Journal of critical care
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Journal of critical care · Oct 2013
High glucose variability increases cerebral infarction in patients with spontaneous subarachnoid hemorrhage.
High glucose variability is a significant marker for poor outcome in critically ill patients. We evaluated the impact of high glucose variability on cerebral infarction following spontaneous subarachnoid hemorrhage (SAH). ⋯ Glucose variability is a significant predictor of cerebral infarction in patients with severe spontaneous SAH.
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Journal of critical care · Oct 2013
Effect of acute endotoxemia on analog estimates of mean systemic pressure.
Dynamic estimates of mean systemic pressure based on a Guytonian analog model (Pmsa) appear accurate under baseline conditions but may not remain so during septic shock because blood volume distribution and resistances between arterial and venous beds may change. Thus, we examined the effect of acute endotoxemia on the ability of Pmsa, estimated from steady-state cardiac output, right atrial pressure, and mean arterial pressure, to reflect our previously validated instantaneous venous return measure of mean systemic pressure (Pmsi), derived from beat-to-beat measures of right ventricular stroke volume and right atrial pressure during positive pressure ventilation. We studied 6 splenectomized pentobarbital-anesthetized close chested dogs. ⋯ Cardiac output increased (2628±905 vs 3560±539 mL/min; P<.05) and mean arterial pressure decreased (107±16 vs 56±12 mm Hg; P<.01) during endo. Changes in Pmsi and Pmsa correlated during both control and endo (r2=0.7) with minimal bias by Bland-Altman analysis (mean difference±95% confidence interval, 0.47±5.04 mm Hg). We conclude that changes in Pmsa accurately tracts Pmsi under both control and endo.
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Journal of critical care · Oct 2013
Predictors of mortality in patients with stress-induced cardiomyopathy developed during critical care.
The aims of this study were to define predictors of in-hospital mortality and to explore the implication of Acute Physiology and Chronic Health Evaluation (APACHE) II score in patients with stress-induced cardiomyopathy (SCM) developed during critical care. ⋯ The in-hospital mortality in patients with SCM that developed during critical care was associated with underlying malignancy, male sex, old age, and APACHE II score.