Journal of critical care
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Journal of critical care · Dec 2019
Hemodynamic decompensation in normotensive patients admitted to the ICU with pulmonary embolism.
Many normotensive patients with acute pulmonary embolism (PE) are admitted to an intensive care unit (ICU) to monitor for hemodynamic decompensation. We investigated the incidence and causes of early hemodynamic decompensation in normotensive patients admitted to an ICU with PE. ⋯ Among patients admitted to the ICU with acute normotensive PE, early hemodynamic decompensation was rare. In patients who experienced decompensation, major bleeding and thrombotic complications were equally likely to have been the precipitant- highlighting the risks of diagnostic anchoring in this population. As our results suggest that ICU-level care may not be necessary for many of these patients, additional tools are needed to assist in the triage of normotensive patients with PE.
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Journal of critical care · Dec 2019
Safety of antimicrobial de-escalation for culture-negative severe pneumonia.
This study investigated the outcomes of antimicrobial de-escalation (ADE) based on mortality and the incidence of multi-drug resistant (MDR) pathogen occurrence in patients with culture-negative pneumonia presenting with sepsis and septic shock. ⋯ We observed similar ICU mortality and MDR pathogen occurrence in patients with culture-negative pneumonia presenting with sepsis/shock regardless of whether they received ADE. Additionally, ADE lowered the antimicrobial burden.
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Journal of critical care · Dec 2019
A pilot study of a novel molecular host response assay to diagnose infection in patients after high-risk gastro-intestinal surgery.
SeptiCyte LAB measures the expression of four host-response RNAs in peripheral blood to distinguish sepsis from sterile inflammation. This study evaluates whether sequential monitoring of this assay has diagnostic utility in patients after esophageal surgery. ⋯ Sequential measurement of SeptiCyte LAB may have diagnostic value in the monitoring of surgical patients at high risk of postoperative infection, but its clinical performance in this setting needs to be validated.
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Journal of critical care · Dec 2019
Psychometric validation of the Chinese patient- and family satisfaction in the intensive care unit questionnaires.
To assess the psychometric properties of the Chinese version of the 23-item Patient Satisfaction in the Intensive Care Unit (PS-ICU-23) and 24-item Family Satisfaction in the Intensive Care Unit (FS-ICU-24) questionnaires. ⋯ Both Chinese PS-ICU-23 and FS-ICU-24 questionnaires have sound psychometric properties but family satisfaction may not be a good proxy for patient satisfaction in ICU.
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Journal of critical care · Dec 2019
Hypotension within one-hour from starting CRRT is associated with in-hospital mortality.
To investigate early hemodynamic instability and its implications on adverse outcomes in patients who require continuous renal replacement therapy (CRRT). ⋯ Hypotension occurs frequently in patients receiving CRRT despite having a reputation as the dialysis modality with better hemodynamic tolerance. It is an independent predictor for worse outcomes. Further studies are required to understand this phenomenon.