Journal of critical care
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Journal of critical care · Apr 2015
Observational StudyHyperlactatemia is an independent predictor of mortality and denotes distinct subtypes of severe sepsis and septic shock.
Current guidelines and most trials do not consider elevated lactate (Lac) serum concentrations when grading sepsis severity. We therefore assessed the association of different types of circulatory dysfunction regarding presence of hyperlactatemia and need for vasopressor support with clinical presentation and outcome of sepsis. ⋯ Hyperlactatemia increases risk of death independent of vasopressor need resulting in different phenotypes within the classic categories of severe sepsis and septic shock.
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Journal of critical care · Apr 2015
Meta AnalysisAdjuvant treatment with crude rhubarb for patients with systemic inflammation reaction syndrome/sepsis: A meta-analysis of randomized controlled trials.
The objective of this study is to evaluate the benefits of adjuvant treatment with crude rhubarb in patients with systemic inflammation reaction syndrome/sepsis by conducting a meta-analysis. ⋯ Adjuvant treatment with crude rhubarb appears to have additional benefits in septic patients. Antiinflammation and anticoagulant/antiaggregant properties may be its potential mechanism.
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Journal of critical care · Apr 2015
A web-based survey of United Kingdom sedation practice in the intensive care unit.
The purpose of this work was to obtain a detailed perspective of sedation practice. Sedation included sedative and opioid choice, presence of local guidelines, and use of scoring systems. ⋯ This survey confirmed expected variation in UK sedation practice. Recognized strategies such as target sedation score and sedation policy are underused. A 43% uptake in delirium screening suggests that larger engagement is required to meet national standards.
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Journal of critical care · Apr 2015
Randomized Controlled TrialLow dose of glucocorticoid decreases the incidence of complications in severely burned patients by attenuating systemic inflammation.
Excessive systemic inflammatory response remains as a major problem underlying severe burns. This study aimed to assess the effect of low-dose glucocorticoid treatment in downregulating systemic inflammation in severely burned patients. ⋯ Low dose of glucocorticoid treatment during the acute phase could reduce the levels of proinflammatory cytokines in severely burned patients and subsequently decrease the incidence of pulmonary infection and stress ulcer, as well as the length of hospital stay.
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Journal of critical care · Apr 2015
The Critical Care Communication project: Improving fellows' communication skills.
The aim of this study was to develop an evidence-based communication skills training workshop to improve the communication skills of critical care fellows. ⋯ This 3-day communication skills training program increased critical care fellows' self-reported family meeting communication skills.