Journal of critical care
-
Journal of critical care · Aug 2012
Multicenter StudyEvolution of neutrophil apoptosis in septic shock survivors and nonsurvivors.
The aims were to analyze the temporal evolution of neutrophil apoptosis, to determine the differences in neutrophil apoptosis among 28-day survivors and nonsurvivors, and to evaluate the use of neutrophil apoptosis as a predictor of mortality in patients with septic shock. ⋯ During the first 12 days of septic shock development, the level of neutrophil apoptosis decreases and does not recover normal values. No differences were observed between surviving and nonsurviving patients.
-
Journal of critical care · Aug 2012
Multicenter StudyUS practitioner opinions and prescribing practices regarding corticosteroid therapy for severe sepsis and septic shock.
The aim of this study was to examine opinions and practices of US critical care practitioners (USCCPs) toward corticosteroid therapy in adult patients with severe sepsis or septic shock. ⋯ Corticosteroids are commonly used by USCCPs in adult patients with septic shock; however, criteria used to initiate therapy and opinions regarding their impact vary.
-
Journal of critical care · Aug 2012
Comparative StudyComparison of physician prediction with 2 prognostic scoring systems in predicting 2-year mortality after intensive care admission: a linked-data cohort study.
Patients who survive an episode of critical illness continue to experience significant mortality after hospital discharge. This study assessed the accuracy of physician prediction of 2-year mortality and compared it with 2 objective prognostic models. ⋯ Physicians tended to overpredict the risk of 2-year mortality of critically ill patients, but accuracy was comparable with 2 objective prognostic models.
-
Journal of critical care · Aug 2012
Absolute eosinophils count as a marker of mortality in patients with severe sepsis and septic shock in an intensive care unit.
Eosinophils in the circulating blood undergo apoptosis during sepsis syndromes induced by the action of certain cytokines. ⋯ Eosinophils counts were lower in patients who died of sepsis than in those who survived, but its clinical usefulness seems limited. Their role as an indicator of clinical stability seems to be important.
-
Journal of critical care · Aug 2012
Comparative StudyComparison of 3 different methods used to measure the rapid shallow breathing index.
Rapid shallow breathing index (RSBI) is conveniently measured through the ventilator. If continuous positive airway pressure (CPAP) is used, it may change the RSBI value. We measured the RSBI with a handheld spirometer and through the ventilator, with and without CPAP, to assess differences. ⋯ The RSBI values measured through the ventilator with CPAP 5 cm H(2)O are much lower than the values measured with a handheld spirometer. Even the RSBI values measured with CPAP 0 cm H(2)O are significantly lower. This is attributable to the base flow delivered by some ventilators. The difference must be taken into account during weaning assessment.