Journal of critical care
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Journal of critical care · Jun 2015
Observational StudyIntravenous immunoglobulin improves sepsis-induced coagulopathy: A retrospective, single-center observational study.
Inflammation and coagulation are closely interrelated processes in the pathogenesis of sepsis. This study aimed to determine whether intravenous immunoglobulin (IVIg) could improve the hyperinflammatory state and coagulation/fibrinolysis abnormalities in patients with sepsis. ⋯ Intravenous immunoglobulin treatment significantly improved hemostatic abnormalities along with the hyperinflammatory state in patients with sepsis. Accordingly, IVIg treatment should be classified as an adjunctive therapy for patients complicated with sepsis-induced coagulopathy.
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Journal of critical care · Jun 2015
Observational StudyAcute kidney injury in a Malaysian intensive care unit: Assessment of incidence, risk factors, and outcome.
Acute kidney injury (AKI) is common and carries a high mortality rate. Most epidemiological studies were retrospective and were done in Western populations. We aim to assess its incidence using both urine output and creatinine criteria and its association with risk factors and outcome. ⋯ Acute kidney injury is common in our ICU, and almost half are of highest severity stage. Patients with high severity of illness and septic shock were at risk for AKI. The presence of AKI independently predicted mortality.
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Journal of critical care · Jun 2015
Soluble urokinase-type plasminogen activator levels are related to plasma cytokine levels but have low predictive value for mortality in trauma patients.
Soluble urokinase-type plasminogen activator (suPAR) represents a marker for immune activation and has predictive value in critically ill patients. The kinetics of suPAR and its correlation with the immune response and outcome in trauma patients are unknown. ⋯ After trauma, initial suPAR plasma concentrations are higher in nonsurvivors compared with survivors, but its predictive value is low. Soluble urokinase-type plasminogen activator levels increase over time after trauma, and concentrations at later time points are related to cytokine levels at the ED.
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Journal of critical care · Jun 2015
Observational StudyOutcomes of an emergency department intensive care unit in a tertiary medical center in Taiwan: An observational study.
The boarding of critically ill patients in the emergency department (ED) could reduce quality of care and increase mortality. An ED intensive care unit (ICU) was set up in a 3715-bed medical center to facilitate timely delivery of critical care. This study reports comparative outcomes of EDICU patients with specialty ICU patients. ⋯ Emergency department ICU has admitted a disproportionately higher proportion of patients without sacrificing quality of care. Specialty care could be secured through direct communication between EDICU and specialty physicians and forming close collaboration between departments and ICUs.
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Journal of critical care · Jun 2015
Outcomes and prognostic factors in patients with prolonged acute mechanical ventilation: A single-center study in Korea.
The purpose of the study is to evaluate outcomes and objective parameters related to poor prognosis in patients who were defined as prolonged acute mechanical ventilation (PAMV; ventilator care ≥96 hours) in the medical intensive care unit of a university-affiliated tertiary care hospital in Korea. ⋯ Four clinical factors (body mass index ≤21, requirement for neuromuscular blockers, vasopressors, and hemodialysis) on day 4 of mechanical ventilation were associated with 28-day mortality in PAMV patients.