Journal of critical care
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Journal of critical care · Jun 2017
Observational StudyCost-effectiveness of hospital treatment and outcomes of acute methanol poisoning during the Czech Republic mass poisoning outbreak.
During an outbreak of mass methanol poisoning in the Czech Republic in 2012-2014, we compared the total hospital costs and one-year medical costs in the patients treated with different antidotes (fomepizole versus ethanol) and modalities of hemodialysis (intermittent hemodialysis, IHD, versus continuous renal replacement therapy, CRRT). ⋯ The total hospital costs in the patients with acute methanol poisoning were more than three times higher in the patients treated with fomepizole than in the patients treated with ethanol after adjustment for the severity of poisoning. The dialysis modality did not affect the total hospital costs, but the trend to lower costs was present in IHD-group.
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Journal of critical care · Jun 2017
Observational StudySerum oxygen radical activity and total antioxidation capacity are related with severities of surgical patient with sepsis: Prospective pilot study.
The purpose of this pilot study was to evaluate the correlation between clinical severity and serum oxygen radical activity (ORA) and total antioxidation capacity (TAC) in critically ill surgical patients with sepsis. ⋯ Serum TAC level may be a useful biomarker to predict severity of critically ill surgical patients with sepsis.
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Journal of critical care · Jun 2017
Correlation between transition percentage of minute volume (TMV%) and outcome of patients with acute respiratory failure.
We have previously shown in patients receiving adaptive support ventilation (ASV) that there existed a Transition %MinVol (TMV%) where the patient's work of breathing began to reduce. In this study, we tested the hypothesis that higher TMV% would be associated with poorer outcome in patients with acute respiratory failure. ⋯ An increase, or lack of decrease, of TMV% from Day 1 to Day 2 was associated with higher risk of in-hospital death.
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Journal of critical care · Jun 2017
Hyperoxia: At what level of SpO2 is a patient safe? A study in mechanically ventilated ICU patients.
Concerns have been expressed regarding a possible association between arterial hyperoxia and adverse outcomes in critically ill patients. Oxygen status is commonly monitored noninvasively by peripheral saturation monitoring (SpO2). However, the risk of hyperoxia above specific SpO2 levels in critically ill patients is unknown. The purpose of this study was to determine a threshold value of SpO2 above which the prevalence of arterial hyperoxia distinctly increases. ⋯ In critically ill patients, the prevalence of arterial hyperoxia increases when SpO2 is >95%. Above this saturation level, supplemental oxygen should be administered with caution in patients potentially susceptible to adverse effects of hyperoxia.
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Journal of critical care · Jun 2017
Early bronchoalveolar lavage for intubated trauma patients with TBI or chest trauma.
To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. ⋯ More than half of all E-BAL patients had pneumonia present early after admission. E-BAL was associated with fewer days on antibiotics and better outcomes than L-BAL.