment. ⋯ Patients with CAP with IgG2 levels <301 mg/dL had a poorer prognosis and a higher risk of death. Our study suggests the usefulness of IgG2 to predict CAP evolution and to provide support measures or additional treatment.
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Journal of critical care · Oct 2016
The Intensive care unit specialist: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine.
The role of the critical care specialist has been unequivocally established in the management of severely ill patients throughout the world. Data show that the presence of a critical care specialist in the intensive care unit (ICU) environment has reduced morbidity and mortality, improved patient safety, and reduced length of stay and costs. ⋯ The curriculum to ensure appropriate training around the world is diverse but should ideally meet some minimum standards. The World Federation of Societies of Intensive and Critical Care Medicine has set up a task force to address issues concerning the training, functions, roles, and responsibilities of an ICU specialist.
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Journal of critical care · Oct 2016
Comment LetterThe venous-arterial CO2 to arterial-venous O2 content difference ratio: Easy to monitor?
Blood sampling for venous-arterial CO2 to arterial-venous O2 content difference ratio starts to be widely used as a hemodynamic monitoring tool, despite that this calculation remains cumbersome. We propose using indirect calorimetry and respiratory quotient for this purpose, with the same physiological concept.
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Journal of critical care · Oct 2016
Is inhaled prophylactic heparin useful for prevention and management of pneumonia in ventilated ICU patients?
The purpose was to determine the efficacy of prophylactic inhaled heparin for the prevention and treatment of pneumonia in patients receiving mechanical ventilation (MV). ⋯ A phase 2, double-blind, randomized controlled trial stratified for study center and patient type (nonoperative, postoperative) was conducted in 3 university-affiliated intensive care units. Patients aged at least 18 years and requiring invasive MV for more than 48 hours were randomized to usual care, nebulization of unfractionated sodium heparin (5000 U in 2 mL), or nebulization with 0.9% sodium chloride (2 mL) 4 times daily with the main outcome measures, the development of ventilator-associated pneumonia (VAP), ventilator-associated complication, and Sequential Organ Failure Assessment scores in patients with admission pneumonia or developing VAP.