Journal of critical care
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Journal of critical care · Jun 2016
Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation.
To explore whether extravascular lung water (EVLW) provides a valuable prognostic tool guiding fluid therapy in septic shock patients after initial resuscitation. ⋯ A higher EVLW in septic shock patients after initial resuscitation was associated with a more positive fluid balance and increased mortality, which is an independent predictor of the 28-day mortality in septic shock patients after initial resuscitation.
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Journal of critical care · Jun 2016
Computed tomography confirms a reduction in diaphragm thickness in mechanically ventilated patients.
Patients who require mechanical ventilation (MV) may experience diaphragm atrophy, which may delay the discontinuation of MV. Here, we used computed tomographic (CT) scans to confirm this phenomenon. ⋯ Computed tomography confirmed that diaphragm thickness was reduced in critically ill patients who underwent MV.
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Journal of critical care · Jun 2016
Serial measurements of troponin and echocardiography in patients with moderate-to-severe acute respiratory distress syndrome.
To assess the clinical significance of serial troponin I levels (measured in the first 72 hours from admission) in 42 consecutive patients with moderate-to-severe acute respiratory distress syndrome (ARDS). Echocardiography and electrocardiogram testings were serially performed in the time window. ⋯ In moderate-to-severe ARDS, serial troponin I assessment together with echocardiography evaluation helped to identify a subgroup at higher risk for in-ICU death. Moreover, troponin release can be related to right ventricular dysfunction, thus highlighting the clinical role of echocardiography in ARDS patients.
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Journal of critical care · Jun 2016
Lactate and combined parameters for triaging sepsis patients into intensive care facilities.
To find predictors of intensive care unit (ICU) requirement within the first 48 hours in newly diagnosed sepsis patients presenting at the emergency department. ⋯ We suggested a way to predict ICU requirement in sepsis patients and proposed a combined score that might be better than individual parameters. Further validation should be performed before using them clinically.
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Journal of critical care · Jun 2016
Coupled plasma filtration adsorption improves hemodynamics in septic shock.
Septic shock involves a dysregulation of the immune response to an infection. This may lead to hemodynamic dysfunction and multiple-organ failure. The main aim of this study was to evaluate the effect of coupled plasma filtration adsorption (CPFA) on the hemodynamic profile in patients with septic shock. ⋯ Treatment with CPFA improves hemodynamic parameters in septic shock patients, ameliorating organ failure.