Journal of critical care
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Journal of critical care · Dec 2012
Predictors of the complication of postintubation hypotension during emergency airway management.
Arterial hypotension is a recognized complication of emergency intubation that is independently associated with increased morbidity and mortality. Our aim was to identify factors associated with postintubation hypotension after emergency intubation. ⋯ Preintubation and peri-intubation factors predict the complication of PIH. Elevated SI strongly and independently forewarned of cardiovascular deterioration after emergency intubation with pre-RSI SI 0.8 or higher as the optimal threshold to identify patients at risk.
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Journal of critical care · Dec 2012
Clinical TrialImpact of red blood cells transfusion on ICU-acquired bloodstream infections: a case-control study.
Our study investigated the impact of packed red blood cell (pRBC) transfusion on the occurrence of bloodstream infections (BSIs) in patients admitted in a multidisciplinary intensive care unit (ICU), further assessing potential associations with particular BSI types. A nested matched (1:1) case-control design was implemented. Sex, age, admission category, Acute Physiology and Chronic Health Evaluation score II (plus Injury Severity Score in trauma patients) were used for matching. ⋯ In multivariable analysis, pRBC transfusion was independently associated with 2-fold probability for BSI (adjusting for matching variables and propensity score). There was a significant dose-dependent association of BSI risk with regard to the number of pRBC units transfused (odds ratios [OR], 1.73, 2.09, 2.34 for 1-3, 4-6, and more than 6 pRBC units transfused, respectively, compared with nontransfused patients, P values .116, .018, and .015, respectively). In subgroup analysis, catheter-related BSIs displayed the strongest association with pRBC transfusion (OR = 5.01, P = .014).
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Journal of critical care · Dec 2012
Prognostic factors and outcomes of patients with pulmonary hypertension admitted to the intensive care unit.
Patients with pulmonary hypertension (PH) can decompensate to the point where they require care in the intensive care unit (ICU). Our objective is to examine the outcomes and characteristics of patients with PH admitted to the ICU. ⋯ Mortality is high in critically ill patients with PH. The identification of prognostic baseline characteristics and interventions in the ICU is important and warrants further investigation.
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Journal of critical care · Dec 2012
Predicting in-hospital mortality among critically ill patients with end-stage liver disease.
Critically-ill patients with end-stage liver disease (ESLD) are at high risk for death during intensive care unit hospitalization, and currently available prognostic models have limited accuracy in this population. We aimed to identify variables associated with in-hospital mortality among critically ill ESLD patients and to develop and validate a simple, parsimonious model for bedside use. ⋯ In critically ill ESLD patients, a parsimonious model including only MELD and mechanical ventilation is more accurate than APACHE II alone for predicting in-hospital mortality. This simple bedside model can provide clinicians and patients with valuable prognostic information for medical decision-making.
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The purpose of this study is to determine the frequency of exposure keratopathy in sedated/mechanically ventilated patients in the intensive care unit and its risk factors. ⋯ The frequency of exposure keratopathy in sedated/mechanically ventilated patients is high with lagophthalmos and chemosis as the main risk factors.