Journal of critical care
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Journal of critical care · Feb 2012
Hemodynamic effects of positive end-expiratory pressure during abdominal hyperpression: a preliminary study in healthy volunteers.
An increase in abdominal pressure induces an increase in left ventricular afterload under clinical conditions. We tested the hypothesis that positive end-expiratory pressure (PEEP) could reverse the hemodynamic consequences of abdominal hyperpression by opposing the increase in left ventricular afterload. ⋯ The increase in left ventricular afterload induced by MAST inflation can be efficiently reduced by the use of a moderate PEEP. Potential clinical applications in the abdominal compartment syndrome or in the setting of laparoscopic surgery should be developed.
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Journal of critical care · Feb 2012
Editorial CommentPalliative care in a neonatal intensive care unit.
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Journal of critical care · Dec 2011
Multicenter StudyImpact of different types of organ failure on outcome in intensive care unit patients with acute kidney injury.
The aim of this study was to explore the impact of different types of associated organ failure in patients with acute kidney injury (AKI). ⋯ The prognosis of ICU patients with AKI depended on the total number and types of associated failed organ systems. Respiratory failure was the most common associated organ failure, but neurologic and hepatic failures were associated with the worst prognosis.
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Journal of critical care · Dec 2011
Subtle change of cystatin C, with or without acute kidney injury, associated with increased mortality in the intensive care unit.
Recent epidemiologic studies suggest a significant association between small increases in serum creatinine (sCr) and adverse outcomes. The Acute Kidney Injury Network (AKIN) sought to increase the sensitivity of the AKIN criteria for acute kidney injury (AKI) by recommending the use of small changes in sCr for the diagnosis of AKI. Several recent studies have reported that serum cystatin C (cysC) is more accurate than sCr as a surrogate for the glomerular filtration rate. This study was performed to determine whether small increases in cysC (≥0.3 mg/L within 48 hours) are associated with clinical outcomes in critically ill patients. ⋯ Small increases of cysC were associated with increased mortality in intensive care unit patients independent of diagnosis of AKI by AKIN criteria.