Critical care medicine
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Critical care medicine · Jun 2018
Hepcidin and Anemia in Surgical Critical Care: A Prospective Cohort Study.
Because anemia of inflammation is common in ICU patients and hepcidin is the key regulator of iron homeostasis, we examined time-dependent changes in hepcidin, erythropoietin, iron, and inflammatory markers in surgical ICU patients with anemia. ⋯ Hepcidin serum concentrations are markedly increased on ICU admission, and decrease significantly over the course of the ICU stay (28 d). Decreased hepcidin concentrations are associated with increased reticulocyte response and decreased inflammatory response reflected by decreased interleukin-6 and C-reactive protein concentrations, but not with anemia resolution.
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Critical care medicine · Jun 2018
Outcomes in Patients with Vasodilatory Shock and Renal Replacement Therapy Treated with Intravenous Angiotensin II.
Acute kidney injury requiring renal replacement therapy in severe vasodilatory shock is associated with an unfavorable prognosis. Angiotensin II treatment may help these patients by potentially restoring renal function without decreasing intrarenal oxygenation. We analyzed the impact of angiotensin II on the outcomes of acute kidney injury requiring renal replacement therapy. ⋯ In patients with acute kidney injury requiring renal replacement therapy at study drug initiation, 28-day survival and mean arterial pressure response were higher, and rate of renal replacement therapy liberation was greater in the angiotensin II group versus the placebo group. These findings suggest that patients with vasodilatory shock and acute kidney injury requiring renal replacement therapy may preferentially benefit from angiotensin II.
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Critical care medicine · Jun 2018
Observational StudyUltrasound-Guided Laryngeal Air Column Width Difference as a New Predictor for Postextubation Stridor in Children.
To assess the efficacy of ultrasound-guided laryngeal air column width difference in predicting postextubation stridor in children. ⋯ Laryngeal air column width difference measurement may serve as a simple reliable noninvasive method for predicting postextubation stridor in children.
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Critical care medicine · Jun 2018
Climate of Respect Evaluation in ICUs: Development of an Instrument (ICU-CORE).
To develop a valid, reliable measure that reflected the environment of respectfulness within the ICU setting. ⋯ We created a reliable set of scales to measure the climate of respectfulness in intensive care settings. These measures can be used for ongoing quality improvement that aim to enhance the experience of ICU patients and their families.
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Critical care medicine · Jun 2018
Simulation-Based Assessment of Critical Care "Front-Line" Providers.
Develop a standardized simulation method to assess clinical skills of ICU providers. ⋯ The simulation assessments yielded reasonably reliable measures of Critical Care Medicine decision-making skills. Despite a wide range of performance, those with more ICU training and experience performed better, providing evidence to support the validity of the scores. Simulation-based assessments may ultimately prove useful to determine readiness to assume decision-making roles in the ICU.