Journal of critical care
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Journal of critical care · Jun 2011
Protein C as an early biomarker to distinguish pneumonia from sepsis.
Patients with pneumonia often are unrecognized as also having sepsis. We evaluated protein C, as a potential biomarker, to differentiate between patients with pneumonia and sepsis. ⋯ In this study, protein C levels performed well in differentiating between patients with sepsis or pneumonia in the early period after diagnosis.
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Journal of critical care · Jun 2011
Failure to achieve euglycemia despite aggressive insulin control signals abnormal physiologic response to trauma.
We hypothesize that a failure to normalize a patient's glucose on an automated euglycemia protocol signals an adverse response after trauma and that this response can identify patients with an increased mortality. ⋯ A posttraumatic patient's response to tight glycemic control revealed important prognostic information about the patients' physiologic status. Patients who failed to reach euglycemia in the first 6 hours of admission had an increased hospital mortality. The time to normalization is significantly longer in those patients who died. Patients who did not correct rapidly required significantly higher insulin doses, suggesting insulin resistance.
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Journal of critical care · Jun 2011
Albumin and C-reactive protein have prognostic significance in patients with community-acquired pneumonia.
This study aims to determine the association of commonly used biochemical markers, such as albumin and C-reactive protein (CRP), with mortality and the prognostic performance of these markers combined with the pneumonia severity index (PSI) for mortality and adverse outcomes in patients with community-acquired pneumonia (CAP). ⋯ Albumin and CRP were associated with 28-day mortality in hospitalized patients with CAP, and these markers increased prognostic performance when combined with the PSI scale.
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Journal of critical care · Jun 2011
N-terminal pro-brain natriuretic peptide as a marker of right ventricular dysfunction after open-lung approach in patients with acute lung injury/acute respiratory distress syndrome.
The purpose of the study was to evaluate the utility of N-terminal pro-brain natriuretic peptide (NT-proBNP) as a marker of right ventricular (RV) dysfunction after open-lung approach (OLA) in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). ⋯ In patients with ALI/ARDS, intraindividual NT-proBNP changes correlated with RV afterload following OLA, thereby serving as a potential marker for RV dysfunction after OLA.
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Journal of critical care · Jun 2011
Increased pulmonary artery systolic storage associated with improved ventilation-to-perfusion ratios in acute respiratory distress syndrome.
The possibility that the increased pulmonary artery systolic storage (PASS) correlates with an improved distribution of ventilation/perfusion (V(A)/Q) and hence benefits gas exchange in acute respiratory distress syndrome (ARDS) was examined. Pulmonary artery systolic storage is the fraction of stroke volume stored in PA during systole and then discharged to the capillaries. The increased PASS can augment the diastolic pulmonary capillary blood flow (PCBF), which can then increase capillary blood volume participating in gas diffusion. We examined this by assessing the correlation between PASS and physiologic dead space to tidal volume (VD/VT) ratio. ⋯ Our data indicate that the increased PASS correlates with an improved distribution of V(A)/Q and hence benefits gas exchange in ARDS.