Journal of critical care
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Journal of critical care · Oct 2017
Multicenter Study Observational StudyNon-survivor septic patients have persistently higher serum sCD40L levels than survivors.
Soluble CD40 ligand (sCD40L) is a protein with proinflammatory and prothrombotic effects. Previously we found higher circulating sCD40L levels in non-survivor than in survivor patients at sepsis diagnosis. Now some questions arise such as how are serum sCD40L levels during the first week of severe sepsis?, is there an association between serum sCD40L levels during the first week and mortality?, and serum sCD40L levels during the first week could be used as sepsis mortality biomarker?. This study was developed to answer these asks. ⋯ The novel findings of our study were that there were higher serum sCD40L levels persistently during the first week in non-survivor than in survivor patients, that there is an association between serum sCD40L levels during the first week and sepsis mortality, and that serum sCD40L levels during the first week could be used as sepsis mortality biomarker.
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Journal of critical care · Oct 2017
Multicenter StudyHopelessness: Independent associations with health-related quality of life and short-term mortality after critical illness: A prospective, multicentre trial.
To assess the independent associations between ability to cope and hopelessness with measures of health-related quality of life (HRQoL) and their effects on mortality up to 3 years after discharge in patients who have been treated in an intensive care unit (ICU). ⋯ The psychological factors ability to cope and hopelessness both strongly affected HRQoL after ICU care, and this effect was stronger than the effects of coexisting disease. Hopelessness also predicted mortality after critical illness. Awareness of the psychological state of patients after a stay in ICU is important to identify which of them are at risk.
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Journal of critical care · Oct 2017
Multicenter Study Observational StudyBiomarkers kinetics in the assessment of ventilator-associated pneumonia response to antibiotics - results from the BioVAP study.
Our aim was to evaluate the role of biomarker kinetics in the assessment of ventilator-associated pneumonia (VAP) response to antibiotics. ⋯ C-reactive protein kinetics can be used to identify VAP patients with poor outcome as soon as four days after the initiation of treatment. (Trial registration - NCT02078999; registered 3 August 2012).
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Journal of critical care · Oct 2017
Multicenter StudyComplications following hospital admission for traumatic brain injury: A multicenter cohort study.
To evaluate the incidence, determinants and impact on outcome of in-hospital complications in adults with traumatic brain injury (TBI). ⋯ More than 20% of patients with TBI developed a complication. Many of these complications were associated with increased mortality and LOS. Results highlight the importance of prevention strategies adapted to treatment decisions and underline the need to improve knowledge on the underuse and overuse of clinical interventions.
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Journal of critical care · Oct 2017
Multicenter StudyHypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage.
Hypoalbuminemia and systemic inflammatory response syndrome (SIRS) are reported in critically-ill patients, but their relationship is unclear. We sought to determine the association of admission serum albumin and SIRS with outcomes in patients with intracerebral hemorrhage (ICH). ⋯ In patients with ICH, hypoalbuminemia is strongly associated with SIRS. SIRS, but not hypoalbuminemia, predicts poor outcome at discharge. Recognizing and managing SIRS early may prevent death or disability in ICH patients.