Journal of critical care
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Journal of critical care · Apr 2018
Comparative StudyDiagnostic and predictive values of procalcitonin in bloodstream infections for nosocomial pneumonia.
We evaluated the diagnostic accuracy of PCT to distinguish between gram-negative (GN) and gram-positive (GP) bloodstream infections nosocomial pneumonia (NP) patients and compared PCT levels with the pneumonia severity index (PSI) for predicting mortality. ⋯ PCT could differentiate between GN and GP bloodstream infections in patients with NP. However, PCT levels were less predictive of mortality compared with the PSI.
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Journal of critical care · Apr 2018
Predictors of dysphagia in critically injured patients with neck trauma.
Trauma patients admitted to the intensive care unit (ICU) are at heightened risk for oropharyngeal dysphagia and pulmonary aspiration. Timely and appropriate referrals for dysphagia may reduce mortality rates and hospital readmissions. This study sought to identify predictors of dysphagia in a large cohort of patients with multiple traumatic injuries. ⋯ Oropharyngeal dysphagia is a common complication in trauma patients. Our results propose a set of predictors that should be considered when identifying critically injured patients at risk for dysphagia.
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Journal of critical care · Apr 2018
Serum anion gap predicts lactate poorly, but may be used to identify sepsis patients at risk for death: A cohort study.
(1) To test whether serum bicarbonate or anion gap can be used to predict elevated lactate or mortality in emergency department (ED) patients with sepsis, and (2) to define thresholds that may predict elevated lactate and mortality. ⋯ Anion gap and serum bicarbonate poorly predict changes in lactate and mortality. In resource-limited settings where lactate is unavailable, anion gap ≥20mEq/L may be used to further risk-stratify patients for ongoing sepsis care, but lactate remains a preferred biomarker.
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Journal of critical care · Apr 2018
3-month prognostic impact of severe acute renal failure under veno-venous ECMO support: Importance of time of onset.
Veno-venous ECMO is increasingly used for the management of refractory ARDS. In this context, acute kidney injury (AKI) is a major and frequent complication, often associated with poor outcome. We aimed to identify characteristics associated with severe renal failure (Kidney Disease Improving Global Outcome (KDIGO) 3) and its impact on 3-month outcome. ⋯ KDIGO 3 AKI occurrence is correlated with the severity of patients' clinical condition prior to ECMO insertion and is negatively associated with 90-day survival.
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Journal of critical care · Apr 2018
Validation of the Prognosis for Prolonged Ventilation (ProVent) score in patients receiving 14days of mechanical ventilation.
To evaluate the performance of the Prognosis for Prolonged Ventilation (ProVent) 14 score in patients requiring prolonged mechanical ventilation (PMV). ⋯ The ProVent 14 score accurately identified patients receiving PMV with a high 1-year mortality risk. Further validation in a larger sample is required.