Journal of critical care
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Journal of critical care · Apr 2016
Observational StudyDevelopment and validation of the "Pediatric Risk of Nosocomial Sepsis (PRiNS)" score for health care-associated infections in a medical pediatric intensive care unit of a developing economy-a prospective observational cohort study.
Given the high burden of health care-associated infections (HAIs) in resource-limited settings, there is a tendency toward overdiagnosis/treatment. This study was designed to create an easy-to-use, dynamic, bedside risk stratification model for classifying children based on their risk of developing HAIs during their pediatric intensive care unit (PICU) stay, to aid judicious resource utilization. ⋯ The "Pediatric Risk of Nosocomial Sepsis" score can reliably classify children into high- and low-risk groups, based on their risk of developing HAIs in the PICU of a resource-limited setting. In view of its high sensitivity and specificity, diagnostic and therapeutic interventions may be directed away from the low-risk group, ensuring effective utilization of limited resources.
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Journal of critical care · Apr 2016
Observational StudyEfficacy of noninvasive mechanical ventilation in prevention of intubation and reintubation in the pediatric intensive care unit.
To determine the efficiency of noninvasive mechanical ventilation (NIV) both in protection from intubation and in preventing reintubation of postextubation in patients in the pediatric intensive care unit (PICU). ⋯ Noninvasive mechanical ventilation effectively and reliably reduced endotracheal intubation in the treatment of respiratory failure due to different clinical situations. Our results suggest that NIV can play an important role in PICUs in helping to avoid intubation and prevent reintubation. Although there were serious underlying diseases in most of our patients, such as immunosuppression, 70% avoided intubation with use of NIV.
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Journal of critical care · Apr 2016
Incidence and predictors of ischemic cerebrovascular stroke among patients on extracorporeal membrane oxygenation support.
There are scant data on the predictors of ischemic cerebrovascular stroke occurring during extracorporeal membrane oxygenation (ECMO). We investigated the incidence and predictors of ischemic stroke in subjects receiving ECMO support. ⋯ Ischemic stroke is not uncommon in subjects receiving ECMO support with independent risk factor being a pre-ECMO lactic acid greater than 10 mmol/L.
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Journal of critical care · Apr 2016
Observational StudyCan mortality due to circulatory failure in comatose out-of-hospital cardiac arrest patients be predicted on admission? A study in a retrospective derivation cohort validated in a prospective cohort.
Circulatory failure (CF) influences management of out-of-hospital cardiac arrest (OHCA) patients and the decision of circulatory assistance. We performed a study to identify on hospital admission patients at risk for CF-related death. ⋯ A logistic score based on arterial pH and shock requiring catecholamines on admission can predict CF-related death in OHCA patients.
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Journal of critical care · Apr 2016
Can lung ultrasonography predict prone positioning response in acute respiratory distress syndrome patients?
The purpose was to assess whether lung ultrasonography (L-US) is a useful tool in prediction of prone positioning (PP) oxygenation response in patients with acute respiratory distress syndrome (ARDS). ⋯ Our results demonstrated that a simple and short L-US examination could be a useful tool in prediction of PP oxygenation response in ARDS patients. A normal L-US pattern of both anterobasal lung regions in supine position may predict a significant PaO2/FIO2 ratio improvement.