Journal of critical care
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Journal of critical care · Oct 2017
Serial blood lactate measurements and its prognostic significance in intensive care unit management of aneurysmal subarachnoid hemorrhage patients.
This study assesses the behavior of serial blood lactate measurements during intensive care unit (ICU) stay to identify prognostic factors of unfavorable neurological outcomes (UO) in patients with aneurysmal subarachnoid hemorrhage (SAH). ⋯ The lactate level at 48h after admission was the most accurate predictor of UO with a high specificity in SAH patients.
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Journal of critical care · Oct 2017
Observational StudyLow brain tissue oxygenation contributes to the development of delirium in critically ill patients: A prospective observational study.
To test the hypothesis that poor brain tissue oxygenation (BtO2) during the first 24h of critical illness correlates with the proportion of time spent delirious. We also sought to define the physiological determinants of BtO2. ⋯ Poor cerebral oxygenation during the first 24 hours of critical illness contributes to the development of delirium.
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Journal of critical care · Oct 2017
The characteristics and impact of source of infection on sepsis-related ICU outcomes.
Source of infection is an independent predictor of sepsis-related mortality. To date, studies have failed to evaluate differences in septic patients based on the source of infection. ⋯ There are significant differences in patient characteristics, microbiology positivity, organs affected, mortality, length of stay and cost based on the source of sepsis. These differences should be considered in future studies to be able to deliver personalized care.
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Journal of critical care · Oct 2017
Observational StudyInferior vena cava collapsibility detects fluid responsiveness among spontaneously breathing critically-ill patients.
Measurement of inferior vena cava collapsibility (cIVC) by point-of-care ultrasound (POCUS) has been proposed as a viable, non-invasive means of assessing fluid responsiveness. We aimed to determine the ability of cIVC to identify patients who will respond to additional intravenous fluid (IVF) administration among spontaneously breathing critically-ill patients. ⋯ IVC collapsibility, as measured by POCUS, performs well in distinguishing fluid responders from non-responders, and may be used to guide IVF resuscitation among spontaneously breathing critically-ill patients.
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Journal of critical care · Oct 2017
A novel prognostic indicator for in-hospital and 4-year outcomes in patients with pulmonary embolism: TIMI risk index.
Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) was recently evaluated in patients with acute myocardial infarction and found as an important prognostic index. In the current study, we evaluated the prognostic value of TRI in patients with moderate-high and high risk pulmonary embolism (PE) who were treated with thrombolytic agents. ⋯ TRI in Q4, as compared to Q1-3, was significantly predictive of short term and long-term outcomes in PE patients who treated with thrombolytic agents. Our data suggest TRI to be an independent, feasible, and cost-effective tool for rapid risk stratification in moderate-high and high risk PE patients who treated with thrombolytic agents.