Journal of critical care
-
Journal of critical care · Feb 2019
Strong correlation between doppler snuffbox resistive index and systemic vascular resistance in septic patients.
To compare systemic vascular resistance index (SVRI) as measured by invasive transpulmonary indicator dilution (TPID) and non-invasive Doppler-derived resistive index in septic patients. ⋯ Using ultrasound to measure RI is a noninvasive, inexpensive, reliable method to evaluate peripheral vascular resistance in septic patients, and it is highly correlated with SVRI. In addition, SBRI can be used to evaluate peripheral circulatory disturbances in septic patients.
-
Journal of critical care · Feb 2019
Comparative StudyImpact of chronic hypertension on time to goal mean arterial pressure and clinical outcomes in critically ill patients with septic shock requiring vasopressors.
Mean arterial pressure (MAP) reflects the adequacy of tissue perfusion. In septic shock, vasopressors are recommended to target MAP ≥65 mmHg. The impact of chronic hypertension (HTN) on MAP achievement and outcomes are uncertain. ⋯ Patients with HTN achieved goal MAP more rapidly but had higher odds of mortality.
-
Journal of critical care · Feb 2019
Validation of diagnostic gene sets to identify critically ill patients with sepsis.
Gene expression diagnostics have been proposed to identify critically ill patients with sepsis. Three expression-based scores have been developed, but have not been compared in a prospective validation. We sought to validate these scores using an independent dataset and analysis. ⋯ All three scores distinguished septic from non-septic ICU patients, with the SMS showing the best performance overall in our cohort. Our results suggest that models developed from the co-analysis of multiple cohorts are more generalizable. Further work is needed to identify expression-based biomarkers of response to specific therapies.
-
Journal of critical care · Feb 2019
Review Meta AnalysisSafety and efficacy of iron therapy on reducing red blood cell transfusion requirements and treating anaemia in critically ill adults: A systematic review with meta-analysis and trial sequential analysis.
To evaluate the safety (risk of infection) and efficacy (transfusion requirements, changes in haemoglobin (Hb)) of iron therapy in adult intensive care unit (ICU) patients. ⋯ Iron therapy results in a modest increase in Hb. The current evidence is inadequate to exclude an important effect on transfusion requirements or infection.
-
Journal of critical care · Feb 2019
Pain among non-verbal critically Ill mechanically ventilated patients: Prevalence, correlates and predictors.
To investigate pain levels and factors that are predictive of pain for mechanically ventilated patients during rest and during routine nursing procedures. ⋯ Many mechanically ventilated patients suffer resting and procedural pain. Many variables were found to play a role. Clinicians need to consider these variables and intervene to decrease pain among patients at risk.