Journal of critical care
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Journal of critical care · Feb 2014
A pilot investigation of the association of genetic polymorphisms regulating corticotrophin-releasing hormone with posttraumatic stress and depressive symptoms in medical-surgical intensive care unit survivors.
To determine if single nucleotide polymorphisms of the corticotrophin-releasing hormone binding protein (CRHBP, rs10055255) and CRH receptor type 1 (CRHR1, rs1876831) were associated with posttraumatic stress disorder (PTSD) and depressive symptoms following medical-surgical intensive care unit (ICU) hospitalization. ⋯ Despite a small sample size, our findings suggest a potential role for genetic variants of CRHBP and CRHR1 in the development of post-ICU psychiatric morbidity.
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Journal of critical care · Feb 2014
Consideration of additional factors in Sequential Organ Failure Assessment score.
The Sequential Organ Failure Assessment (SOFA) score, originally developed to assess organ failure status, is widely used as a prognostic indicator in intensive care unit patients. Additional prognostic factors, such as age and comorbidities, may complement the predictive performance of the SOFA. ⋯ The performance of the SOFA score to predict hospital mortality can be improved by considering age and comorbidity factors.
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Journal of critical care · Feb 2014
Outcome of hypotensive ward patients who re-deteriorate after initial stabilization by the Medical Emergency Team.
We evaluated the outcome of hypotensive ward patients who re-deteriorated after initial stabilization by the Medical Emergency Team (MET) in our hospital, due to limited data in this regard. ⋯ Hypotensive ward patients who re-deteriorate after initial stabilization have higher mortality. METs should consider implementing at least an 8-hour follow-up in patients who are deemed stable to remain on the wards after hypotensive episodes.
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Journal of critical care · Feb 2014
Prediction of delirium in critically ill patients with elevated C-reactive protein.
Delirium is thought to be associated with systemic inflammatory response. However, its association with the most widely used inflammatory biomarker C-reactive protein (CRP) has not been well established. We aimed to examine whether CRP on intensive care unit (ICU) entry was associated with subsequent development of delirium. ⋯ C-reactive protein measured on ICU entry and its changes within 24 hours are risk indicators of delirium. Further studies exploring the treatment of delirium according to CRP levels are warranted.
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Journal of critical care · Feb 2014
The effect of positive balance on the outcomes of critically ill noncardiac postsurgical patients: A retrospective cohort study.
Fluid balance remains a highly controversial topic in the critical care field, and no consensus has been reached about the fluid levels required by critically ill surgical patients. In this study, we investigated the relationship between fluid balance and in-hospital mortality in critically ill surgical patients. ⋯ In critically ill noncardiac postsurgical patients whose APAHCE II scores were greater than 20, a positive balance in the ICU can be associated with mortality risk. To determine the direct effect of positive fluid balance, a larger scaled, prospective randomized study will be required.