Journal of critical care
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Journal of critical care · Dec 2016
The prognostic value of the strong ion gap in acute pancreatitis.
In this study, we aimed to evaluate the predictive value of Stewart-derived parameters for the development of severe type of acute pancreatitis (AP) and for AP-related mortality. ⋯ In a cohort of patients with AP, SIG was a strong independent predictor of severity and mortality. Besides, SIG might also be an early marker for acute kidney injury in AP patients. Additional research is needed to identify the nature of the unmeasured anions responsible for such findings.
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Journal of critical care · Dec 2016
Prognostication of critically ill patients with acute-on-chronic liver failure using the Chronic Liver Failure-Sequential Organ Failure Assessment: A Canadian retrospective study.
We evaluated the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) score to predict survival in a Canadian critically ill cohort with acute-on-chronic liver failure. ⋯ The CLIF-SOFA and SOFA scores during the first 3 days of ICU admission appear to be highly predictive of in-hospital mortality.
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Journal of critical care · Dec 2016
Validation of the Critical-Care Pain Observation Tool in brain-injured critically ill adults.
Pain is a common symptom in the intensive care unit (ICU). Brain-injured patients are often unable to reliably self-report their pain, calling forth the need to use behavioral scales such as the Critical-Care Pain Observation Tool (CPOT). This study aimed to test the reliability and validity of the CPOT use with brain-injured ICU adults. ⋯ Overall, the CPOT use was found to be reliable and valid in this patient group and is new evidence fulfilling an important gap highlighted in the Society of Critical Care Medicine practice guidelines.
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Journal of critical care · Dec 2016
Individual-specific principal component analysis of circulating inflammatory mediators predicts early organ dysfunction in trauma patients.
We hypothesized that early inflammation can drive, or impact, later multiple organ dysfunction syndrome (MODS), that patient-specific principal component analysis (PCA) of circulating inflammatory mediators could reveal conserved dynamic responses which would not be apparent from the unprocessed data, and that this computational approach could segregate trauma patients with regard to subsequent MODS. ⋯ Identification of patient-specific "core responses" can lead to early segregation of diverse trauma patients with regard to later MODS. Hence, we suggest that a focus on dynamic inflammatory networks rather than individual biomarkers is warranted.
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Journal of critical care · Dec 2016
Observational StudyThe association between hemoglobin concentration and neurologic outcome after cardiac arrest.
The purpose of the study is to determine the association between hemoglobin concentration (Hgb) and neurologic outcome in postarrest patients. ⋯ Higher Hgb after cardiac arrest is associated with favorable neurologic outcome, particularly within the first 6 hours. It is unclear if this effect is due to impaired oxygen delivery or if Hgb is a marker for more severe illness.