Journal of critical care
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Journal of critical care · Oct 2018
Observational StudyLow endocan levels are predictive of Acute Respiratory Distress Syndrome in severe sepsis and septic shock.
Endocan is a circulating proteoglycan measured at high blood levels during severe sepsis, with a likely lung anti-inflammatory function. The aim of this study was to assess whether paradoxically low endocan levels at Intensive Care Unit (ICU) admission could predict Acute Respiratory Distress Syndrome (ARDS) within 72 h in severe septic patients. ⋯ In a cohort of severe septic patients, we observed that low blood levels of endocan at ICU admission were predictive of ARDS at 72 h.
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Journal of critical care · Oct 2018
Decompressive laparotomy for the treatment of the abdominal compartment syndrome during extracorporeal membrane oxygenation support.
Extracorporeal membrane oxygenation (ECMO) is increasingly used with various indications. The clinical course can be complicated by an abdominal compartment syndrome (ACS). A decompressive laparotomy (DL) can be an option. ⋯ Approximately 10% of patients undergoing VA-ECMO support developed an ACS. If DL is undertaken, SAPS II scores can be used as predictive factor for mortality.
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Journal of critical care · Oct 2018
Non-invasive positive pressure ventilation in lung transplant recipients with acute respiratory failure: Beyond the perioperative period.
The purpose of this study is to evaluate outcomes in MICU lung transplant recipients with acute respiratory failure treated with non-invasive positive pressure ventilation (NPPV) and identify factors associated with NPPV failure (need for intubation). ⋯ NPPV is a viable option for lung transplant recipients with acute respiratory failure. Extreme caution should be exercised when used in patients with high severity of illness (APACHE III >78) and/or severe hypoxemia (PaO2/FiO2 ≤ 151).
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Journal of critical care · Oct 2018
Days alive and free as an alternative to a mortality outcome in pivotal vasopressor and septic shock trials.
RCTs in septic shock negative for mortality may show organ dysfunction benefits. We hypothesized that RCTs in septic shock show significant differences between treatment groups in organ support despite no mortality differences. ⋯ Differences between treatment groups in organ dysfunction in RCTs in septic shock occur despite lack of mortality differences depending on calculation method. If standardized and validated further, DAF could become the primary endpoint of RCTs in septic shock.