Journal of critical care
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Journal of critical care · Apr 2011
Validation of the Intensive Care Delirium Screening Checklist in nonintubated intensive care unit patients in a resource-poor medical intensive care setting in South India.
Delirium is a common, difficult-to-diagnose clinical condition in critical care units. The lack of recognition of delirium often results in increased morbidity and mortality. The study aimed to determine the validity and reliability of the Intensive Care Delirium Screening Checklist (ICDSC) in a resource-poor medical intensive care setting in South India. ⋯ Our findings indicate that in nonintubated intensive care unit patients, the ICDSC can be used to screen for delirium but should not be used as a diagnostic instrument in this patient population and that residents can be trained in the use of the instrument in resource-poor critical care settings. Using a different threshold for positivity of 3 rather than 4 appeared to offer improved screening characteristics in this resource-poor critical care setting.
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Journal of critical care · Apr 2011
Procalcitonin levels are lower in intensive care unit patients with H1N1 influenza A virus pneumonia than in those with community-acquired bacterial pneumonia. A pilot study.
The purpose of the study was to know the kinetics of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) in critically ill patients with H1N1 influenza A virus pneumonia and to compare levels of these inflammatory mediators with patients with acute community-acquired bacterial pneumonia. ⋯ Among patients admitted to the ICU with pneumonia, the PCT level could help identify H1N1 influenza A virus pneumonia and thus enable earlier antiviral therapy.
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Journal of critical care · Apr 2011
Multicenter StudyA prediction survival model for out-of-hospital cardiopulmonary resuscitations.
The aims of this study were to double check old (Resuscitation Predictor Scoring [RPS], Advanced Cardiac Life Support, and Early Prediction Score [EPS]) and form new (Serbian Quality of Life immediately [SR-QOLi], Serbian Quality of Life short-term [SR-QOLs], and Serbian Quality of Life long-term [SR-QOLl]) scores for survival prediction in out-of-hospital cardiopulmonary resuscitation (OHCPR) in Serbia. ⋯ In the course of the research, SR-QOL models were created for prediction of the immediate (SR-QOLi), short-term (SR-QOLs), and long-term (SR-QOLl) survival after the OHCPR, better predictions in our environment.
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Journal of critical care · Apr 2011
Global end-diastolic volume, serum osmolarity, and albumin are risk factors for increased extravascular lung water.
The transpulmonary thermodilution technique allows the determination of cardiac preload (global end-diastolic volume index) and quantification of pulmonary edema (extravascular lung water index [EVLWI]). Pulmonary edema commonly develops in critically ill patients; however, the underlying pathophysiology, that is, hydrostatic (cardiac) or permeability-induced (noncardiac), often remains unclear. In this study, hemodynamic and serum parameters of osmolarity and oncotic pressure were analyzed to identify risk factors for increased EVLWI. ⋯ Hypervolemia, hypoalbuminemia, and high plasma osmolarity are associated with increased EVLWI.
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Journal of critical care · Apr 2011
Serum adiponectin upon admission to the intensive care unit may predict mortality in critically ill patients.
Adiponectin has been proposed as an important regulator of glucose metabolism influencing obesity and insulin resistance, which are important risk factors for the outcome of critically ill patients. Moreover, experimental models of inflammation suggest protective anti-inflammatory properties of adiponectin. We therefore investigated the potential pathogenic role and prognostic value of circulating adiponectin levels in critical illness. ⋯ Although serum concentrations did not differ in critically ill patients from controls, low adiponectin levels at admission to ICU have been identified as an independent predictor of survival.