Journal of critical care
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Journal of critical care · Dec 2011
Randomized Controlled Trial Multicenter StudySevere protein C deficiency is associated with organ dysfunction in patients with severe sepsis.
The aim of this study was to assess the relationship between protein C levels and temporal changes in organ dysfunction. ⋯ Severe protein C deficiency in patients with severe sepsis is associated with both the incidence and severity of organ dysfunction and subsequent worsening of organ function and may be a useful predictor of organ failure in severe sepsis.
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The purpose of the study was to evaluate the time taken for delivery of each component of care following patient deterioration and to assess the effect on response times of strategies implemented to improve the system. ⋯ Significant delays in responding to acute deterioration persist despite strategies to facilitate the functioning of the RRT system. Simple strategies such as policy directives are not sufficient to effect change in complex health care systems.
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Journal of critical care · Dec 2011
The use of an electronic medical record based automatic calculation tool to quantify risk of unplanned readmission to the intensive care unit: a validation study.
The aim of this study was to refine and validate an automatic risk of unplanned readmission (Stability and Workload Index for Transfer, or SWIFT) calculator in a prospective cohort of consecutive medical intensive care unit (ICU) patients in a teaching hospital with comprehensive electronic medical records (EMRs). ⋯ The EMR-based automatic tool accurately calculates SWIFT score and can facilitate ICU discharge decisions without the need for manual data collection.
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Journal of critical care · Dec 2011
Multicenter StudyAcute kidney injury in critically ill patients with pandemic influenza A pneumonia 2009 in Korea: a multicenter study.
We assessed the incidence and clinical characteristics of acute kidney injury (AKI) in critically ill patients infected with pandemic influenza A (H1N1) and its effect on clinical outcomes. ⋯ A significant number of patients with H1N1-related critical illness developed AKI within 72 hours of ICU admission, and this early development of AKI was associated with 30-day mortality.
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Journal of critical care · Dec 2011
Randomized Controlled TrialHydrocortisone at stress-associated concentrations helps maintain human heart rate variability during subsequent endotoxin challenge.
We evaluated the differential impact of stress-associated vs high pharmacologic concentrations of hydrocortisone pretreatment on heart rate variability (HRV) during a subsequent systemic inflammatory stimulus. ⋯ Pretreatment with a stress dose of hydrocortisone but not a higher pharmacologic dose maintained a significantly higher ApEn after endotoxin exposure when compared to a placebo. In addition, decreases in ApEn preceded increases in heart rate.