Journal of critical care
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Journal of critical care · Feb 2018
Multicenter StudyEffects of polymyxin B hemoperfusion on hemodynamics and prognosis in septic shock patients.
We designed this study to examine the clinical effects of polymyxin B hemoperfusion (PMX-HP) in septic shock patients. ⋯ PMX-HP may have potential benefits for hemodynamic and prognostic outcomes in septic shock patients with intra-abdominal or gram-negative bacterial infection.
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Journal of critical care · Feb 2018
ReviewSpatial methods for evaluating critical care and trauma transport: A scoping review.
The objective of this scoping review is to inform future applications of spatial research regarding transportation of critically ill patients. We hypothesized that this review would reveal gaps and limitations in the current research regarding use of spatial methods for critical care and trauma transport research. ⋯ There is a gap between the availability of spatial tools and their usage for analyzing and improving medical transportation. The adoption of geospatially guided transport decisions can meaningfully impact healthcare expenditures, especially in healthcare systems looking to strategically control expenditures with minimum impact on patient outcomes.
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Journal of critical care · Feb 2018
Multicenter StudyEnd-of-life discussions: Who's doing the talking?
To determine, in a tertiary academic medical center, the reported frequency of end-of-life discussions among nurses and the influence of demographic factors on these discussions. ⋯ In a survey conducted in two tertiary care institutions, more than one-third of nurses from all disciplines responded that they never or almost never discuss end-of-life issues with their patients. Specialty influenced the likelihood of discussing end-of-life issues with patients.
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Journal of critical care · Feb 2018
Comparative StudyThe comparative effectiveness of noninvasive and invasive ventilation in patients with pneumonia.
To compare the outcomes of patients hospitalized with pneumonia treated with noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV). ⋯ Initial NIV was associated with better survival among the subgroup of patients hospitalized with pneumonia who had COPD or heart failure. Patients who failed NIV had high in-hospital mortality, emphasizing the importance of careful patient selection monitoring when managing severe pneumonia with NIV.
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Journal of critical care · Feb 2018
High serum soluble CD40L levels previously to liver transplantation in patients with hepatocellular carcinoma are associated with mortality at one year.
CD40L and its soluble form (sCD40L) are proteins of the tumor necrosis factor superfamily (TNFSF) that exhibit prothrombotic and proinflammatory properties when binding to CD40, which is a cell surface receptor of the tumor necrosis factor receptor superfamily (TNFRSF). High circulating levels of sCD40L have been associated with poor prognosis in patients with hepatocellular carcinoma (HCC). However, it is unknown whether there is an association between circulating sCD40L levels and survival in patients with HCC underwent to liver transplantation (LT), and this was the objective of that study. ⋯ The new finding of our study was that high serum sCD40L levels previously to LT in patients with HCC are associated with higher mortality at one year.