Journal of critical care
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Journal of critical care · Dec 2017
ReviewPneumonia in the tropics: Report from the Task Force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine.
The aetiology of community acquired pneumonia varies according to the region in which it is acquired. This review discusses those causes of CAP that occur in the tropics and might not be readily recognizable when transplanted to other sites. Various forms of pneumonia including the viral causes such as influenza (seasonal and avian varieties), the coronaviruses and the Hantavirus as well as bacterial causes, specifically the pneumonic form of Yersinia pestis and melioidosis are discussed.
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Journal of critical care · Dec 2017
Multicenter StudyA multifactor model for predicting mortality in critically ill patients: A multicenter prospective cohort study.
The objective of this study was to develop a model using a combination of routine clinical variables to predict mortality in critically ill patients. ⋯ The developed multifactor model can be used to effectively predict mortality in critically ill patients at ICU admission.
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Journal of critical care · Dec 2017
ReviewCritical care of tropical disease in low income countries: Report from the Task Force on Tropical Diseases by the World Federation of Societies of Intensive and Critical Care Medicine.
Tropical disease results in a great burden of critical illness. The same life-saving and supportive therapies to maintain vital organ functions that comprise critical care are required by these patients as for all other diseases. ⋯ Improving critical care in low income countries requires a focus on hospital design, training, triage, monitoring & treatment modifications, the basic principles of critical care, hygiene and the involvement of multi-disciplinary teams. As a large proportion of critical illness from tropical disease is in low income countries, the impact and reductions in mortality rates of improved critical care in such settings could be substantial.
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Journal of critical care · Dec 2017
Comparative StudyAutomatic quantitative computed tomography segmentation and analysis of aerated lung volumes in acute respiratory distress syndrome-A comparative diagnostic study.
Quantitative lung computed tomographic (CT) analysis yields objective data regarding lung aeration but is currently not used in clinical routine primarily because of the labor-intensive process of manual CT segmentation. Automatic lung segmentation could help to shorten processing times significantly. In this study, we assessed bias and precision of lung CT analysis using automatic segmentation compared with manual segmentation. ⋯ Automatic single CT image and whole lung segmentation were faster than manual segmentation (0.17 vs 125.35seconds [P<.0001] and 10.46 vs 7739.45seconds [P<.0001]). Automatic lung CT segmentation allows fast analysis of aerated lung regions. A reduction of processing times by more than 99% allows the use of quantitative CT at the bedside.
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Journal of critical care · Dec 2017
Comparative Study Observational StudySuccessful treatment of toxic epidermal necrolysis using plasmapheresis: A prospective observational study.
Toxic epidermal necrolysis (TEN) is a rare, severe, life-threatening skin disease and it requires urgent critical care, including admission to the intensive care unit (ICU). It is characterized by fatal sequelae and high mortality. Currently, insufficient evidence exists to support the use of any systemic adjuvant therapy, such as cyclophosphamide, intravenous immunoglobulin (IVIg), or corticosteroids. ⋯ Severity of the disease and the efficacy of treatments were evaluated by the severity-of-illness score for TEN. The results indicated that plasmapheresis may be superior to conventional therapies, such as IVIg or corticosteroids. Furthermore, plasmapheresis combined with other treatments might not be advantageous compared to the effect of plasmapheresis alone.