Journal of critical care
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Journal of critical care · Dec 2018
Heart rate variability is associated with outcome in spontaneous intracerebral hemorrhage.
Autonomic imbalance as measured by heart rate variability (HRV) has been associated with poor outcome after stroke. Observations on HRV changes in intracerebral hemorrhage (ICH) are scarce. Here, we aimed to investigate HRV in ICH as compared to a control group and to explore associations with stroke severity, hemorrhage volume and outcome after ICH. ⋯ Autonomic changes seems to be present in acute ICH and are associated with poor outcome independently. This may have future monitoring and therapeutic implications.
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Journal of critical care · Dec 2018
Hospital case volume and clinical outcomes in critically ill patients with acute kidney injury treated with dialysis.
To determine whether patients with severe acute kidney injury who receive dialysis (AKI-D) experience better outcomes at centres that care for more patients with AKI-D. ⋯ There are no Centre volume survival associations in the management of AKI-D despite high mortality and dependence rate.
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Journal of critical care · Dec 2018
Right-to-left ventricular end diastolic diameter ratio in severe sepsis and septic shock.
The ratio of right ventricular end-diastolic diameter (EDD) to left ventricular EDD (RV/LV) is a measure predictive of right ventricular failure. We hypothesized that an increase in RV/LV would be associated with poor prognosis in severe sepsis and septic shock. ⋯ An increased RV/LV does not predict mortality in severe sepsis or septic shock.
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Journal of critical care · Dec 2018
A feasibility study to assess pre-admission status and six month outcomes of major trauma patients admitted to an intensive care unit, using the WHO DAS 2.0.
To report the feasibility of assessing pre-admission functional status of ICU trauma patients, with repeat assessment at six months post ICU discharge using a standardised measure. ⋯ Standardised assessment of pre-admission function was feasible. Future research should investigate the clinical relevance of scores and the validity of the measure in trauma patients.
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Journal of critical care · Dec 2018
Positive end-expiratory pressure titrated according to respiratory system mechanics or to ARDSNetwork table did not guarantee positive end-expiratory transpulmonary pressure in acute respiratory distress syndrome.
Pulmonary recruitment and positive end-expiratory pressure (PEEP) titrated according to minimal static elastance of the respiratory system (PEEPEstat,RS) compared to PEEP set according to the ARDSNetwork table (PEEPARDSNetwork) as a strategy to prevent ventilator-associated lung injury (VALI) in patients with acute respiratory distress syndrome (ARDS) increases mortality. Alternatively, avoiding negative end-expiratory transpulmonary pressure has been discussed as superior PEEP titration strategy. Therefore, we tested whether PEEPEstat,RS or PEEPARDSNetwork prevent negative end-expiratory transpulmonary pressure in ARDS patients. ⋯ In patients with moderate-to-severe ARDS, PEEP titrated according to the minimal static elastance of the respiratory system or according to the ARDSNetwork table did not prevent negative end-expiratory transpulmonary pressure.