Journal of critical care
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Journal of critical care · Oct 2013
ReviewReporting the methodology of height and weight acquisition in studies of body mass index-based prognosis in critically ill patients.
Conflicting findings were reported on the body mass index (BMI)-based prognosis of critically patients. Errors in source weight and height data can confound BMI group allocation. The aim of the present work was to examine investigators' reporting on the methods of height and weight acquisition (HWA). ⋯ These findings demonstrate the prevalent risk for BMI group misallocation in the reviewed studies, which may confound BMI-based prognosis, raising concerns about the validity of reported BMI-related prognostic impact.
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Journal of critical care · Oct 2013
ReviewA review of current agents for anticoagulation for the critical care practitioner.
There has been a tremendous boom in the arena of anticoagulant therapy recently. Although the indications for these agents reside in the noncritical care environment, over time, the impact of these agents have infiltrated the critical care environment particularly due to devastating complications with associated use. ⋯ It is important that the critical care practitioner does not ignore these agents but becomes familiar with them to better prepare for the management of patients on one or more anticoagulant agents in the intensive care unit. To equip the critical care practitioners with the knowledge about commonly used anticoagulants, we provide an extensive review of the pharmacology, indications, and adverse effects related to these agents as well as suggestions on preventing or managing complications.
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Journal of critical care · Oct 2013
Development and validation of a novel fusion algorithm for continuous, accurate, and automated R-wave detection and calculation of signal-derived metrics.
Previous studies have shown that heart rate complexity may be a useful indicator of patient status in the critical care environment but will require continuous, accurate, and automated R-wave detection (RWD) in the electrocardiogram (ECG). Although numerous RWD algorithms exist, accurate detection remains a challenge. The purpose of this study was to develop and validate a novel fusion algorithm (Automated Electrocardiogram Selection of Peaks, or AESOP) that combines the strengths of several well-known algorithms to provide a more reliable real-time solution to the RWD problem. ⋯ By fusing several best algorithms, AESOP uses the strengths of each algorithm to perform more robustly and reliably in real time. The AESOP algorithm will be integrated into a real-time heart rate complexity software program for decision support and triage in critically ill patients.
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Journal of critical care · Oct 2013
Intra-abdominal hypertension in the critically ill: Interrater reliability of bladder pressure measurement.
Intra-abdominal hypertension is frequently underdiagnosed and defined by intra-abdominal pressure (IAP) 12 mm Hg or higher. Increasing IAP may compromise organ viability and culminate in abdominal compartment syndrome. Bladder pressure measurement is a surrogate for IAP, but measurement properties are unknown in the intensive care unit. Our primary objective was to assess the agreement of bladder pressure measurements in critically ill patients. ⋯ Agreement on bladder pressure was high among 4 clinicians and were not significantly different between physicians and nurses. Given that medical/surgical treatments are considered on bladder pressure values, understanding their reliability is essential to monitor critically ill patients.
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Our aim was to investigate the level and the maturation status of dendritic cells (DCs) in pediatric patients with sepsis and its relation to prognosis. ⋯ Sepsis is associated with reduced level of DCs and decreases their maturation. The estimation of DCs number and maturation state may be used as prognostic makers of sepsis.