Journal of critical care
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Journal of critical care · Oct 2013
Prolonged sevoflurane administration in the off-pump coronary artery bypass graft surgery: Beneficial effects.
The benefits of intraoperative administration of halogenated agents in patients undergoing cardiac surgery have been shown by numerous studies. The mechanisms of preconditioning and postconditioning appear to be the cause of these benefits. The possibility of maintaining the early postoperative sedation with halogenated agents, after its intraoperative administration, can increase their benefits. ⋯ Sevoflurane administration in patients undergoing off-pump coronary artery bypass graft, in the operating room and the intensive care unit, decreases myocardial injury markers compared with patients who only received sevoflurane in the intraoperative period, but both were a better option to decrease levels of myocardial markers when compared with the propofol group.
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Journal of critical care · Oct 2013
Comparative StudyThe use of the pulse oximetric saturation/fraction of inspired oxygen ratio for risk stratification of patients with severe sepsis and septic shock.
Our aims were to determine whether the pulse oximetric saturation/fraction of inspired oxygen (S/F) can be used for the early identification of patients with sepsis who are at increased risk for death and to compare the S/F ratio with the Pao2/fraction of inspired oxygen (P/F) ratio. ⋯ A low S/F at ICU admission is associated with increased risk of death in patients with severe sepsis or septic shock.
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Journal of critical care · Oct 2013
Coagulopathy, catecholamines, and biomarkers of endothelial damage in experimental human endotoxemia and in patients with severe sepsis: A prospective study.
The aim of this study was to investigate associations between circulating catecholamines, endothelial damage, and coagulopathy in experimental human endotoxemia and septic patients. ⋯ Experimental endotoxemia induced a discrete hemostatic response without sympathoadrenal activation or endothelial damage. Septic patients had high levels of catecholamines and endothelial damage biomarkers that correlated with each other and with markers of hypocoagulability and disease severity.
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Journal of critical care · Oct 2013
Is vitamin D deficiency associated with development of Acinetobacter baumannii infections in critically ill patients?
A growing number of evidence demonstrates deficiency of vitamin D in critically ill patients. We aimed to evaluate the vitamin D status of our critically ill patients and its relevance to infections in these patients. ⋯ Vitamin D deficiency is common in critically ill patients. Even though there was no statistical difference between vitamin D deficient and sufficient patients regarding development of infections in general, A baumannii infections were significantly more frequent in the deficient group. Vitamin D deficiency was found as one of the independent risk factors for A baumannii infections. Further multicenter studies with a larger sample size are required to validate our data.
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Journal of critical care · Oct 2013
Evaluation of hemostatic biomarker abnormalities that precede platelet count decline in critically ill patients with sepsis.
The hemostatic biomarkers for early diagnosis of sepsis-associated coagulopathy have not been identified. The purpose of this study was to evaluate hemostatic biomarker abnormalities preceding a decrease in platelet count, which is a surrogate indicator of overt coagulopathy in sepsis. ⋯ Decreased PC and α2-PI activity preceded a decrease in platelet count in intensive care unit patients with sepsis.