Journal of critical care
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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.
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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
Does intensive care unit severity of illness influence recall of baseline physical function?
The aim of this study is to evaluate if severity of illness in the intensive care unit influences patients' retrospective recall of their baseline physical function from before hospital admission. ⋯ Intensive care unit severity of illness was not associated with patients' retrospectively recalled baseline physical function. Patients with a lower level of education may be more influenced by ICU severity of illness, but the magnitude of this effect may not be clinically meaningful.
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Journal of critical care · Dec 2011
Association between out-of-hospital emergency department transfer and poor hospital outcome in critically ill stroke patients.
Transfer of critically ill patients from outside emergency department has the potential for delaying the admission to the intensive care unit. We sought to determine the effect of outside emergency department transfer on hospital outcomes in critically ill patients with stroke. ⋯ These data suggest that in critically ill patients with stroke, transfer from outside emergency department is independently associated with poor outcome at hospital discharge. Further research is needed as to identify the potential causes for this effect.
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Journal of critical care · Dec 2011
Discrepancies in the RIFLE classification are due to the method used to assess the level of derangement of kidney function.
We hypothesized that RIFLE based on creatinine clearance (CrCl) is superior to that based on serum creatinine (sCr) or Cockroft-Gault (C-G) because it is an earlier marker of kidney dysfunction. ⋯ RIFLE classification using sCr or C-G at the third day of admission predicts outcome less accurately than with the use of CrCl. Because of the delay in the rise of sCr after a sudden glomerular filtration rate decrease, RIFLE based in CrCl may represent an advantage in terms of precocity.