Journal of critical care
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Journal of critical care · Feb 2017
Observational StudyRelevance of serum sclerostin concentrations in critically ill patients.
Sclerostin is a negative regulator of bone metabolism and associated with chronic morbidities. We investigated circulating sclerostin in critically ill patients. ⋯ Serum sclerostin concentrations are significantly elevated in critically ill patients, linked to renal or hepatic organ failure, and associated with bone resorption markers, supporting its value as a potential tool for the assessment of ICU-related metabolic bone disease.
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Journal of critical care · Feb 2017
Impact of hospital case-volume on subarachnoid hemorrhage outcomes: A nationwide analysis adjusting for hemorrhage severity.
There have been suggestions that patients with subarachnoid hemorrhage (SAH) have a better outcome when treated in high-volume centers. Much of the published literature on the subject is limited by an inability to control for severity of SAH. ⋯ After adjustment for severity of SAH, treatment in a high-volume center was associated with a lower risk of in-hospital mortality and a higher odds of a good functional outcome.
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Journal of critical care · Feb 2017
Observational StudyIschemia-modified albumin is a predictor of short-term mortality in patients with severe sepsis.
One of the most important events leading to morbidity and mortality in patients with severe sepsis is the development of global tissue hypoperfusion and oxidative damage. Ischemia-modified albumin (IMA), an albumin generated under ischemic and oxidative conditions, is a marker of oxidative stress and hypoperfusion. Here, we investigated whether IMA level could predict short-term mortality with severe sepsis. ⋯ The IMA level, especially at least 110 U/mL, may be a useful predictor of death for patients with severe sepsis.
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Journal of critical care · Feb 2017
The clinical benefit of a follow-up thoracic computed tomography scan regarding parenchymal lung injury and acute respiratory distress syndrome in polytraumatized patients.
To evaluate the increase of parenchymal lung injury (PLI) volume between the initial and a follow-up computed tomography (CT) scan and to ascertain which of the 2 scans was more appropriate to predict acute respiratory distress syndrome (ARDS). ⋯ The CT scans performed directly after admission are sufficient to define patients at risk for ARDS. Therefore, solely the incidence of PLI does not justify a routine follow-up CT scan.
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Journal of critical care · Feb 2017
Comparative StudyMeasurement of pleural pressure swings with a fluid-filled esophageal catheter vs pulmonary artery occlusion pressure.
Pleural pressure measured with esophageal balloon catheters (Peso) can guide ventilator management and help with the interpretation of hemodynamic measurements, but these catheters are not readily available or easy to use. We tested the utility of an inexpensive, fluid-filled esophageal catheter (Peso) by comparing respiratory-induced changes in pulmonary artery occlusion (Ppao), central venous (CVP), and Peso pressures. ⋯ A fluid-filled esophageal catheter provides a high-quality, easily accessible, and inexpensive measure of change in pleural pressure and provided insights into patient-ventilator interactions.