Journal of critical care
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Journal of critical care · Oct 2016
Investigation of hemophagocytic lymphohistiocytosis in severe sepsis patients.
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition characterized by uncontrolled inflammation and has common clinical and laboratory features with sepsis. The aim of this study was to investigate patients treated with severe sepsis who had bicytopenia for the presence of HLH. ⋯ This study emphasizes to consider the possibility of HLH and the need of rapid assessment of patients with severe sepsis who had bicytopenia and were resistant to treatment in intensive care.
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Journal of critical care · Oct 2016
Heart-type fatty acid-binding protein and myocardial creatine kinase enable rapid risk stratification in normotensive patients with pulmonary embolism.
Risk assessments of hemodynamically stable patients with pulmonary embolisms (PE) remain challenging. In this context heart-type fatty acid-binding protein (H-FABP), creatine kinase isoenzyme MB (CK-MB), and troponin I (TnI) may hold prognostic utility for patients with pulmonary embolism. ⋯ Both H-FABP and CK-MB are associated with short term mortality in normotensive PE patients and could be advantageous for risk stratification in this intermediate risk group.
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Journal of critical care · Oct 2016
Opioid overdose leading to intensive care unit admission: Epidemiology and outcomes.
There is a scarcity of studies assessing the patient population admitted to the intensive care unit (ICU) with opioid overdose. We sought to characterize the epidemiologic features and outcomes of this patient population. ⋯ Opioid overdose is a common cause of ICU admission and affects a relatively young population. Most have respiratory failure requiring mechanical ventilation. It is associated with a relatively high inhospital mortality. Coingestions appear to have an impact on outcomes.
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Journal of critical care · Oct 2016
Observational StudyPredicting success of high-flow nasal cannula in pneumonia patients with hypoxemic respiratory failure: The utility of the ROX index.
The purpose of the study is to describe early predictors and to develop a prediction tool that accurately identifies the need for mechanical ventilation (MV) in pneumonia patients with hypoxemic acute respiratory failure (ARF) treated with high-flow nasal cannula (HFNC). ⋯ In patients with ARF and pneumonia, the ROX index can identify patients at low risk for HFNC failure in whom therapy can be continued after 12 hours.
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Journal of critical care · Oct 2016
Can early initiation of continuous renal replacement therapy improve patient survival with septic acute kidney injury when enrolled in early goal-directed therapy?
The purpose of our study was to investigate the timing of continuous renal replacement therapy (CRRT) application, based on the interval between the start of early goal-directed therapy (EGDT) and CRRT initiation, to ascertain whether the timing was an independent predictor of mortality in patients with septic acute kidney injury (AKI). ⋯ Early initiation of CRRT may be of benefit. Given the complex nature of this intervention and the ongoing controversy regarding early vs late initiation of therapy in acute and chronic situations, it is vital to develop accurate clinical trials to find definitive answers.