Journal of critical care
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Journal of critical care · Jun 2011
The epidemiology of acute respiratory failure in hospitalized patients: a Brazilian prospective cohort study.
The purpose of this study was to assess risk factors associated with the development of acute respiratory failure (ARF) and death in a general intensive care unit (ICU). ⋯ Acute respiratory failure represents a large percentage of all ICU patients, and the high mortality is related to some preventable factors such as the time to ICU admission.
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Journal of critical care · Jun 2011
Multicenter StudyEarly changes of procalcitonin may advise about prognosis and appropriateness of antimicrobial therapy in sepsis.
The objective of this study is to define if early changes of procalcitonin (PCT) may inform about prognosis and appropriateness of administered therapy in sepsis. ⋯ Changes of serum PCT within the first 48 hours reflect the benefit or not of the administered antimicrobial therapy. Serial PCT measurements should be used in clinical practice to guide administration of appropriate antimicrobials.
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Journal of critical care · Jun 2011
Randomized Controlled TrialMild hypothermia therapy reduces blood glucose and lactate and improves neurologic outcomes in patients with severe traumatic brain injury.
The study aimed to investigate the association between blood glucose or lactate and the outcomes of severe traumatic brain injury (TBI), and to evaluate the effect of mild hypothermia therapy on glucose and lactate levels. ⋯ Hyperglycemia after TBI was associated with poor clinical outcomes, but the predictive value of blood lactate level requires further investigation. Hypothermia therapy improves neurologic outcomes in patients with severe TBI, and reduction in blood glucose may be partially responsible for the improved outcomes.
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Journal of critical care · Jun 2011
Costs and cost-effectiveness of a telemedicine intensive care unit program in 6 intensive care units in a large health care system.
The purpose of this study is to estimate the costs and cost-effectiveness of a telemedicine intensive care unit (ICU) (tele-ICU) program. ⋯ Hospital administrators may conclude that a tele-ICU program aimed at the sickest patients is cost-effective.
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Journal of critical care · Jun 2011
Survival and quality of life after tracheostomy for acute respiratory failure in patients with amyotrophic lateral sclerosis.
Acute respiratory failure (ARF) is a common event in the advanced stage of amyotrophic lateral sclerosis (ALS) and may be rarely a presenting symptom. Frequently, such patients require intubation and mechanical ventilation (MV) and, in a large proportion, receive tracheostomy, as a consequence of weaning failure. In our study, we investigated postdischarge survival and quality of life (QoL) after tracheostomy for ARF in patients with ALS. ⋯ Patients with ALS have a high chance of long-term survival after tracheostomy for ARF. Although administered at the time of a respiratory crisis without being discussed in advance, tracheostomy shows good acceptance and results in acceptable QoL.