Journal of critical care
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Journal of critical care · Feb 2016
Observational StudyNear-infrared spectroscopy to assess microvascular dysfunction: A prospective pilot study in cardiac surgery patients.
The diagnosis of microvascular dysfunction remains challenging after cardiac surgery. We hypothesized that peripheral near-infrared spectroscopy (NIRS) monitoring in combination with a vascular occlusion test could reliably assess postoperative microvascular dysfunction in that setting. ⋯ Peripheral NIRS monitoring in combination with a vascular occlusion test failed to assess cardiopulmonary bypass-induced microvascular dysfunction.
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Journal of critical care · Feb 2016
The role of human metapneumovirus in the critically ill adult patient.
The purpose of the study is to describe the role of human metapneumovirus (hMPV) infection in critical illness and acute respiratory distress syndrome (ARDS). ⋯ Although most patients hospitalized with hMPV had chronic cardiac or pulmonary disease, hMPV can also be associated serious respiratory illness and ARDS in adult patients without significant comorbidities or immunosuppression.
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Journal of critical care · Feb 2016
Observational StudyPrognosis of patients presenting extreme acidosis (pH <7) on admission to intensive care unit.
The purpose was to determine prognosis of patients presenting extreme acidosis (pH <7) on admission to the intensive care unit (ICU) and to identify mortality risk factors. ⋯ Patients with extreme acidosis on admission to ICU have a less severe than expected prognosis. Whereas mortality is almost 100% in cases of cardiac arrest before admission, mortality is much lower in the absence of cardiac arrest before admission, which justifies aggressive ICU therapies.
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Journal of critical care · Feb 2016
Comparative StudyPredicting mortality rates: Comparison of an administrative predictive model (hospital standardized mortality ratio) with a physiological predictive model (Acute Physiology and Chronic Health Evaluation IV)-A cross-sectional study.
Direct comparison of mortality rates has limited value because most deaths are due to the disease process. Predicting the risk of death accurately remains a challenge. ⋯ At less than 0.1, the models are interchangeable, but in spite of a moderate correlation, greater than 0.1 hospital standardized mortality ratio cannot be used to predict mortality.
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Journal of critical care · Feb 2016
Palliative and end-of-life educational practices in US pulmonary and critical care training programs.
To describe educational features in palliative and end-of-life care (PEOLC) in pulmonary/critical care fellowships and identify the features associated with perceptions of trainee competence in PEOLC. ⋯ This survey of PEOLC education in US pulmonary/critical care fellowships identified associations between certain program features and perceived trainee skill in PEOLC. These results generate hypotheses for further study.