Journal of critical care
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Journal of critical care · Oct 2013
Prevention of contrast-induced nephropathy by N-acetylcysteine in critically ill patients: Different definitions, different results.
The use of N-acetylcysteine (NAC) for preventing contrast induced nephropathy (CIN) is debated in the intensive care unit. NAC may alter the concentration of serum creatinine and interfere with CIN diagnosis. The effectiveness of NAC was evaluated with a special attention on its specific effect on creatinine levels compared to cystatin C. ⋯ The incidence of CIN does not seem to be influenced by NAC, except if small changes in creatinine only are considered.
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Journal of critical care · Oct 2013
Predictive value of elevated cystatin C in patients undergoing primary angioplasty for ST-elevation myocardial infarction.
The prognostic value of cystatin C (CysC) has been documented in patients with acute coronary syndrome without ST-segment elevation. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the prognostic value of CysC in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). ⋯ These results suggest that a high admission CysC level was associated with increased in-hospital and one-month cardiovascular mortality in patients with STEMI undergoing primary PCI.
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Mechanical ventilation (MV) predisposes patients to numerous complications, which increases with longer durations of treatment. Identifying individuals more likely to require prolonged MV (PMV) may alter ventilation strategies or potentially minimize the duration of therapy and its associated complications. Our aim was to identify clinical variables at the time of intubation that could identify individuals who will require PMV. ⋯ The novel predictive model, using Intubation in the ICU, Tachycardia, Renal dysfunction, Acidemia, elevated Creatinine, and a decreased HCO3, was highly specific in identifying patients who subsequently required PMV support and performed better than Acute Physiology Age Chronic Health Evaluation III.
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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.