Journal of critical care
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Journal of critical care · Aug 2018
Comparative Study Observational StudyComparison of traditional microbiological culture and 16S polymerase chain reaction analyses for identification of preoperative airway colonization for patients undergoing lung resection.
Preoperative airway colonization is associated with increased risk of postoperative respiratory complications following lung resection. This study compares the rates of preoperative lower respiratory tract colonization identified by traditional culture and novel 16S polymerase chain reaction (PCR) tests. ⋯ Rates of colonization identified by culture and 16S PCR analyses of BAL samples were similar. Future research should attempt to clarify associations between airway colonization identified by 16S PCR and outcomes. 16S PCR may be useful when stratifying risk of postoperative respiratory complications.
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Journal of critical care · Aug 2018
Hospital mortality prediction for intermediate care patients: Assessing the generalizability of the Intermediate Care Unit Severity Score (IMCUSS).
The Intermediate Care Unit Severity Score (IMCUSS) is an easy to calculate predictor of in-hospital death, and the only such tool developed for patients in the intermediate care setting. We sought to examine its external validity. ⋯ The IMCUSS exhibited acceptable discrimination, poor calibration, and underestimated mortality. Other centers should assess the performance of the IMCUSS before adopting its use.
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Journal of critical care · Aug 2018
Tropical diseases in the ICU: A syndromic approach to diagnosis and treatment.
Tropical infections form 20-30% of ICU admissions in tropical countries. Diarrheal diseases, malaria, dengue, typhoid, rickettsial diseases and leptospirosis are common causes of critical illness. Overlapping clinical features makes initial diagnosis challenging. ⋯ Initial therapy is often empiric; a combination of intravenous artesunate, ceftriaxone and either doxycycline or azithromycin would cover a majority of the treatable syndromes. Additional antiviral or antiprotozoal medications are required for some specific syndromes. Involving a physician specializing in tropical or travel medicine is helpful.
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Journal of critical care · Aug 2018
Randomized Controlled TrialEfficacy of early passive tilting in minimizing ICU-acquired weakness: A randomized controlled trial.
To investigate whether passive tilting added to a standardized rehabilitation therapy improved strength at Intensive Care Unit (ICU) discharge. ⋯ Passive tilting added to a standardized rehabilitation therapy did not improve muscle strength at ICU discharge in surgical patients even if a faster recovery with tilting is suggested.
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Journal of critical care · Aug 2018
Observational StudyTrainee physician turnover and 30-day mortality in Korean intensive care units.
Previous studies have found an increase in in-hospital mortality when trainee physicians rotate. Our retrospective cohort study investigated whether trainee physicians' turnover influenced 30-day mortality in Korean intensive care units (ICUs), which have high-intensity daytime intensivist coverage only on weekdays. ⋯ We found no overall association between physician turnover and 30-day mortality of patients admitted to ICUs with high-intensity daytime intensivist coverage or with no intensivist coverage.