Journal of critical care
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Journal of critical care · Oct 2019
Observational StudyWhat determines do-not-resuscitate status in critically ill HIV-infected patients admitted to ICU?
To identify factors associated with do-not-resuscitate (DNR) status in critically ill patients infected with human immunodeficiency virus (HIV) admitted to the Intensive Care Unit (ICU) in the era of combination antiretroviral therapy (cART). ⋯ One in four patients had a DNR designation. Illness acuity, selected comorbidity, previous opportunistic infection and HIV duration were associated with DNR designation.
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Journal of critical care · Oct 2019
Trends in the incidence and mortality of patients with community-acquired septic shock 2003-2016.
To evaluate the incidence and mortality of adult patients with community-acquired septic shock (CASS) and the influence of source control (SC) and other risk factors on the outcome. ⋯ The incidence of CASS increased and the ICU mortality decreased during the study period. The mortality was mainly due to a decrease in mortality in infections not requiring SC.
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Journal of critical care · Oct 2019
Risk factors for new-onset atrial fibrillation on the general adult ICU: A systematic review.
This study was performed to systematically review the available evidence for the risk factors for new-onset atrial fibrillation (NOAF) on the general adult intensive care unit (ICU) and provide a semi-quantitative evidence synthesis. ⋯ We provide the first systematic review with evidence synthesis of risk factors for NOAF on the general adult ICU. Evidence for modifiable risk factors was limited. Further research is therefore required and may contribute towards the evidence-based prevention and management of this important condition.
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Journal of critical care · Oct 2019
Observational StudyCentral venous-to-arterial carbon dioxide difference combined with arterial-to-venous oxygen content difference (PcvaCO2/CavO2) reflects microcirculatory oxygenation alterations in early septic shock.
To explore the relationship between central venous-to-arterial carbon dioxide difference (PcvaCO2), PcvaCO2/arterial-venous oxygen content difference ratio (PcvaCO2/CavO2) and the microcirculatory status, evaluated by using near-infrared spectroscopy, in septic shock patients. ⋯ In a population of early septic shock patients, increases in PcvaCO2 and PcvaCO2/CavO2 reflected different alterations at the microcirculatory level. While PcvaCO2 was related to global flow, the PcvaCO2/CavO2 ratio was associated to impaired local oxygen utilization and diminished microvascular reactivity.
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Journal of critical care · Oct 2019
Observational StudyEarly prediction of treatment failure in severe community-acquired pneumonia: The PRoFeSs score.
To identify a single/panel of biomarkers and to provide a point score that, after 48 h of treatment, could early predict treatment failure at fifth day of Intensive Care Unit (ICU) stay in severe community-acquired pneumonia (SCAP) patients. ⋯ In SCAP, a combination of biomarkers measured at admission and 48 h later may early predict treatment failure. PRoFeSs score may recognize patients with poor short-term prognosis.