Journal of critical care
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Journal of critical care · Jun 2010
Systematized Nomenclature of Medicine-Clinical Terms direction and its implications on critical care.
The aim of this study was to describe the new advancements in Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) terminology and its applicability to critical care documentation. ⋯ We propose that SNOMED-CT is suitable for use in critical care; however, work is urgently required to validate the completeness of terminology and to determine clinicians' perceptions on the utility of such a standardized terminology for use in critical care clinical information systems.
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The aim of this study was to assess the etiology of cardiac troponin elevation among patients admitted to the intensive care unit (ICU) and to examine whether etiology affects mortality and length of stay. ⋯ The most common cause of troponin elevation among critically ill patients was MI. Patients with elevated troponin had worse outcomes compared with patients without troponin elevation, and troponin elevation not due to MI was predictive of increased hospital mortality.
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In assessing neurologic prognosis after cardiac arrest (CA), electroencephalogram (EEG) reactivity has not been specifically included with EEG classifications. Most studies have divided recordings into benign and malignant; however, some patterns within these groups may have greater prognostic significance than such broad classifications. We sought to explore reactivity, with broad classifications and subclassifications for their prognostic significance. ⋯ Electroencephalogram reactivity after CA is a relatively favorable EEG feature; generalized suppression or generalized epileptiform activity, without reactivity, is associated with lack of recovery of awareness.
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Journal of critical care · Jun 2010
Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock.
The purpose of the study was to determine the independent risk factors on mortality in patients with community-acquired severe sepsis and septic shock. ⋯ In addition to the severity of illness, hypoalbuminemia was identified as the most important prognostic factor in community-acquired bloodstream infection with severe sepsis and septic shock.
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Journal of critical care · Jun 2010
Overuse of stress ulcer prophylaxis in the critical care setting and beyond.
Patients admitted to the intensive care unit (ICU) are susceptible to stress ulcers. We hypothesize that despite recommendations, stress ulcer prophylaxis (SUP) is still overused in the ICU and often continued after resolution of risk factors for bleeding. ⋯ Although judicious use of SUP in high-risk patients can decrease the incidence of gastrointestinal bleeding, inappropriate use may increase drug reactions, unnecessary hospital costs, and personal monetary burden. Our findings argue for improvement measures to reduce initial inpatient overuse of SUP and to prompt discontinuation before hospital discharge.