Journal of critical care
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Journal of critical care · Apr 2015
Observational StudyChanges in fibrinolysis and severity of organ failure in sepsis: A prospective observational study using point-of-care test-ROTEM.
We hypothesized that the thromboelastometry (ROTEM; Pentapharm GmbH, Munich, Germany) fibrinolysis parameter "maximum lysis" (ML) would have an independent inverse association with the severity of organ failure in sepsis. ⋯ Lower ML and higher INR values predicted greater severity of organ failure at presentation. Further studies are required, as ROTEM could aid selection of patients and guide interventions aimed at fibrinolysis in severe sepsis.
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Journal of critical care · Apr 2015
Correlation of lactate/albumin ratio level to organ failure and mortality in severe sepsis and septic shock.
This study examines the clinical utility of the increased lactate/albumin ratio as an indicator of multiple-organ dysfunction syndrome (MODS) and mortality in severe sepsis and septic shock. ⋯ Increased lactate/albumin ratio correlates with the development of MODS and mortality in patients with severe sepsis and septic shock.
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Journal of critical care · Apr 2015
Clinician perspectives on protocols designed to minimize sedation.
Within a multicenter randomized trial comparing protocolized sedation with protocolized sedation plus daily interruption (DI), we sought perspectives of intensive care unit (ICU) clinicians regarding each strategy. ⋯ Most respondents liked both sedation strategies. Nurses and physicians had different preferences and rationales for liking or disliking each strategy.
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Journal of critical care · Apr 2015
Observational StudyDiaphragmatic regional displacement assessed by ultrasound and correlated to subphrenic organ movement in the critically ill patients-an observational study.
The objectives of the study are to identify the most reliably imaged regions of the diaphragm, to evaluate the correlation of movement between different parts of each hemidiaphragm, and to assess the agreement between liver or spleen displacement and movement of the ipsilateral hemidiaphragm. ⋯ The diaphragm medial part is visualized in the majority of studied patients. The medial and middle thirds may be used interchangeably to assess hemidiaphragm movement. Acceptable agreement does not exist for diaphragm and solid organ movement, other than for the left middle region and the spleen.
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Journal of critical care · Apr 2015
Comparative StudyGas exchange and lung mechanics in patients with acute respiratory distress syndrome: Comparison of three different strategies of positive end expiratory pressure selection.
The purpose of the study was to compare gas exchange and lung mechanics between different strategies to select positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS). ⋯ Using a best respiratory compliance approach resulted in better oxygenation levels without risk of overdistension according to SI and P(tpi), achieving a mild risk of lung collapse according to P(tpe).