Journal of intensive care
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Journal of intensive care · Jan 2015
A model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest.
It has been recommended that all survivors of out-of-hospital cardiac arrest (OHCA) have immediate coronary angiography (CAG), even though it has been reported that half of the survivors have normal coronary arteries. Our aim was to develop a model which might identify those who have angiographically normal coronary arteries. Reliable prediction would reduce unnecessary CAG. ⋯ Survivors of OHCA who have no history of diabetes mellitus, who have no past history of ACS, and who present with no ST segment abnormalities may not require urgent/emergent CAG. Further studies are needed to guide clinicians in the determination of emergent cardiac catheterization following resuscitation of OHCA.
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Journal of intensive care · Jan 2015
Prospective evaluation of inappropriate unable-to-assess CAM-ICU documentations of critically ill adult patients.
Delirium occurs in the intensive care unit and identification is often performed using a validated assessment tool such as the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) patients. The CAM-ICU has three ratings: positive, negative, and unable to assess (UTA). Patients may often be assigned UTA when it is inappropriate given the level of sedation or medical condition. The purpose of this study is to evaluate the rate of inappropriate UTA CAM-ICU documentations. ⋯ Rates of inappropriate UTA CAM-ICU documentations may be significantly higher than reported in literature. Additional research is needed to identify an acceptable rate of inappropriate UTA CAM-ICU assessments and its clinical impact on delirium management.
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Journal of intensive care · Jan 2015
Eosinophil count at intensive care unit admission was not predictor of hospital mortality: results of a case control study.
Predicting mortality in the intensive care unit (ICU) is one of the biggest challenges in critical care medicine. Several studies have linked the presence of eosinopenia with adverse outcomes in different populations. ⋯ In our study, eosinophil count at ICU admission was not associated with increased hospital mortality. The larger increase in number of eosinophils observed during the first week of ICU stay in surviving patients deserves to be investigated further.
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Journal of intensive care · Jan 2015
Effectiveness of lower target temperature therapeutic hypothermia in post-cardiac arrest syndrome patients with a resuscitation interval of ≤30 min.
Therapeutic hypothermia (TH) is a standard strategy to reduce brain damage in post-cardiac arrest syndrome (PCAS) patients. However, it is unknown whether the target temperature should be adjusted for PCAS patients in different states. ⋯ PCAS patients with a resuscitation interval of <30 min may be candidates for TH with a target temperature of <34 °C.
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Journal of intensive care · Jan 2015
Effects of prehospital epinephrine administration on neurological outcomes in patients with out-of-hospital cardiac arrest.
To determine if the effects of epinephrine administration on the outcome of out-of-hospital cardiac arrest (OHCA), patients are associated with the duration of cardiopulmonary resuscitation (CPR) performed by Emergency Medical Service (EMS) personnel. ⋯ Epinephrine administration is associated with an increase of ROSC and with improvement in the neurological outcome on which EMSs' CPR duration is performed between 15 and 19 min.