Journal of critical care
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Journal of critical care · Oct 2022
Clinicians' Views on the use of triggers for specialist palliative care in the ICU: A qualitative secondary analysis.
To understand clinicians' views regarding use of clinical criteria, or triggers, for specialist palliative care consultation in the ICU. ⋯ ICU and palliative care clinicians identified important issues to consider when implementing triggers for specialist palliative care consultation. Future research is needed to longitudinally examine the most appropriate triggers and best practices for trigger implementation.
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Journal of critical care · Oct 2022
Characterising acute kidney injury: The complementary roles of biomarkers of renal stress and renal function.
Although epidemiological studies have enhanced our understanding of acute kidney injury, defining the biologic processes corresponding to the clinical phenotype remains challenging. We have examined biomarkers associated with renal stress plus markers of glomerular function to assess whether this approach may aid prediction of AKI or other relevant endpoints. ⋯ The combination of cell-cycle arrest biomarkers, TIMP-2 and IGFBP7, with serum creatinine but not cystatin C or PENK improved risk stratification for the development of stage 2 or 3 AKI over [TIMP-2]·[IGFBP7] alone.
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Journal of critical care · Oct 2022
Small, short-term, point-of-care creatinine changes as predictors of acute kidney injury in critically ill patients.
To assess short-term creatinine changes as predictors of acute kidney injury (AKI) when used alone and in combination with AKI risk factors. ⋯ In combination with key risk factors, frequent point-of-care creatinine assessment on arterial blood gases to detect small, short-term creatinine changes provides a robust, novel, low-cost, and rapid method for predicting AKI in critically ill patients.
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Journal of critical care · Oct 2022
Loss of cerebral blood flow and cerebral perfusion pressure in brain death: A transcranial Duplex ultrasonography study.
We investigated cerebral perfusion pressure (CPP) at the time loss of cerebral blood flow (CBF) occurred during brain death (BD). We hypothesized that a critical closing pressure (CrCP) may be reached before CPP drops to 0 mmHg. ⋯ CrCP may be reached although CPP is still positive, resulting in complete loss of CBF and BD. By including bedside TCD, neuromonitoring may contribute to early identification of patients at risk to experience loss of CBF and subsequent BD.