Journal of critical care
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Journal of critical care · Oct 2012
The Sequential Organ Failure Assessment score and copeptin for predicting survival in ventilator-associated pneumonia.
Ventilator-associated pneumonia remains the most common nosocomial infection in the critically ill and contributes to significant morbidity. Eventual decisions regarding withdrawal or maximal therapy are demanding and rely on physicians' experience. Additional objective tools for risk assessment may improve medical judgement. Copeptin, reflecting vasopressin release, as well as the Sequential Organ Failure Assessment (SOFA) score, reflecting the individual degree of organ dysfunction, might qualify for survival prediction in ventilator-associated pneumonia. We investigated the predictive value of the SOFA score and copeptin in ventilator-associated pneumonia. ⋯ The predictive value of serial-measured SOFA significantly exceeds those of single SOFA and copeptin measurements. Serial SOFA scores accurately predict outcome in ventilator-associated pneumonia.
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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
Decreased plasma gelsolin is associated with 1-year outcome in patients with traumatic brain injury.
Decreased plasma gelsolin level has been associated with 1-month mortality after traumatic brain injury (TBI). Thus, we investigated the ability of gelsolin to predict 1-year mortality and functional outcome in these patients. ⋯ Plasma gelsolin level is a useful, complementary tool to predict functional outcome and mortality 1 year after TBI.
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Journal of critical care · Oct 2012
Central line placement in patients with and without prophylactic plasma.
Central line placement (CLP) is a common life-saving intervention in critically ill patients, and patients with coagulation abnormalities as identified by an abnormal international normalized ratio (INR) may receive prophylactic plasma transfusion before the procedure despite previously published data that such a practice is not efficacious. Over a 14-month period, 287 CLPs were performed in the intensive care unit. ⋯ Only 1 case of bleeding was observed in a patient with an INR of 3.9, who received fresh frozen plasma preprocedure (0/73 vs 1/27; P = .6). The occurrence of bleeding was very low overall with CLP (0.3%; 95% confidence interval, 0%-2%), and no benefit of prophylactic plasma was observed.
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Journal of critical care · Oct 2012
Hypothermia attenuates the severity of oxidative stress development in asphyxiated newborns.
This retrospective case-control study aimed to examine the development of oxidative stress in asphyxiated infants delivered at more than 37 weeks of gestation. ⋯ This study demonstrated that hypothermia attenuated the development of systemic oxidative stress in asphyxiated newborns.