Journal of critical care
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Journal of critical care · Aug 2011
Patient factors associated with transfusion practices in Veterans Affairs intensive care units: implications for further research.
We sought to describe how patient characteristics influence the frequency of red blood cell (RBC) transfusions among critically ill patients after taking into account hemoglobin (Hgb) level. ⋯ Intensive care unit patients admitted for AMI, unstable angina, and congestive heart-failure had higher likelihood of receiving RBC transfusions below specific Hgb levels varying from 6 to 11 g/dL. Further research is needed to determine how these transfusion practices influence outcomes.
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Journal of critical care · Aug 2011
Correlation between coagulopathy and outcome in severe head trauma in neurointensive care and trauma units.
Abnormal blood coagulation after traumatic brain injury is a common finding. Some studies have proposed these changes as useful predictors of outcome in patients with head trauma. This study aimed at evaluating the association of the routine tests of blood coagulation within the first hours after severe head trauma with prognosis of patients with severe head trauma. ⋯ On-admission PT, PTT, INR and platelet count may be used as predictors of outcome and prognosis of patients with severe head trauma.
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Journal of critical care · Aug 2011
Herpes simplex virus: a marker of severity in bacterial ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units and has a high morbidity and mortality rate. It is mainly a bacterial disease, although the potential role of viruses as pathogens or copathogens in VAP is under discussion. Our study aims were to determine the incidence of herpes simplex virus (HSV) in the lower respiratory tract (LRT) secretions in patients with bacterial VAP and to assess its potential clinical relevance. ⋯ Herpes simplex virus excretion in LRT secretions is not infrequent in VAP, and it is associated with greater severity and worse prognosis.
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Journal of critical care · Aug 2011
Increasing patient safety event reporting in 2 intensive care units: a prospective interventional study.
The aims of this study were to increase the reporting of patient safety events and to enhance report analysis and responsive action. ⋯ After the introduction of this new approach, reporting rates have increased significantly throughout the first year. Differences in reporting rates among workers and units may reveal priorities and barriers to reporting. The integrated approach facilitated prompt response to selected reports.
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Journal of critical care · Aug 2011
Factors influencing enoxaparin anti-Xa activity in surgical critically ill patients.
The objectives of the present study were to describe the incidence of low anti-Xa levels defined as below 0.1 IU/mL in a general surgical intensive care unit population and to evaluate factors independently influencing anti-Xa activity. ⋯ In the study, prophylactic SC enoxaparin in critically ill patients at the current 30 mg SC twice daily dosage attained an anti-Xa level more than 0.1 U/mL in nearly all patients. In addition, low creatinine clearances and female sex are associated with higher anti-Xa activity AUC(0-12h).