Journal of critical care
-
Journal of critical care · Apr 2018
Observational StudyWhich one is a better predictor of ICU mortality in septic patients? Comparison between serial serum lactate concentrations and its removal rate.
To predict 28-day mortality with serum lactate and oxygenation profile in sepsis. ⋯ Serial measurements of serum lactate with special emphasis on its concentration at 24hour after admission remains the most predictive of short-term mortality in the ICU. Other predictors of mortality are relatively inferior and must be used collectively in context to better predict the clinical outcome of sepsis.
-
Journal of critical care · Apr 2018
Observational StudyExposure keratopathy: Incidence, risk factors and impact of protocolised care on exposure keratopathy in critically ill adults.
We aimed to determine the rate of exposure keratopathy (EK) in critically ill patients, identify risk factors for developing EK and ascertain the effectiveness of a protocol to prevent EK. ⋯ EK is common in critically ill patients and a simple protocol substantially reduces the incidence of EK and is easily achieved in clinical practice.
-
Journal of critical care · Apr 2018
Comparative StudyDiagnostic and predictive values of procalcitonin in bloodstream infections for nosocomial pneumonia.
We evaluated the diagnostic accuracy of PCT to distinguish between gram-negative (GN) and gram-positive (GP) bloodstream infections nosocomial pneumonia (NP) patients and compared PCT levels with the pneumonia severity index (PSI) for predicting mortality. ⋯ PCT could differentiate between GN and GP bloodstream infections in patients with NP. However, PCT levels were less predictive of mortality compared with the PSI.
-
Journal of critical care · Apr 2018
Predictors of dysphagia in critically injured patients with neck trauma.
Trauma patients admitted to the intensive care unit (ICU) are at heightened risk for oropharyngeal dysphagia and pulmonary aspiration. Timely and appropriate referrals for dysphagia may reduce mortality rates and hospital readmissions. This study sought to identify predictors of dysphagia in a large cohort of patients with multiple traumatic injuries. ⋯ Oropharyngeal dysphagia is a common complication in trauma patients. Our results propose a set of predictors that should be considered when identifying critically injured patients at risk for dysphagia.
-
Journal of critical care · Apr 2018
Serum anion gap predicts lactate poorly, but may be used to identify sepsis patients at risk for death: A cohort study.
(1) To test whether serum bicarbonate or anion gap can be used to predict elevated lactate or mortality in emergency department (ED) patients with sepsis, and (2) to define thresholds that may predict elevated lactate and mortality. ⋯ Anion gap and serum bicarbonate poorly predict changes in lactate and mortality. In resource-limited settings where lactate is unavailable, anion gap ≥20mEq/L may be used to further risk-stratify patients for ongoing sepsis care, but lactate remains a preferred biomarker.