Journal of critical care
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Journal of critical care · Aug 2016
Multicenter StudyDefining and treating acute kidney injury patients in Brazilian intensive care units: Results from a cross-sectional nationwide survey.
The purpose of the study is to characterize the practices of Brazilian intensivists toward acute kidney injury (AKI) definition and management. ⋯ Despite recent advances in AKI definition and management, most of the surveyed ICU physicians in Brazil have not incorporated them in their clinical practice. Important differences in the management of AKI patients were observed among Brazilian ICU physicians, which is relevant for educational interventions and future research.
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Journal of critical care · Aug 2016
Observational StudySerum caspase 3 levels are associated with early mortality in severe septic patients.
Higher caspase 3 activity has been found in lymphocytes of septic patients than of healthy controls. However, an association between serum caspase 3 levels at moment of severe sepsis diagnosis and mortality in septic patients has not been previously demonstrated, and this was the main objective of the present study. ⋯ The major novel findings of our study were that there is an association between serum caspase 3 levels at moment of severe sepsis diagnosis and mortality in septic patients and that serum caspase 3 levels could be used as prognostic biomarker, and further studies are needed to corroborate these findings.
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Journal of critical care · Aug 2016
Interleukin 6, galectin 3, growth differentiation factor 15, and soluble ST2 for mortality prediction in critically ill patients.
The aim of this study was to compare the prognostic value of interleukin 6 (IL-6), galectin 3, growth differentiation factor 15 (GDF-15), and soluble ST2 (sST2) in an unselected cohort of critically ill patients. ⋯ In this heterogeneous group of critically ill patients, only SAPS II, IL-6, and sST2 remained independent and additive prognostic markers for 90-day all-cause mortality. A combination of the SAPS II with the 2 complementary biomarkers might provide a valuable tool for risk stratification of critically ill patients.
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Journal of critical care · Aug 2016
Comparative StudyComparison between respiratory changes in the inferior vena cava diameter and pulse pressure variation to predict fluid responsiveness in postoperative patients.
The objective of our study was to assess the reliability of the distensibility index of the inferior vena cava (dIVC) as a predictor of fluid responsiveness in postoperative, mechanically ventilated patients and compare its accuracy with that of the pulse pressure variation (PPV) measurement. ⋯ The individual PPV discriminative properties for predicting fluid responsiveness in postoperative patients seemed superior to those of dIVC.
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Journal of critical care · Aug 2016
Observational StudyIdentification of acute brain failure using electronic medical records.
Up to 80% of critically ill patients have acute neurologic dysfunction syndromes. We evaluated interrater reliability between the examination by the investigator and the charted assessment by the nurse because the accuracy and reliability of detailed data sets extracted from the electronic medical records represents a keystone for creating EMR-based definitions. ⋯ Neurologic assessments documented on the EMR are reliable.