Journal of critical care
-
Journal of critical care · Jun 2010
High concentrations of resistin in the peripheral blood of patients with acute basal ganglia hemorrhage are associated with poor outcome.
Resistin increases in peripheral blood of patients with intracerebral hemorrhage (ICH). We sought to evaluate its relation with disease outcome. ⋯ Increased resistin level is found after ICH, in association with a poor clinical outcome.
-
Journal of critical care · Jun 2010
Discontinuation of vasopressin before norepinephrine increases the incidence of hypotension in patients recovering from septic shock: a retrospective cohort study.
There are little data regarding the discontinuation of vasoactive medications in patients recovering from septic shock. We designed this retrospective cohort study to evaluate the incidence of hypotension based on the order of removal of norepinephrine (NE) and vasopressin (AVP) in patients receiving concomitant NE and AVP infusions for the treatment of septic shock. ⋯ Discontinuation of AVP before NE may lead to a higher incidence of hypotension in patients recovering from septic shock receiving concomitant AVP and NE.
-
Journal of critical care · Jun 2010
Comparative StudyThe 4Ts scoring system for heparin-induced thrombocytopenia in medical-surgical intensive care unit patients.
Heparin-induced thrombocytopenia (HIT) is commonly considered but rarely confirmed in critically ill patients. The 4Ts score (Thrombocytopenia, Timing of thrombocytopenia, Thrombosis, and oTher reason) might identify individual patients at risk of having this disorder. ⋯ Significant thrombocytopenia during heparin administration occurred in 9.5% of critically ill patients, but HIT was confirmed in only 4.1% of those undergoing testing, for an overall incidence of 0.4%. A low 4Ts score occurred in 78% of patients investigated for HIT; none of these patients had a positive SRA. We conclude that HIT is uncommon in critically ill patients and that the 4Ts score is worthy of further evaluation in this patient population.
-
Journal of critical care · Jun 2010
Mortality reduction after implementing a clinical practice guidelines-based management protocol for severe traumatic brain injury.
The objective of this study was to examine the effect of implementing a clinical practice guidelines-based management protocol on the outcome of patients with severe traumatic brain injury (TBI). ⋯ The protocol implementation was associated with a reduction in hospital and ICU mortality. This improvement was not associated with an increase in the frequency of tracheostomies and in ICU or hospital LOS, suggesting that the improved survival was not associated with the increased number of surviving patients with severe disability and that the functional status might have also improved.
-
Journal of critical care · Jun 2010
Revised Acute Physiology and Chronic Health Evaluation score as a predictor of neurosurgery intensive care unit readmission: a case-controlled study.
Patients with neurologic system problems are among the most common patients readmitted to the intensive care unit (ICU). Readmission predictors for neurologic ICU patients have not been established. Previous research suggests that the Revised Acute Physiology and Chronic Health Evaluation (APACHE II) score is one indication of the critical status of ICU-admitted patients; however, the ability of the discharge APACHE II to predict readmission to the ICU requires further study. The purpose of this study was to investigate the ability of the APACHE II scoring system to predict ICU readmission of neurosurgical and ICU patients. ⋯ The risk of ICU readmission of neurologic ICU patients can be predicted by determining APACHE II score upon ICU discharge.