Journal of critical care
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Journal of critical care · Apr 2016
Early central diabetes insipidus: An ominous sign in post-cardiac arrest patients.
Central diabetes insipidus (CDI) after cardiac arrest is not well described. Thus, we aim to study the occurrences, outcomes, and risk factors of CDI of survivors after out-of-hospital cardiac arrest (OHCA). ⋯ All patients diagnosed with CDI had poor neurologic outcomes, and occurrence of CDI was associated with mortality. Central diabetes insipidus patients with death or brain death had earlier occurrence of CDI and more maximum urine output.
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Journal of critical care · Apr 2016
ReviewBarbiturates for the treatment of alcohol withdrawal syndrome: A systematic review of clinical trials.
To perform a systematic review of the clinical trials concerning the use of barbiturates for the treatment of acute alcohol withdrawal syndrome (AWS). ⋯ Although the evidence is limited, based on our findings, adding phenobarbital to a BZD-based regimen is a reasonable option, particularly in patients with BZD-refractory AWS.
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Journal of critical care · Apr 2016
Review Meta AnalysisThe effects of chlorhexidine gluconate bathing on health care-associated infection in intensive care units: A meta-analysis.
The purpose was to assess the effects of chlorhexidine gluconate (CHG) bathing on health care-associated infections among critically ill patients. ⋯ Daily CHG bathing was associated with reduced risks of acquiring CLABSI, MRSA, and VRE. A prolonged intervention period and concomitant nasal antibiotic use were associated with lower risks of MRSA acquisition.
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Journal of critical care · Apr 2016
Azithromycin use and outcomes in severe sepsis patients with and without pneumonia.
Studies investigating the association between macrolides and outcomes in both pulmonary and nonpulmonary critically ill patients are limited. We aimed to examine the association between azithromycin use and clinical outcomes in severe sepsis patients with and without pneumonia receiving mechanical ventilation. ⋯ Azithromycin was associated with more ICU-free days in severe sepsis patients with and without pneumonia. Further investigations are warranted to better elicit the association of macrolide use on clinical outcomes in severe sepsis patients, especially those without pneumonia.
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Journal of critical care · Apr 2016
Troponin elevation predicts critical care needs and in-hospital mortality after thrombolysis in white but not black stroke patients.
Stroke patients undergoing intravenous thrombolysis (IVT) are at increased risk for critical care interventions and mortality. Cardiac troponin elevation is common in stroke patients; however, its prognostic significance is unclear. The present study evaluates troponin elevation as a predictor of critical care needs and mortality in post-IVT patients and describes racial differences in its predictive accuracy. ⋯ Troponin is a useful predictor of poor outcome in white but not black post-IVT stroke patients.