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
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
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.
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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
Portable miniaturized extracorporeal membrane oxygenation systems for H1N1-related severe acute respiratory distress syndrome: a case series.
Technological advances improved the practice of "modern" extracorporeal membrane oxygenation (ECMO). In the present report, we describe the experience of a referral ECMO center using portable miniaturized ECMO systems for H1N1-related severe acute respiratory distress syndrome (ARDS). ⋯ In our experience, ECMO support was a valuable therapeutic option for H1N1-related severe ARDS. The use of portable miniaturized systems allowed urgent rescue of patients from referring hospitals and safe interhospital and intrahospital transport during ECMO support.