Journal of critical care
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Journal of critical care · Oct 2012
Fractional excretion of urea as a diagnostic index in acute kidney injury in intensive care patients.
Acute kidney injury (AKI) is a dynamic process that evolves from an early reversible condition to an established disease. Value of urine indices in the event of AKI is uncertain in critically ill patients. The aim of this study was to evaluate the performance of fractional excretion of urea (FeU) for differentiating persistent from transient AKI in patients admitted to the intensive care unit. ⋯ Fractional excretion of urea less than 40% was found to be a sensitive and specific index in differentiating transient from persistent AKI in intensive care unit patients especially if diuretics had been administered.
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Journal of critical care · Oct 2012
Randomized Controlled Trial Multicenter StudyImpact of a multidimensional approach on ventilator-associated pneumonia rates in a hospital of Shanghai: findings of the International Nosocomial Infection Control Consortium.
The aim of this study was to analyze the impact of a multidimensional infection control approach on the reduction of ventilator-associated pneumonia (VAP) in intensive care units (ICUs) patients of one hospital in China. ⋯ Implementing a multidimensional infection control intervention for VAP was associated with a significant cumulative reduction in the VAP rate in our ICUs.
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Journal of critical care · Oct 2012
Multicenter Study Clinical TrialPrehospital amiodarone may increase the incidence of acute respiratory distress syndrome among patients at risk.
Amiodarone has been implicated as a risk factor for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) when used in the hospital. This study aims to estimate whether prehospital amiodarone also increases the risk of ALI/ARDS. ⋯ Prehospital use of amiodarone may independently increase the risk for ARDS in patients who have at least 1 predisposing condition for ALI.
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Journal of critical care · Oct 2012
Randomized Controlled TrialTopical nitroglycerin and lidocaine locally vasodilate the radial artery without affecting systemic blood pressure: a dose-finding phase I study.
Small radial artery diameter (RAD) and vasospasm are barriers to radial artery cannulation. We performed this study to determine if topical nitroglycerin and/or nitroglycerin plus topical lidocaine increases RAD without affecting systemic blood pressure. ⋯ Topical nitroglycerin and lidocaine significantly increase RAD within 30 to 60 minutes with no effect on contralateral radial artery or blood pressure, indicating a direct, local effect on the radial artery. (Clinicaltrials.gov number NCT00686231).