Journal of critical care
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Journal of critical care · Jun 2010
Rehabilitation therapy and outcomes in acute respiratory failure: an observational pilot project.
The aim of this study was to describe the frequency, physiologic effects, safety, and patient outcomes associated with traditional rehabilitation therapy in patients who require mechanical ventilation. ⋯ This pilot project illustrated important barriers to providing rehabilitation to mechanically ventilated patients in an ICU and impairments in strength, range of motion, and functional outcomes at hospital discharge.
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Journal of critical care · Jun 2010
Soluble triggering receptor expressed on myeloid cells 1 and the diagnosis of sepsis.
Early diagnosis and assessment of the systemic inflammatory response to infection are difficult with usual markers (fever, leukocytosis, C-reactive protein [CRP]). Triggering receptor expressed on myeloid cells-1 (TREM-1) expression on phagocytes is up-regulated by microbial products. We studied the ability of soluble TREM-1 (sTREM-1) to identify patients with sepsis. ⋯ C-reactive protein and ESR performed better than sTREM-1 and white blood cell count in diagnosing infection.
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Journal of critical care · Jun 2010
Outcome of patients with injection drug use-associated endocarditis admitted to an intensive care unit.
The purpose of this study was to study the outcome of patients with injection drug use-associated infective endocarditis (IDU-IE) admitted to an intensive care unit (ICU). ⋯ Complicated IDU-IE necessitating admission to ICU is associated with high mortality. In addition to consequences of sepsis, septic embolization to central nervous system and lungs contributes to development of organ failure. Increased severity of illness and prior history of endocarditis are associated with poor outcome.
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Journal of critical care · Jun 2010
Practice variability in the assessment and treatment of critical illness-related corticosteroid insufficiency.
Little is known about how published evidence regarding use of steroids in septic shock has been incorporated into clinical practice. ⋯ Treatment and evaluation of critical illness-related corticosteroid insufficiency in critically ill patients at our institution are inconsistent. Many patients with VDSS do not receive either treatment or evaluation for critical illness-related corticosteroid insufficiency, and patients who do not meet the current criteria are being evaluated and/or treated for critical illness-related corticosteroid insufficiency.
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Journal of critical care · Jun 2010
Hospitalist bed management effecting throughput from the emergency department to the intensive care unit.
Emergency department (ED) patients in need of an intensive care unit (ICU) admission are very sick. Reducing the length of time to get these patients into ICU beds is associated with improved outcomes. ⋯ Conscientious management of hospital beds, in this case by hospitalist physicians providing ABM, can have a positive and substantial impact on the ED throughput of critically ill patients admitted to ICU beds. This efficiency is likely to positively have impacted on patient satisfaction and safety.