Journal of critical care
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Journal of critical care · Dec 2007
Comparative StudyInterhospital transfer of critically ill patients: demographic and outcomes comparison with nontransferred intensive care unit patients.
We examined the association between access to intensive care services and mortality in a cohort of critically ill patients. ⋯ We found some evidence to suggest that differential access to intensive care services impacts mortality within this case mix of patients. These findings may have implications for current efforts to centralize and regionalize critical care services.
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Journal of critical care · Dec 2007
Adrenal insufficiency in early phase of pediatric acute lung injury/acute respiratory distress syndrome.
Adequate adrenal function is essential to survive critical illness. Several recent articles have reported the significant effect of adrenal insufficiency (AI) in patients with sepsis. However, the prevalence of AI in pediatric acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is so far still scanty. Thus, we elected to study its prevalence and its clinical outcome. ⋯ Our study demonstrated that the prevalence of AI was common in pediatric ALI/ARDS. These results would be an initial step to further study the impact of AI on clinical outcomes of these children in a larger scale.
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Journal of critical care · Dec 2007
Intensive care unit exposures for long-term outcomes research: development and description of exposures for 150 patients with acute lung injury.
Long-term follow-up studies in critical care have described survivors' outcomes, but provided less insight into the patient/disease characteristics and intensive care therapies ("exposures") associated with these outcomes. Such insights are essential for improving patients' long-term outcomes. This report describes the development of a strategy for comprehensively measuring relevant exposures for long-term outcomes research, and presents empiric results from its implementation. ⋯ Using a multistep, iterative process, a comprehensive and feasible exposure measurement strategy for long-term outcomes research was successfully developed and implemented.
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Journal of critical care · Dec 2007
Venous thromboembolism in critical illness in a community intensive care unit.
Venous thromboembolism (VTE) can be a life-threatening complication of critical illness. Venous thromboembolism rates observed depend on the population studied, the screening modality used, and thromboprophylaxis prescribed. Few studies report on the rates of clinically diagnosed VTE in critically ill patients. The purpose of this study was to characterize the incidence of clinically diagnosed VTE, prophylactic strategies used, and diagnostic studies ordered in a critically ill population at a tertiary community intensive care unit (ICU), both during and after their ICU stay. ⋯ The rates of clinically diagnosed VTE rates in critically ill patients are substantial. Venous thromboembolism occurs before, during, and after ICU discharge. Continued vigilance and thromboprophylaxis are warranted across the continuum of critical illness.
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Journal of critical care · Dec 2007
Low-dose steroid therapy does not affect hemodynamic response in septic shock patients.
Several studies showed that low-dose steroid therapy (LDST) in patients with septic shock leads to a significantly shorter duration of shock and a decreased mortality. However, these results have been criticized. Our purpose was to evaluate the effects of LDST on time to shock reversal and mortality in septic shock. ⋯ In our study, treatment with low-dose steroid therapy was not associated to a reduction in time to shock reversal or mortality.