Journal of critical care
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Journal of critical care · Jun 2015
Real-time, ultrasound-guided infraclavicular axillary vein cannulation for renal replacement therapy in the critical care unit-A prospective intervention study.
The cannulation of the axillary vein for renal replacement therapy is a rarely performed procedure in the critical care unit. We defined the venipuncture and catheterization success rates and early mechanical complication rates of this technique in critical care patients with acute kidney injury. ⋯ Real-time, ultrasound-guided, infraclavicular axillary vein cannulation for renal replacement therapy in the critical care unit is a reliable method of dual-lumen hemodialysis catheter insertion and can be considered a reasonable alternative to jugular and femoral routes in special clinical circumstances.
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Journal of critical care · Jun 2015
Disease heterogeneity and risk stratification in sepsis-related occult hypoperfusion: A retrospective cohort study.
Occult hypoperfusion is associated with increased mortality in patients with sepsis. We sought to determine the practice patterns and outcomes of patients with sepsis-related occult hypoperfusion and introduce a potential method for risk stratification. ⋯ Patients defined as having occult hypoperfusion comprise a heterogeneous group with a varied degree of illness severity. Identifying those with low risk of clinical deterioration may be important for titration of care.
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Journal of critical care · Jun 2015
Decreased serum level of lipoprotein cholesterol is a poor prognostic factor for patients with severe community-acquired pneumonia that required intensive care unit admission.
The purpose of this study is to investigate the prognostic values of the serum levels of lipids in patients with severe community-acquired pneumonia (CAP) that required intensive care unit (ICU) admission. ⋯ Decreased serum HDL cholesterol level from days 1 to 7 may be of prognostic value.
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Journal of critical care · Jun 2015
Is Clostridium difficile infection an increasingly common severe disease in adult intensive care units? A 10-year experience.
Despite the high concentration of patients with known risk factors for Clostridium difficile infection (CDI) in intensive care units (ICUs), data on ICU patients are scarce. The aim of this study was describe the incidence, clinical characteristics, and evolution of CDI in critically ill patients. ⋯ The incidence of A-ICU CDI has decreased steadily over the last 10 years. A significant proportion of A-ICU CDI episodes are pre-ICU and are more severe than in-ICU CDI episodes. Most episodes of A-ICU CDI were nonsevere, with low associated mortality.
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Journal of critical care · Jun 2015
Observational StudyFeasibility, safety, and outcome of very early enteral nutrition in critically ill patients: Results of an observational study.
In critically ill patients, early enteral nutrition (EN) within 24 to 72 hours is recommended. Although vasopressor-dependent shock after resuscitation is not a contraindication for EN initiation, feasibility and safety of very early (within 6 hours) EN initiation soon after resuscitation are unknown. ⋯ Initiation of EN within 6 hours of ICU admission is feasible and safe and can be implemented routinely in all ICU patients.