Critical care medicine
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Critical care medicine · Jan 2010
Comparative StudyCirculating NT-proCNP predicts sepsis in multiple-traumatized patients without traumatic brain injury.
C-type natriuretic peptide (CNP), a member of the natriuretic peptide family, is produced in vascular endothelium. We assessed the accuracy of natriuretic (NT)-proCNP, the N-terminal fragment of the C-type natriuretic peptide precursor, in predicting development of sepsis in multiple-traumatized patients with/without traumatic brain injury verified by computed tomography. ⋯ Our data showed that the levels of circulating NT-proCNP between multiple-traumatized patients without traumatic brain injury who do and do not develop sepsis are distinctly different. Plasma NT-proCNP concentration can potentially serve as an accurate predictor of sepsis in this cohort of patients.
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Critical care medicine · Jan 2010
Comparative StudyClinical and economic outcomes of the electronic intensive care unit: results from two community hospitals.
To determine the impact of a telemedicine system, the electronic intensive care unit (eICU), on ICU, and non-ICU mortality, total mortality, total and ICU-specific length of stay, and total hospital cost at two community hospitals. ⋯ In our study of >4000 patients representing two community hospitals, we did not find a reduction in mortality, length of stay, or hospital cost attributable to the introduction of the eICU.
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Critical care medicine · Jan 2010
Comparative StudyIncreased intensity of treatment and decreased mortality in elderly patients in an intensive care unit over a decade.
Data collected from two cohorts of patients aged > or =80 yrs and admitted to an intensive care unit in France were compared to determine whether intensive care unit care and survival had evolved from the 1990s to the 2000s. ⋯ The characteristics and intensity of treatment for elderly people admitted to the intensive care unit changed significantly over a decade. The intensity of treatments has increased over time and survival has improved over time as well. A potential link between increased treatment and improved survival in the elderly may be evoked.
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Critical care medicine · Jan 2010
Comparative StudyPredicting dead space ventilation in critically ill patients using clinically available data.
To develop and validate an equation to predict dead space to tidal volume ratio (Vd/Vt) from clinically available data in critically ill mechanically ventilated patients. ⋯ Vd/Vt is predictable from clinically available data. Whether this predicted quantity is valuable clinically must still be determined.
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Critical care medicine · Jan 2010
Gut mucosal cell damage in meningococcal sepsis in children: relation with clinical outcome.
The pathophysiological sequelae of meningococcal sepsis are mainly caused by deregulated microvasculature function, leading to impaired tissue blood flow. Because mature enterocytes are known to be susceptible to altered perfusion, we aimed to investigate: (1) the development of enterocyte damage; and (2) the relation between enterocyte damage and severity of disease and outcome in children with meningococcal sepsis. ⋯ Elevated plasma intestinal fatty acid binding protein is found in eight of 19 children with severe pediatric intensive care unit stay at the time of clinical presentation, suggesting the presence of enterocyte damage. Furthermore, prolonged enterocyte damage is found in nonsurvivors. Further studies are needed to clarify the potential role for assessment of plasma intestinal fatty acid binding protein in monitoring treatment of pediatric intensive care unit stay.