Critical care : the official journal of the Critical Care Forum
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Comparative Study
SOFA is superior to MOD score for the determination of non-neurologic organ dysfunction in patients with severe traumatic brain injury: a cohort study.
To compare the discriminative ability of the SOFA and MOD scoring systems with respect to hospital mortality and unfavorable neurologic outcome in patients with severe traumatic brain injury admitted to intensive care. ⋯ In patients with brain injury, the SOFA scoring system has superior discriminative ability and stronger association with outcome compared to the MOD scoring system with respect to hospital mortality and unfavorable neurologic outcome.
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This report describes the case mix and outcome (mortality, intensive care unit (ICU) and hospital length of stay) for admissions to ICU for head injury and evaluates the predictive ability of five risk adjustment models. ⋯ Traumatic brain injury requiring intensive care has a high mortality rate. Non-survivors have a short length of ICU and hospital stay. APACHE II and III have poorer calibration and discrimination than SAPS II, MPM II and the ICNARC model in traumatic brain injury; however, no model had perfect calibration.
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Comparative Study
Measurement of alveolar derecruitment in patients with acute lung injury: computerized tomography versus pressure-volume curve.
Positive end-expiratory pressure (PEEP)-induced lung derecruitment can be assessed by a pressure-volume (P-V) curve method or by lung computed tomography (CT). However, only the first method can be used at the bedside. The aim of the study was to compare both methods for assessing alveolar derecruitment after the removal of PEEP in patients with acute lung injury or acute respiratory distress syndrome. ⋯ Alveolar derecruitment measured by the CT and P-V curve methods are tightly correlated. However, the large limits of agreement indicate that the P-V curve and the CT method are not interchangeable.
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Comparative Study
Community-acquired pneumonia on the intensive care unit: secondary analysis of 17,869 cases in the ICNARC Case Mix Programme Database.
This paper describes the case mix, outcome and activity for admissions to intensive care units (ICUs) with community-acquired pneumonia (CAP). ⋯ CAP makes up a small, but important and rising, proportion of adult ICU admissions. Survival of over half of all cases vindicates the use of ICU facilities in CAP management. Nevertheless, overall mortality remains high, especially in those admitted later in their hospital stay.
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Little is known about the condition of the large bowel in patients with sepsis. We have previously demonstrated increased concentrations of L-lactate in the rectal lumen in patients with abdominal septic shock. The present study was undertaken to assess the concentrations of L- and D-lactate in rectal lumen and plasma in septic patients including the possible relation to site of infection, severity of disease, and outcome. ⋯ In patients with severe sepsis and septic shock, luminal concentrations of L- and D-lactate in the rectum were related to severity of disease and outcome.