Journal of critical care
-
Journal of critical care · Oct 2017
ReviewInterventions affecting mortality in critically ill and perioperative patients: A systematic review of contemporary trials.
Confounders in randomized controlled trials (RCTs) reporting significant effects on mortality in critically ill patients using non-surgical techniques have not been systematically explored. We aimed to identify factors unrelated to the reported intervention that might have affected the findings and robustness of such trials. ⋯ These observations imply that major systematic biases exist and affect trial findings irrespective of the intervention being studied.
-
Journal of critical care · Oct 2017
Multicenter StudyHypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage.
Hypoalbuminemia and systemic inflammatory response syndrome (SIRS) are reported in critically-ill patients, but their relationship is unclear. We sought to determine the association of admission serum albumin and SIRS with outcomes in patients with intracerebral hemorrhage (ICH). ⋯ In patients with ICH, hypoalbuminemia is strongly associated with SIRS. SIRS, but not hypoalbuminemia, predicts poor outcome at discharge. Recognizing and managing SIRS early may prevent death or disability in ICH patients.
-
Journal of critical care · Oct 2017
Multicenter StudyComplications following hospital admission for traumatic brain injury: A multicenter cohort study.
To evaluate the incidence, determinants and impact on outcome of in-hospital complications in adults with traumatic brain injury (TBI). ⋯ More than 20% of patients with TBI developed a complication. Many of these complications were associated with increased mortality and LOS. Results highlight the importance of prevention strategies adapted to treatment decisions and underline the need to improve knowledge on the underuse and overuse of clinical interventions.
-
Journal of critical care · Oct 2017
Observational StudyInferior vena cava collapsibility detects fluid responsiveness among spontaneously breathing critically-ill patients.
Measurement of inferior vena cava collapsibility (cIVC) by point-of-care ultrasound (POCUS) has been proposed as a viable, non-invasive means of assessing fluid responsiveness. We aimed to determine the ability of cIVC to identify patients who will respond to additional intravenous fluid (IVF) administration among spontaneously breathing critically-ill patients. ⋯ IVC collapsibility, as measured by POCUS, performs well in distinguishing fluid responders from non-responders, and may be used to guide IVF resuscitation among spontaneously breathing critically-ill patients.