Crit Care Resusc
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Venous blood gas (VBG) analysis is suggested as an alternative to arterial blood gas (ABG) analysis. In haemodynamically stable patients, there is clinically acceptable arteriovenous (AV) agreement for pH and bicarbonate (HCO3-) concentration, but in haemodynamically unstable patients, evidence is conflicting. We aimed to evaluate the level of AV agreement for the values of pH, PCO2, base excess, HCO3- and lactate between ABGs and VBGs in critically ill patients with varying degrees of hypotension. ⋯ In critically ill patients with varying degrees of hypotension in the ICU, there is clinically acceptable AV agreement for the values of pH, HCO3-, base excess and lactate, an agreement that does not deteriorate significantly with falling blood pressure.
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Randomized Controlled Trial
Nucleosome levels and toll-like receptor expression during high cut-off haemofiltration: a pilot assessment.
To measure plasma nucleosome levels and expression of toll-like receptors (TLRs) in a pilot cohort of patients with severe acute kidney injury (AKI) within a randomised controlled trial of continuous venovenous haemofiltration with high cut-off filters (CVVH-HCO) v standard filters (CVVH-std). ⋯ Nucleosome concentration was elevated in the plasma of patients with severe AKI and mildly correlated with disease severity, but was not affected by treatment with CVVH-HCO or CVVH-std. Similarly, levels of TLR2 and TLR4 expression did not decrease over time during CVVHCrit HCO treatment.
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Patients with haematological malignancies are at risk of concomitant critical neurological events warranting intensive care unit admission. We aimed to examine the characteristics and outcomes of this patient population, as more knowledge could facilitate decision making on ICU admission and treatment. ⋯ Patients with a history of haematological malignancy presenting with a critical neurological event have comparable survival rates with other patients with a haematologic malignancy admitted to the ICU. Our findings suggest that restrictions in ICU care are not justified for this patient population.