Journal of critical care
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Journal of critical care · Jun 2012
Incidence, morbidity, and mortality of contrast-induced acute kidney injury in a surgical intensive care unit: a prospective cohort study.
Data on contrast-induced acute kidney injury (CI-AKI) in intensive care unit (ICU) are scarce and controversial. The objectives of the study were to evaluate the incidence and characteristics of CI-AKI in a surgical ICU. ⋯ These results show that CI-AKI is not inconsequential in critically ill patients. In the present study, AKIN criteria appear to be most relevant to define CI-AKI. Further studies are required to explore CI-AKI prevention in ICU.
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Journal of critical care · Jun 2012
Use of an abnormal laboratory value-drug combination alert to detect drug-induced thrombocytopenia in critically Ill patients.
The aim of this study was to assess the performance of a commercially available clinical decision support system (CDSS) drug-laboratory result alert in detecting drug-induced thrombocytopenia in critically ill patients. ⋯ A commercial CDSS drug-laboratory alert is effective at identifying drug-induced thrombocytopenia in the intensive care unit and may improve patient safety. Compared with previous studies, the combination alert performs better than alerts based exclusively on laboratory values and should be considered to reduce alert fatigue.
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Journal of critical care · Jun 2012
Spontaneous breathing trial needs to be prolonged in critically ill and older patients requiring mechanical ventilation.
To investigate a modified weaning procedure to predict extubation outcome in critically older and ventilated patients. ⋯ For critically older and ventilated patients, a prolonged SBT in conjunction with evolution of the RSBI ratio over baseline during SBT may serve as a useful procedure to predict extubation outcome.
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Journal of critical care · Jun 2012
Regional lung opening and closing pressures in patients with acute lung injury.
In acute lung injury (ALI), the application of positive end-expiratory pressure (PEEP) is known to prevent the alveoli from cyclic collapse and reopening and to homogenize ventilation. The setting of adequate PEEP could be optimized by the knowledge of regional lung opening and closing pressures at the bedside. The aim of our study was to determine regional opening and closing pressures in ventilated patients by electrical impedance tomography (EIT). ⋯ Regional lung opening and closing pressures can be assessed by EIT. This information may facilitate the setting of adequate PEEP levels in patients in future.