Journal of critical care
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Journal of critical care · Oct 2019
ReviewRisk related therapy in meta-analyses of critical care interventions: Bayesian meta-regression analysis.
The relationship between treatment efficacy and patient risk is explored in a series of meta-analyses from the critical care domain, focusing on mortality outcome. ⋯ Underlying risk-related therapy is apparent in meta-analyses of the critically-ill and identification is of importance to both the conduct and interpretation of these meta-analyses.
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Journal of critical care · Oct 2019
Multicenter StudyQuality of life assessment following amputation for septic shock: a long-term descriptive survey after symmetric peripheral gangrene.
To assess health-related quality of life (HRQOL) following rehabilitation of amputees suffering symmetric peripheral gangrene (SPG) after septic shock. ⋯ ICU survivors referred to rehabilitation centers after SPG-related amputations had impaired HRQOL. At the time of HRQOL assessment, they considered themselves in good health and preferred to be treated again despite disability. Appraisal of long-term functional outcome should not be used to guide end-of-life decision-making in this situation.
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Journal of critical care · Oct 2019
Observational StudyIntegration of urinary neutrophil gelatinase-associated lipocalin with serum creatinine delineates acute kidney injury phenotypes in critically ill children.
Acute kidney injury (AKI) is prevalent in critically ill patients and associated with poor outcomes. Current AKI diagnostics- changes to serum creatinine (SCr) and urine output- are imprecise. Integration of injury biomarkers with SCr may improve diagnostic precision. ⋯ Unique biomarker combinations on admission are predictive of distinct Day 3 AKI severity phenotypes. These classifications may enable a more personalized approach to the early management of AKI. Expanded study in larger populations is warranted.
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Journal of critical care · Oct 2019
Trends in the incidence and mortality of patients with community-acquired septic shock 2003-2016.
To evaluate the incidence and mortality of adult patients with community-acquired septic shock (CASS) and the influence of source control (SC) and other risk factors on the outcome. ⋯ The incidence of CASS increased and the ICU mortality decreased during the study period. The mortality was mainly due to a decrease in mortality in infections not requiring SC.
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Journal of critical care · Oct 2019
High-sensitivity troponin T is an important independent predictor in addition to the Simplified Acute Physiology Score for short-term ICU mortality, particularly in patients with sepsis.
Elevated cardiac troponin levels have been shown to be associated with a poor prognosis under some intensive care conditions. This study investigated whether inclusion of high-sensitivity troponin T (hsTnT) increased the prognostic accuracy of the Simplified Acute Physiology Score (SAPS 3) for general intensive care unit (ICU) patients, cardiac arrest patients, or patients with a non-cardiac arrest diagnosis. ⋯ Addition of hsTnT evaluation to SAPS 3 enhances the predictive capability of this model in relation to mortality. In sepsis, the hsTnT level may be an important prognostic marker.