Journal of critical care
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Journal of critical care · Jun 2019
Multicenter Study Observational StudyAdherence to fluid resuscitation guidelines and outcomes in patients with septic shock: Reassessing the "one-size-fits-all" approach.
The Surviving Sepsis Campaign and Centers for Medicare and Medicaid Services (CMS) Severe Sepsis and Septic Shock Management Bundle (SEP-1) recommend rapid crystalloid infusion (≥30 mL/kg) for patients with sepsis-induced hypoperfusion or septic shock. We aimed to assess compliance with this recommendation, factors associated with non-compliance, and how compliance relates to mortality. ⋯ These findings question a "one-size-fits-all" approach to fluid administration and performance measures for patients with sepsis.
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Journal of critical care · Jun 2019
Multicenter Study Observational StudyHuman atrial natriuretic peptide for acute kidney injury in adult critically ill patients: A multicenter prospective observational study.
Acute kidney injury (AKI) is common in the intensive care unit (ICU). Selected clinical studies have implied human atrial natriuretic peptide (hANP) improves renal function; however, the treatment effects for AKI are unclear. ⋯ In critically ill patients with AKI, the treatment effect of hANP was not evident on dialysis-free survival in the ICU.
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Journal of critical care · Jun 2019
Multicenter Study Observational StudyPersistently high circulating tissue inhibitor of matrix metalloproteinase-1 levels in non-survivor brain trauma injury patients.
Previously, higher circulating levels of matrix metalloproteinase (MMP)-9 and tissue inhibitor matrix metalloproteinases (TIMP)-1 were reported in the first hours after TBI in blood samples from patients with poor prognosis. Thus, the objectives of this study were to determine whether MMP-9 and TIMP-1 levels during the first week of a severe TBI could be used as biomarker predictive of mortality. ⋯ The most relevant new findings of our study were that TIMP-1 levels during the first week of a severe TBI were higher in non-surviving than in surviving patients and that could be used as biomarker predictive of mortality.
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Journal of critical care · Jun 2019
Physical impairment and perceived general health preceding critical illness is predictive of survival.
We hypothesized that item response based assessment of physical reserve preceding ICU admission is a predictor of survival. ⋯ Physical reserve as assessed by ALDS and perceived general health, preceding ICU admission is predictive of mortality. Obtaining patient's physical reserve or pre-existing perceived general health should be part of routine assessment whether a patient may benefit from ICU admission.
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Journal of critical care · Jun 2019
The relationship between self-report and performance-based measures of physical function following an ICU stay.
To examine relationships between self-report and performance-based measures of physical function in ICU patients randomized to standardized rehabilitation therapy (SRT) or usual care (UC). ⋯ Self-report and performance-based measures of physical function appear to assess different constructs at hospital discharge. Following recovery, these measures converge, but indicate different constructs are being assessed. As such, both self-report and performance-based measures of physical function should be used with ICU patients.