Journal of critical care
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Journal of critical care · Feb 2018
Prior antimicrobial therapy duration influences causative pathogens identification in ventilator-associated pneumonia.
To determine whether prior antimicrobial therapy, divided in recent or current antibiotic treatment, influences the identification rate and/or the type of causative pathogens in patients with suspected episodes of ventilator-acquired pneumonia. ⋯ In patients with a high probability of VAP, current but not recent antibiotic use is associated with a lower rate of positive culture with a higher proportion of MDR pathogens, mostly MDR Pseudomonas aeruginosa.
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Journal of critical care · Feb 2018
High serum soluble CD40L levels previously to liver transplantation in patients with hepatocellular carcinoma are associated with mortality at one year.
CD40L and its soluble form (sCD40L) are proteins of the tumor necrosis factor superfamily (TNFSF) that exhibit prothrombotic and proinflammatory properties when binding to CD40, which is a cell surface receptor of the tumor necrosis factor receptor superfamily (TNFRSF). High circulating levels of sCD40L have been associated with poor prognosis in patients with hepatocellular carcinoma (HCC). However, it is unknown whether there is an association between circulating sCD40L levels and survival in patients with HCC underwent to liver transplantation (LT), and this was the objective of that study. ⋯ The new finding of our study was that high serum sCD40L levels previously to LT in patients with HCC are associated with higher mortality at one year.
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Journal of critical care · Feb 2018
Observational StudyThiamine in septic shock patients with alcohol use disorders: An observational pilot study.
Alcohol-use disorders (AUDs) have been associated with increased sepsis-related mortality. As patients with AUDs are often thiamine deficient, we investigated practice patterns relating to thiamine administration in patients with AUDs presenting with septic shock and explored the association between receipt of thiamine and mortality. ⋯ A considerable proportion of patients with AUDs admitted for septic shock do not receive thiamine. Thiamine administration in this patient population was associated with decreased mortality.
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Journal of critical care · Feb 2018
Observational StudyThe ability of intensive care unit physicians to estimate long-term prognosis in survivors of critical illness.
To assess the reliability of physicians' prognoses for intensive care unit (ICU) survivors with respect to long-term survival and health related quality of life (HRQoL). ⋯ Prognoses estimated by physicians incorrectly predicted long-term survival and HRQoL in one-third of ICU survivors. Moreover, inaccurate prognoses were generally the result of overoptimistic expectations of outcome.
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Journal of critical care · Feb 2018
Reduction of non-enzymatic antioxidants in plasma during ECMO-treatment in ARDS by influence A H1N1.
In critically ill patient it is observed a severe oxidative stress, not only due to the acute pathology but also for some therapeutic treatments. The aim of the present study was to analyze the variations of non-enzymatic antioxidants in plasma during veno-venous ECMO-treatment in a homogeneous population of critical patients with ARDS. ⋯ The veno-venous ECMO-treatment causes a significant reduction of some of the major non-enzymatic antioxidants and a possible increase in insulin resistance in patients with ARDS by influence A H1N1.