Journal of critical care
-
Journal of critical care · Jun 2012
Controlled Clinical TrialA pilot clinical trial to evaluate a novel time-to-positivity assay to measure the effectiveness of antibiotic therapy for septic patients in intensive care.
The purpose of the study was to investigate whether a novel assay of antibiotic efficacy could predict clinical outcome measures in septic patients in the intensive care unit (ICU). ⋯ This pilot study provides preliminary evidence that measurement of Tpos1 24 hours after the initiation of antibiotic therapy is associated with ICU length of stay and might be of value as a surrogate marker of antibiotic activity.
-
Journal of critical care · Jun 2012
Lung-protective mechanical ventilation does not protect against acute kidney injury in patients without lung injury at onset of mechanical ventilation.
Preclinical and clinical studies suggest that mechanical ventilation contributes to the development of acute kidney injury (AKI), particularly in the setting of lung-injurious ventilator strategies. ⋯ In the present study in critically patients without ALI at onset of mechanical ventilation, lower tidal volume ventilation did not reduce the development or worsening of AKI compared with conventional tidal volume ventilation.
-
Journal of critical care · Jun 2012
Comparative StudyA comparison of predictive equations of energy expenditure and measured energy expenditure in critically ill patients.
Multiple equations exist for predicting resting energy expenditure (REE). The accuracy of these for estimating energy requirements of critically ill patients is not clear, especially for obese patients. We sought to compare REE, calculated with published formulas, with measured REE in a cohort of mechanically ventilated subjects. ⋯ None of these equations accurately estimated measured REE in this group of mechanically ventilated patients, most underestimating energy needs. Development of improved predictive equations for adequate assessment of energy needs is needed.
-
Journal of critical care · Jun 2012
Evolution of peripheral vs metabolic perfusion parameters during septic shock resuscitation. A clinical-physiologic study.
Perfusion assessment during septic shock resuscitation is difficult and usually complex determinations. Capillary refill time (CRT) and central-to-toe temperature difference (Tc-toe) have been proposed as objective reproducible parameters to evaluate peripheral perfusion. The comparative evolution of peripheral vs metabolic perfusion parameters in septic shock resuscitation has not been studied. We conducted a prospective observational clinical-physiologic study to address this subject. ⋯ Early recovery of peripheral perfusion anticipates a successful resuscitation compared with traditional metabolic parameters in septic shock patients. Our findings support the inclusion of serial peripheral perfusion assessment in multimodal monitoring strategies for septic shock resuscitation.
-
Journal of critical care · Jun 2012
Critically ill patients with cancer and sepsis: clinical course and prognostic factors.
The purposes of this study were to evaluate the clinical course and to identify independent predictors of mortality in patients with cancer with sepsis. ⋯ Sepsis remains a frequent complication in patients with cancer and associated with high mortality. Our results can be of help to assist intensivists in clinical decisions and to improve characterization and risk stratification in these patients.