Journal of critical care
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Journal of critical care · Jun 2016
Comparative StudyIs there a difference in efficacy, safety, and cost-effectiveness between 3-factor and 4-factor prothrombin complex concentrates among trauma patients on oral anticoagulants?
The aim of this study was to compare the efficacy, safety, and cost-effectiveness of 3-factor prothrombin complex concentrate (3F-PCC) vs 4-factor prothrombin complex concentrate PCC (4F-PCC) in trauma patients requiring reversal of oral anticoagulants. ⋯ Three-factor PCC and 4F-PCC were both safe in correcting INR, but 4F-PCC was more effective, leading to better cost-effectiveness. Replacing 3F-PCC with 4F-PCC for urgent coagulopathy reversal may benefit patients and institutions.
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Journal of critical care · Jun 2016
High prolactin levels are associated with more delirium in septic patients.
We investigated whether high prolactin levels were associated with delirium in septic patients because neuropsychiatric disorders are frequently associated with hyperprolactinemia. ⋯ High prolactin levels may be a risk factor for delirium in septic patients.
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The prevalence and outcomes of trauma patients requiring an unplanned return to the intensive care unit (ICU) and those initially admitted to a step-down unit or floor and subsequently upgraded to the ICU, collectively termed unplanned ICU (UP-ICU) admission, are largely unknown. ⋯ UP-ICU admission, although infrequent, was associated with significantly greater hospital length of stay, rate of major abdominal surgery, need for mechanical ventilation, and mortality rates than PL-ICU and NO-ICU admission groups.
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Journal of critical care · Jun 2016
Clinical application of the ProVent score in Korean patients requiring prolonged mechanical ventilation: A 10-year experience in a university-affiliated tertiary hospital.
We evaluated the clinical usefulness of a prognostic scoring system ("the ProVent score") in Korean patients requiring prolonged mechanical ventilation. ⋯ In our study, the ProVent score could be applied to predict 1-year mortality for patients requiring prolonged mechanical ventilation in Korea. Among variables contributing to this score, only thrombocytopenia was an independent prognostic factor for 1-year mortality.
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Journal of critical care · Jun 2016
How to make the axillary vein larger? Effect of 90° abduction of the arm to facilitate ultrasound-guided axillary vein puncture.
Placement of central venous catheters by the infraclavicular route can be achieved by ultrasound-guided puncture of the axillary vein. However, in some cases, the axillary vein may be difficult to puncture because it is too deep or too small or because it is collapsing significantly during breathing. The objective of this observational study was to determine the effect of 90° abduction of the arm associated with forward position of the shoulder on axillary vein diameters. ⋯ These findings suggest that a 90° abduction of the arm, particularly if associated with a forward position of the shoulder, facilitates the visualization of the axillary vein, making its ultrasound-guided venipuncture easier.