Journal of critical care
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Journal of critical care · Dec 2012
Cross-validation of a Sequential Organ Failure Assessment score-based model to predict mortality in patients with cancer admitted to the intensive care unit.
This study aims to validate the performance of the Sequential Organ Failure Assessment (SOFA) score to predict death of critically ill patients with cancer. ⋯ The SOFA score had good discrimination to predict ICU and hospital mortality. However, the observed underestimation of ICU deaths and unsatisfactory goodness-of-fit test of the model in surgical patients to indicate calibration of the score to predict ICU mortality is advised in this group.
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Journal of critical care · Dec 2012
Interrelationship between blood and tissue lactate in a general intensive care unit: a subcutaneous adipose tissue microdialysis study on 162 critically ill patients.
The aim of the study was to study the interrelationship between blood and tissue lactate in critically ill patients with or without shock admitted in a general intensive care unit. ⋯ In critical illness, the detailed dynamics between blood and tissue lactate are affected by the presence of shock. In patients with shock, microdialysis-assessed tissue lactate is higher compared with those without shock and may detect metabolic disturbances before these become evident in the systemic circulation.
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Journal of critical care · Dec 2012
Adverse outcomes associated with delayed intensive care consultation in medical and surgical inpatients.
The impact of delay in obtaining an intensive care unit (ICU) consult from inpatient wards is unclear. The goal of this study was to examine the effect of time to ICU consult from medical and surgical wards on mortality and length of stay (LOS). ⋯ Increased duration to ICU consult from MET time is associated with adverse outcomes. These adverse outcomes are different between medical and surgical patients.
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Journal of critical care · Dec 2012
A qualitative study to identify opportunities for improving trauma quality improvement.
Quality improvement (QI) is a central tenant of trauma center accreditation in most countries, but its effectiveness is largely unknown. We sought to explore opportunities for improving trauma QI. ⋯ Quality improvement programs exist as accreditation requirements in most centers. However, trauma QI practices depend on a range of local and regional factors, and concrete opportunities for improvement that address impact and sustainability exist.
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Journal of critical care · Dec 2012
Clinical TrialChronic heart failure modifies the response to positive end-expiratory pressure in patients with chronic obstructive pulmonary disease.
Potentially beneficial effects of positive end-expiratory pressure (PEEP) in patients with chronic obstructive pulmonary disease (COPD) must be balanced against further overinflation and increased alveolar dead space. Concurrent chronic heart failure (CHF) is common and can lead to changes in lung that can reduce the detrimental effects of PEEP. ⋯ In subjects with severe COPD alone, caution must be used when administering PEEP 10 cm H(2)O or greater. Subjects with COPD + CHF may benefit from higher levels of PEEP.