Critical care : the official journal of the Critical Care Forum
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We sought to determine whether higher levels of the novel biomarker growth differentiation factor-15 (GDF-15) are associated with poor outcomes and the presence of pulmonary vascular dysfunction (PVD) in patients with acute respiratory distress syndrome (ARDS). ⋯ In patients with ARDS, higher levels of GDF-15 are significantly associated with poor outcome but not PVD.
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Editorial Comment
Identifying patients at risk for augmented renal clearance in the ICU - limitations and challenges.
Augmented renal clearance (ARC) is an important determinant of antibiotic exposure in critically ill patients, and identifying patients at risk is therefore an important goal. There is a growing body of evidence that a younger patient with a low to moderate degree of organ dysfunction typically is at risk of ARC and therefore decreased exposure to renally eliminated antibiotics. Mechanisms potentially involved, such as increased cardiac output, have, however, not been identified as appropriate surrogate markers, and the search for suitable alternatives to readily identify patients with ARC continues.
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Editorial Comment
Improving ascertainment and communication of prognosis in intracerebral hemorrhage.
Prognostication after intracerebral hemorrhage remains a significant challenge for the field of neurocritical care. Despite several available tools that can predict mortality and, to some degree, functional outcomes, deciding which prediction score to use and how best to translate the resultant population-based value to the individual level is not always clear. As more and more scores are published, we need to give due attention to the qualitative aspect of prognostication and explore how best to move this critical aspect of our field forward.
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Comparative Study
Video laryngoscopy improves intubation success and reduces esophageal intubations compared to direct laryngoscopy in the medical intensive care unit.
Tracheal intubation in the Intensive Care Unit (ICU) can be challenging as patients often have anatomic and physiologic characteristics that make intubation particularly difficult. Video laryngoscopy (VL) has been shown to improve first attempt success compared to direct laryngoscopy (DL) in many clinical settings and may be an option for ICU intubations. ⋯ In the medical ICU, video laryngoscopy resulted in higher first attempt and ultimate intubation success rates and improved grade of laryngoscopic view while reducing the esophageal intubation rate compared to direct laryngoscopy.
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End-stage renal disease (ESRD) is associated with an increased propensity for critical illness, but whether ESRD is independently associated with a greater risk of death after major surgical procedures is unclear. ⋯ In this large cohort of surgical ICU patients, presence of ESRD at ICU admission was associated with greater morbidity and mortality and independently associated with a greater risk of in-hospital death. Our data can be useful in preoperative risk stratification.