Journal of critical care
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Journal of critical care · Dec 2018
An open-loop, physiological model based decision support system can reduce pressure support while acting to preserve respiratory muscle function.
To assess whether a clinical decision support system (CDSS) suggests PS and FIO2 maintaining appropriate breathing effort, and minimizing FIO2. ⋯ The CDSS advised on low values of PS often not prohibiting extubation, while acting to preserve respiratory muscle function and preventing passive lung inflation. CDSS advice minimized FIO2 maintaining SpO2 at safe and beneficial values.
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Journal of critical care · Dec 2018
Donor biomarkers as predictors of organ use and recipient survival after neurologically deceased donor organ transplantation.
We sought to build prediction models for organ transplantation and recipient survival using both biomarkers and clinical information. ⋯ Plasma biomarkers in neurologically deceased donors were associated with organ use. SLPI enhanced prediction within a liver transplantation model, whereas IL-6 before transplantation was significantly associated with recipient 3-year survival. Clinicaltrials.gov: NCT00987714.
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Journal of critical care · Dec 2018
Meta AnalysisPrognostic value of plasma brain natriuretic peptide value for patientswith sepsis: A meta-analysis.
The aim of this meta-analysis was to clarify the diagnostic role of plasma BNP and NT-proBNP in predicting mortality for septic patients. ⋯ This meta-analysis indicates that both elevated plasma BNP and NT-proBNP have moderate predicts value for the mortality of septic patients, and the tested method and observation endpoint influence the results of BNP.
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Journal of critical care · Dec 2018
Multicenter StudyC-reactive protein and procalcitonin profile in ventilator-associated lower respiratory infections.
Ventilator-associated tracheobronchitis (VAT) has been suggested as an intermediate process between tracheobronchial colonization and ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. The aim of this study was to evaluate the ability of C-reactive protein (CRP) and procalcitonin (PCT) to differentiate between VAT and VAP. ⋯ Although PCT and CRP presented lower values in VAT as compared to VAP, there was a marked overlap of both biomarkers values in both VA-LRTI not allowing adequate discrimination.
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Journal of critical care · Dec 2018
Observational StudyAssociation between death and loss of stage N2 sleep features among critically Ill patients with delirium.
Critically ill patients experience significant sleep disruption. In this study of ICU patients with delirium, we evaluated associations between the loss of stage N2 features (K-complexes, sleep spindles), grade of encephalopathy based on electroencephalography (EEG), and intensive care unit (ICU) outcomes. We hypothesized that loss of stage N2 features is associated with more severe grades of encephalopathy and worse ICU outcomes including death. ⋯ Loss of stage N2 features is common and associated with more severe encephalopathy and higher odds of death. The absence of either Stage N2 feature, K complexes or sleep spindles, may have important prognostic value.