Journal of critical care
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Journal of critical care · Oct 2012
ReviewFever in non-neurological critically ill patients: a systematic review of observational studies.
There is no recommendation on how increased body temperature should be treated in non-neurological critically ill patients. To understand the epidemiology of fever and its association with mortality, we conducted a systematic review of the literature to search for data related to the association between fever and mortality. ⋯ The limited evidence available suggests that the recommended definition of fever (38.3°C) might be too low to predict increased mortality. Because fever is common in the intensive care unit, there is an urgent need for more studies in this field.
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Journal of critical care · Oct 2012
Impact of pattern of admission on outcomes after aneurysmal subarachnoid hemorrhage.
Patients with aneurysmal subarachnoid hemorrhage (aSAH) require management in centers with neurosurgical expertise necessitating emergent interhospital transfer (IHT). Our objective was to compare outcomes in aSAH IHTs to our institution with aSAH admissions from our institutional emergency department (ED). ⋯ Our institutional ED SAH admissions had significantly better outcomes than did IHTs, suggesting that delays in optimizing care before transfer could deleteriously impact outcomes.
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Journal of critical care · Oct 2012
Failure to reduce C-reactive protein levels more than 25% in the last 24 hours before intensive care unit discharge predicts higher in-hospital mortality: a cohort study.
To discharge a patient from the intensive care unit (ICU) is a complex decision-making process because in-hospital mortality after critical illness may be as high as up to 27%. Static C-reactive protein (CRP) values have been previously evaluated as a predictor of post-ICU mortality with conflicting results. Therefore, we evaluated the CRP ratio in the last 24 hours before ICU discharge as a predictor of in-hospital outcomes. ⋯ In this large cohort of critically ill patients, failure to reduce CRP values more than 25% in the last 24 hours of ICU stay is a strong predictor of worse in-hospital outcomes.
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Journal of critical care · Oct 2012
A method for estimation of plasma albumin concentration from the buffering properties of whole blood.
Hypoalbuminemia is strongly associated with poor clinical outcome. Albumin is usually measured at the central laboratory rather than point of care, but in principle, information exists in the buffering properties of whole blood to estimate plasma albumin concentration from point of care measurements of acid-base and oxygenation status. This article presents and evaluates a new method for doing so. ⋯ This new method may be a valuable tool in screening and monitoring plasma albumin concentration in acutely ill patients, from measurements taken at the point of care.
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Journal of critical care · Oct 2012
Plasma levels of oxidative stress biomarkers and hospital mortality in severe head injury: a multivariate analysis.
The association between biomarkers of oxidative stress and the prognosis of patients with traumatic brain injury (TBI) remains inconclusive. ⋯ Plasma levels of TBARS and carbonyl increase significantly in the first 70 hours after severe TBI but are not independently associated with the hospital mortality.