Journal of critical care
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Journal of critical care · Oct 2020
Case ReportsLate histopathologic characteristics of critically ill COVID-19 patients: Different phenotypes without evidence of invasive aspergillosis, a case series.
Pathological data of critical ill COVID-19 patients is essential in the search for optimal treatment options. ⋯ In this case series common late histopathology in critically ill COVID patients is not classic DAD but heterogeneous with predominant pattern of organizing pneumonia. Postmortem biopsy investigations in critically COVID-19 patients with probable COVID-19 associated pulmonary aspergillosis obtained no evidence for invasive aspergillosis.
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Journal of critical care · Oct 2020
Customization and external validation of the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU) in Brazilian critically ill patients.
To customize and externally validate the recently proposed Simplified Mortality Score for the ICU (SMS-ICU, a simple score for 90-day mortality that has no need for ancillary testing results) for in-hospital mortality and to compare its performance to SAPS 3. ⋯ In this external validation of the SMS-ICU in a large Brazilian cohort, we observed good discrimination of SMS-ICU and acceptable calibration after first-level customization. SMS-ICU can be used as a measure of illness severity for acutely admitted ICU patients in clinical studies.
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Journal of critical care · Oct 2020
Association between sepsis at ICU admission and mortality in patients with ICU-acquired pneumonia: An infectious second-hit model.
We explore the hypothesis that critically ill patients developing ICU-acquired pneumonia (ICU-AP) have worse outcomes and an altered inflammatory response if their ICU admission was sepsis-related. ⋯ Previous sepsis does not appear to predispose to higher mortality nor worse outcomes in patients who develop ICU-acquired pneumonia.
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Journal of critical care · Oct 2020
Comparative StudyAdjunctive therapy with vitamin c and thiamine in patients treated with steroids for refractory septic shock: A propensity matched before-after, case-control study.
Triple therapy with steroids, vitamin C and thiamine has been recently proposed as a safe and beneficial in patients with sepsis. In 2017, we added the use of intravenous vitamin C and thiamine in septic shock patients receiving low dose hydrocortisone because poorly responsive to vasopressors. Aim of this study is to verify whether triple therapy rather than steroids alone can improve outcome in patients with refractory shock. ⋯ Although with significant limitations, our experience indicated that triple therapy seems to provide an improvement of clinical outcomes in patients with refractory septic shock.
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Journal of critical care · Oct 2020
What can be learned from crude intensive care unit mortality? Methodological implications.
Demonstrate the practical range of information that can be obtained about ICU mortality/survival from limited administrative data. ⋯ Simple calculations using the few variables found in administrative database enhanced information provided by the crude mortality rate and demonstrated that temporal patterns of mortality change as stay lengthens. These results highlight the limitations of just using overall crude mortality rates.