Journal of critical care
-
Journal of critical care · Feb 2018
Multicenter StudyInitial fluid resuscitation following adjusted body weight dosing is associated with improved mortality in obese patients with suspected septic shock.
The optimal initial fluid resuscitation strategy for obese patients with septic shock is unknown. We evaluated fluid resuscitation strategies across BMI groups. ⋯ Using AdjBW to calculate initial fluid resuscitation volume for obese patients with suspected shock may improve outcomes compared to other weight-based dosing strategies. The optimal fluid dosing strategy for obese patients should be a focus of future prospective research.
-
Journal of critical care · Feb 2018
Comparative StudyThe role of propionic acid at diagnosis predicts mortality in patients with septic shock.
This study aims to assess the diagnostic and prognostic value of propionic acid in patients with septic shock on a medical intensive care unit (ICU). ⋯ Propionic acid showed diagnostic capacity to diagnose septic shock and revealed prognostic information for mortality.
-
Journal of critical care · Feb 2018
Observational StudyCharacteristics and outcomes of critically-ill medical patients admitted to a tertiary medical center with restricted ICU bed capacity.
In the emergency department (ED) critically-ill medical patients are treated in the resuscitation room (RR). No studies described the outcomes of critically-ill RR patients admitted to a hospital with low capacity of intensive care unit (ICU) beds. ⋯ ED critically-ill medical patients who were treated in the RR had high mortality rates in an institute with restricted ICU beds availability. However, those who were admitted to an ICU showed prolonged short and perhaps long term survival compared to those who were not.
-
Journal of critical care · Feb 2018
Observational StudyImpact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study.
Antibiotic therapy (AT) is the cornerstone of the management of severe community-acquired pneumonia (CAP). However, the best treatment strategy is far from being established. To evaluate the impact of different aspects of AT on the outcome of critically ill patients with CAP, we performed a post hoc analysis of all CAP patients enrolled in a prospective, observational, multicentre study. ⋯ Prolonged AT (>7days) was associated with a longer ICU (14 vs. 7days; p<0.001) and hospital length of stay (LOS) (25 vs. 17days; p<0.001). Combination AT with a macrolide may be the most suitable AT strategy to improve both short and long term outcome of severe CAP patients. AT >7days had no survival benefit and was associated with a longer LOS.
-
Journal of critical care · Feb 2018
qSOFA score: Predictive validity in Enterobacteriaceae bloodstream infections.
To determine whether the quick Sequential Organ Failure Assessment (qSOFA) retains predictive validity in patients with Enterobacteriaceae sepsis that all received appropriate initial antimicrobial therapy. ⋯ Our results support qSOFA score, AMS, and sepsis severity as acceptable bedside tools for prognostication during initial clinical assessment in patients with sepsis. qSOFA retained its predictive validity in this cohort, suggesting that appropriate initial antimicrobial therapy is not an effect modifier for mortality when using qSOFA for prognostication.