Journal of critical care
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Journal of critical care · Dec 2011
Variability of preference toward mechanical ventilator settings: a model-based behavioral analysis.
The purpose of this study was to evaluate Danish clinicians' opinions toward ventilator settings using standardized model-simulated patients. The models ensured that all clinicians received identical presentations of data and anticipated responses to changes in patient state, enabling opinions on the same patient cases to be obtained from different clinicians. ⋯ The present study shows significant difference in opinion on appropriate settings of f, Vt, and Fio(2) in the same computerized decision support system model-simulated patient cases.
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Journal of critical care · Dec 2011
Interaction between fluid balance and disease severity on patient outcome in the critically ill.
There is evidence in literature regarding the benefits of immediate aggressive fluid resuscitation together with conservative fluid management approach after initial stabilization. This retrospective study assesses the relationship between fluid balance during intensive care unit (ICU) stay and outcomes among general critically ill patients. In addition, we also aim to see the effect of fluid gain among patients with different disease severity. ⋯ Early adequate fluid resuscitation together with conservative late fluid management may provide better patient outcomes. The effect of fluid management strategy on patient outcome may depend on the underlying disease severity.
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Journal of critical care · Dec 2011
Renal replacement therapy in prolonged mechanical ventilation patients with renal failure in Taiwan.
Renal failure requiring renal replacement therapy (RRT) is associated with a high mortality rate in intensive care unit (ICU) patients. Little information is available on the outcomes of patients having prolonged mechanical ventilation (PMV) in addition to RRT. The purpose of this study was to investigate the impact of RRT in PMV patients. ⋯ The present study demonstrates that the need for RRT had a negative impact on weaning and mortality in PMV patients compared with patients without RRT. Patients who had RRT initiated at the RCC had a significantly lower weaning rate compared with ESRD patients.
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Journal of critical care · Dec 2011
Acute Kidney Injury Network definition of contrast-induced nephropathy in the critically ill: incidence and outcome.
Contrast-induced nephropathy (CIN) has been extensively studied in the ward but only scarcely in intensive care unit (ICU) patients, even if they may be particularly prone to develop or to worsen acute kidney insufficiency. We aimed to measure the incidence of CIN in a large ICU population using the Acute Kidney Injury Network (AKIN) definition and to investigate its impact on patients' outcome. ⋯ Even if incidence varied greatly depending on the definition, CIN appeared frequent in our critically ill patients. The AKIN definition, independently associated with ICU mortality, may allow unifying diagnostic criteria to further evaluate this condition that impacts morbidity and mortality.