Journal of critical care
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Journal of critical care · Aug 2015
Multicenter Study Observational StudySerum melatonin levels are associated with mortality in severe septic patients.
Melatonin in septic patients has been scarcely explored and only in studies of small sample size (maximum 20 patients). Thus, the objective of this study was to determine whether serum melatonin levels are associated with severity, oxidant and inflammatory state, and mortality in a large series of septic patients. ⋯ The novel finding of our study was that serum melatonin levels are associated with mortality in septic patients.
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Journal of critical care · Aug 2015
Multicenter Study Observational StudyPharmacist's review and outcomes: Treatment-enhancing contributions tallied, evaluated, and documented (PROTECTED-UK).
The purpose was to describe clinical pharmacist interventions across a range of critical care units (CCUs) throughout the United Kingdom, to identify CCU medication error rate and prescription optimization, and to identify the type and impact of each intervention in the prevention of harm and improvement of patient therapy. ⋯ This observational study demonstrated that both medication error resolution and pharmacist-led optimization rates were substantial. Almost 1 in 6 prescriptions required an intervention from the clinical pharmacist. The error rate was slightly lower than an earlier UK prescribing error study (EQUIP). Two thirds of the interventions were of moderate to high impact.
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Journal of critical care · Jun 2015
Multicenter Study Comparative StudyImpact of case volume on aneurysmal subarachnoid hemorrhage outcomes.
To compare aneurysmal subarachnoid hemorrhage (aSAH) outcomes between high- and low-volume referral centers with dedicated neurosciences critical care units (NCCUs) and shared neurosurgical, endovascular, and neurocritical care practitioners. ⋯ The noninferior outcomes at the lower SAH volume center suggests that provider expertise, not patient volume, is critical to providing high-quality specialized care.
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Journal of critical care · Jun 2015
Multicenter Study Observational StudyEvolution and prognosis of long intensive care unit stay patients suffering a deterioration: A multicenter study.
The prognosis of a patient who deteriorates during a prolonged intensive care unit (ICU) stay is difficult to predict. We analyze the prognostic value of the serialized Sequential Organ Failure Assessment (SOFA) score and other variables in the early days after a complication and to build a new predictive score. ⋯ EPIPUSE model can predict mortality with a specificity and positive predictive value of 99% in some groups of patients.
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Journal of critical care · Jun 2015
Multicenter Study Observational StudyProcalcitonin-guided therapy may reduce length of antibiotic treatment in intensive care unit patients with secondary peritonitis: A multicenter retrospective study.
Because procalcitonin (PCT) might be surrogate for antimicrobial discontinuation in general intensive care units (ICUs), this study explored its use for secondary peritonitis in 4 surgical ICUs (SICUs). ⋯ Procalcitonin guidance produced 50% reduction in antibiotic duration (P < .001, log-rank test).