Journal of critical care
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Journal of critical care · Apr 2011
Morbidity and mortality characteristics of morbidly obese patients admitted to hospital and intensive care units.
The purpose of this study is to evaluate the outcomes of hospitalized morbidly obese inpatients. ⋯ As BMI increases, utilization of medical resources also increases such as ICU admission, MV, longer hospital LOS, and tracheostomy. Although overall BMI interquartile mortality rates do not differ significantly in our study, utilization of valuable and costly hospital resources is a major challenge facing health care delivery. Our findings indicate the need for increased efforts and novel strategies for treatment, prevention, and resource allocation to deal with this emerging challenge.
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Journal of critical care · Apr 2011
Global end-diastolic volume, serum osmolarity, and albumin are risk factors for increased extravascular lung water.
The transpulmonary thermodilution technique allows the determination of cardiac preload (global end-diastolic volume index) and quantification of pulmonary edema (extravascular lung water index [EVLWI]). Pulmonary edema commonly develops in critically ill patients; however, the underlying pathophysiology, that is, hydrostatic (cardiac) or permeability-induced (noncardiac), often remains unclear. In this study, hemodynamic and serum parameters of osmolarity and oncotic pressure were analyzed to identify risk factors for increased EVLWI. ⋯ Hypervolemia, hypoalbuminemia, and high plasma osmolarity are associated with increased EVLWI.
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Journal of critical care · Apr 2011
Brain-derived neurotrophic factor and neuron-specific enolase, but not S100β, levels are associated to the occurrence of delirium in intensive care unit patients.
The aim of this study was to determine the association between serum concentrations of brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE), and S100β and the occurrence of delirium in critically ill patients. ⋯ Our results suggest that admission serum BDNF and NSE levels are associated with the occurrence of delirium in ICU patients.
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Journal of critical care · Apr 2011
Is hyperchloremia associated with mortality in critically ill patients? A prospective cohort study.
The aim of the study was to determine if acid-base variables are associated with hospital mortality. ⋯ Hypoalbuminemia and hyperchloremia were associated with mortality. This result involving chloride is something new and should be tested in future studies.
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Journal of critical care · Apr 2011
Delivered dose of continuous venovenous hemofiltration predicts outcome in septic patients with acute kidney injury: a retrospective study.
In continuous venovenous hemofiltration (CVVH) issues like timing and dose remain controversial, particularly in sepsis. The objective of this study is to examine which CVVH characteristic best predicts mortality in sepsis-induced acute kidney injury (AKI). ⋯ Our retrospective data suggest that in sepsis-induced AKI requiring CVVH, delivered dose, rather than timing, mode of administration, and azotemic control, is an independent predictor of mortality. A lower delivered dose is associated with higher mortality.