Journal of critical care
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Journal of critical care · Aug 2012
Comparative StudySerum neutrophil gelatinase-associated lipocalin in ballistic injuries: a comparison between blast injuries and gunshot wounds.
Neutrophil gelatinase-associated lipocalin (NGAL) is part of a functionally diverse family of proteins that generally bind small, hydrophobic ligands. Neutrophil gelatinase-associated lipocalin is expressed in a number of human tissues including gastrointestinal, respiratory, and urinary tracts and tends to rise in response to inflammation. For this reason, we hypothesized that levels of NGAL might be expressed at higher levels after blast injury compared with other ballistic injury. ⋯ Neutrophil gelatinase-associated lipocalin is not a specific marker of blast injury but is predictive of both renal failure and poor outcome.
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Journal of critical care · Aug 2012
Predictors of short-term mortality in patients undergoing percutaneous dilatational tracheostomy.
The purpose of the study was to identify the predictors of short-term mortality in patients undergoing percutaneous dilatational tracheostomy (PDT). ⋯ Patients undergoing PDT have significant short-term mortality with 11% dying within 14 days and an in-hospital mortality rate of 30%. We identified an index diagnosis of ventilator-associated pneumonia and trauma to be associated with a higher survival rate, whereas older age, oncological diagnosis, cardiogenic shock, and ventricular-assist devices were associated with higher mortality. There is significant heterogeneity in both underlying diagnosis and patient outcomes, and these factors should be considered when deciding to perform this procedure and discussed with patients/family members to provide a realistic expectation of potential prognosis.
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Journal of critical care · Aug 2012
The frequency and significance of postintubation hypotension during emergency airway management.
Arterial hypotension is a recognized complication of emergency intubation, but the consequence of this event is poorly described. Our aim was to identify the incidence of postintubation hypotension (PIH) after emergency intubation and to determine its association with inhospital mortality. ⋯ Postintubation hypotension occurs in almost one quarter of normotensive patients undergoing emergency intubation. Postintubation hypotension is independently associated with higher inhospital mortality and longer intensive care unit and hospital LOS.
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Journal of critical care · Aug 2012
Usefulness of heart-type fatty acid-binding protein in patients with severe sepsis.
The purpose of the study was to evaluate the value of heart-type fatty acid-binding protein (hFABP) as a novel clinical biomarker in patients with severe sepsis. ⋯ Serum hFABP is frequently elevated among patients with severe sepsis and appears to be associated with SRMD. Elevated hFABP independently predicts 28-day mortality in severe sepsis.
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Journal of critical care · Aug 2012
The flow-time waveform predicts respiratory system resistance and compliance.
Knowledge of patients' lung compliance and resistance aids clinical management. We investigated whether these values, readily measured during volume assist-control ventilation (VACV), could also be estimated during pressure assist-control ventilation (PACV). ⋯ During PACV, the inspiratory flow waveform is linear, and its slope contains information regarding inspiratory resistance and compliance. Calculated values correlate with those during VACV.