Journal of critical care
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Journal of critical care · Oct 2019
Multicenter Study Observational StudyPerformance of plasma measurement of neutrophil gelatinase-associated lipocalin as a biomarker of bacterial infections in the intensive care unit.
To assess the value of dimeric neutrophil-gelatinase associated lipocalin (NGAL) as an early marker of bacterial infection and its response to antibiotic therapy in intensive care unit (ICU) patients. ⋯ In our cohort of ICU patients, plasma dNGAL was associated with presence of bacterial infections independent of AKI but it performed poor as a predictor of infections. Following antibiotic therapy, dNGAL markedly decreased-supporting further exploration of dNGAL-guided antibiotic de-escalation.
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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
Observational StudyOptimal norepinephrine-equivalent dose to initiate epinephrine in patients with septic shock.
The specific norepinephrine dose at which epinephrine should be added in septic shock is unclear. This study sought to determine the norepinephrine-equivalent dose at epinephrine initiation that correlated with hemodynamic stability. ⋯ Initiation of epinephrine when patients were receiving norepinephrine-equivalent doses of 37-133 μg/min was associated with a higher rate of hemodynamic stability.
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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
Multicenter StudySafety and efficacy of beta-blockers to improve oxygenation in patients on veno-venous ECMO.
Beta-blockers (BB) may improve oxygenation in patients on veno-venous extracorporeal membrane oxygenation (V-V ECMO). This study analyzed safety and efficacy of BB in hypoxemic patients on V-V ECMO. ⋯ In this study, use of BB in hypoxemic patients on V-V ECMO was safe and associated with a moderate increase in SaO2.