Journal of critical care
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Journal of critical care · Oct 2013
Prevention of contrast-induced nephropathy by N-acetylcysteine in critically ill patients: Different definitions, different results.
The use of N-acetylcysteine (NAC) for preventing contrast induced nephropathy (CIN) is debated in the intensive care unit. NAC may alter the concentration of serum creatinine and interfere with CIN diagnosis. The effectiveness of NAC was evaluated with a special attention on its specific effect on creatinine levels compared to cystatin C. ⋯ The incidence of CIN does not seem to be influenced by NAC, except if small changes in creatinine only are considered.
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Journal of critical care · Oct 2013
Changing trends in the use of seizure prophylaxis after traumatic brain injury: A shift from phenytoin to levetiracetam.
Current guidelines for traumatic brain injury (TBI) recommend antiepileptic drugs (AEDs) for 7 days after injury to decrease posttraumatic seizure risk. Phenytoin decreases seizure risk 73% vs placebo during this time. Levetiracetam (LEV) is an alternative; however, no published data validate comparable efficacy. Our objective was to evaluate seizure incidence 7 days after TBI in patients treated with phenytoin (PHT) vs LEV and to characterize practice of AED selection. ⋯ Only 2 patients experienced posttraumatic seizure after receiving AED, indicating low incidence. Most surviving to hospital discharge received AED prophylaxis greater than 7 days despite guideline recommendations. After approval of intravenous LEV, a trend favoring LEV was observed.
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Journal of critical care · Oct 2013
Relationship between plasma high-mobility group box-1 levels and clinical outcomes of ischemic stroke.
High-mobility group box-1 (HMGB1) is regarded as a central mediator of inflammation and involved in many inflammatory diseases. This study aimed to investigate impact of plasma HMGB1 level on 1-year clinical outcomes of ischemic stroke. ⋯ Plasma HMGB1 level represents a novel biomarker for predicting 1-year clinical outcomes of ischemic stroke.
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Journal of critical care · Oct 2013
Predictors of mortality in patients with stress-induced cardiomyopathy developed during critical care.
The aims of this study were to define predictors of in-hospital mortality and to explore the implication of Acute Physiology and Chronic Health Evaluation (APACHE) II score in patients with stress-induced cardiomyopathy (SCM) developed during critical care. ⋯ The in-hospital mortality in patients with SCM that developed during critical care was associated with underlying malignancy, male sex, old age, and APACHE II score.