Crit Care Resusc
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Intensive care patients with traumatic brain injury (TBI) are at high risk of developing deep vein thrombosis (DVT). A high rate of DVT was reported before routine thromboprophylaxis, but the current DVT rate in TBI patients receiving best-practice mechanical and pharmacological prophylaxis is unknown. ⋯ Mechanical and pharmacological prophylaxis appeared to be effective. The incidence of clinically identified PE is of concern and suggests that thromboembolic sources other than large leg veins may not be being adequately controlled by modern thromboprophylaxis regimens.
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Comparative Study
Relationship between illness severity scores in acute kidney injury.
In the field of critical care nephrology, recent publications have used different illness severity scoring systems, making outcome comparisons difficult. ⋯ Simple, robust translational formulae can be developed to allow clinicians to compare illness severity of patients with AKI when illness severity is expressed with different scoring systems.
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To define the relationship between worsening oxygenation status (worst PaO(2)/FiO(2) ratio in the first 24 hours after intensive care unit admission) and mortality in immunosuppressed and immunocompetent ICU patients in the presence and absence of mechanical ventilation. ⋯ Immunosuppression increases the risk of mortality with progressively worsening oxygenation status, but only in the presence of mechanical ventilation. Further research into the impact of mechanical ventilation in immunosuppressed patients is required.
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Case Reports
Two cases of toxic methanol ingestion, one leading to brain death: case reports and a brief review.
Two patients were admitted sequentially to a rural emergency department, then transferred to a tertiary intensive care unit, both with serious methanol poisoning from home-brewed alcohol. They were intubated, mechanically ventilated, and treated with intravenous and nasogastric ethanol and continuous venovenous haemodiafiltration. Although quite similar in presentation, metabolic complications and therapy, one patient became brain dead due to severe cerebral oedema, while the other was discharged without any significant complications. Their course highlights the importance of early treatment of non-ethanol alcohol poisoning.