Journal of critical care
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Journal of critical care · Aug 2011
Cross-validation of a modified score to predict mortality in cancer patients admitted to the intensive care unit.
The aim of this study was to cross-validate an automated and customized severity of illness score as a means of predicting death among adult cancer patients admitted to the intensive care unit (ICU). ⋯ The modified Sequential Organ Failure Assessment score is a good and valid predictor of cancer patients' risk of dying in the ICU and/or hospital despite the modifications needed to automate the score using existing electronic data.
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Journal of critical care · Aug 2011
Early impact of medical emergency team implementation in a country with limited medical resources: a before-and-after study.
The purpose of the study was to determine whether earlier clinical intervention by a medical emergency team (MET) can improve patient outcomes in an Asian country. ⋯ Introduction of a MET reduced the number of cardiac arrests in the general ward during the first 3 months of the academic year. Introduction of MET also decreased the "derangement-to-ICU interval," which was an independent predictor of survival in patients with unplanned ICU admissions. Therefore, MET introduction may lead to improved outcomes for hospitalized patients in a country with limited medical resources.
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Journal of critical care · Aug 2011
Comparative Study Clinical TrialPhysical examination, central venous pressure, and chest radiography for the prediction of transpulmonary thermodilution-derived hemodynamic parameters in critically ill patients: a prospective trial.
Physical examination, assessment of central venous pressure (CVP) and chest radiography are diagnostic tools for estimation of volume status in intensive care unit (ICU) patients. Passive leg raising (PLR) is a test to estimate fluid responsiveness. Transpulmonary thermodilution (TPTD) is established for measurement of cardiac index (CI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI). This study compares the estimation of volume status using physical examination, CVP, chest radiography, PLR, and TPTD. ⋯ In ICU patients, assessment of volume status remains difficult. Physical examination, CVP, and portable radiography do not correlate with TPTD assessment of volume status, preload, or pulmonary hydration.
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Journal of critical care · Aug 2011
The role of echocardiography in the early diagnosis of the complications of endovascular repair of blunt aortic injury.
Endovascular repair of traumatic aortic injury has been associated with severe procedural complications, including endoleaks, coverage of the left subclavian artery, stent collapse, access complications, and questionable durability. Echocardiography has proven to be a valuable tool in the intraoperative detection of these complications. In the current study, we report on the use of echocardiography as an early postoperative diagnostic technique for the evaluation of endovascular stent graft positioning in the intensive care setting. ⋯ Noninvasive echocardiographic monitoring proved to be a valuable tool in the early diagnosis of postoperative stent graft malalignment. To our knowledge, this is the first time that echocardiography is described in the relevant literature as an early diagnostic technique in this setting.