Journal of critical care
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Journal of critical care · Oct 2013
Serum concentrations of A Proliferation-Inducing Ligand (APRIL) are elevated in sepsis and predict mortality in critically ill patients.
Inflammatory and autoimmune diseases have been associated with the tumor necrosis factor superfamily member "A PRoliferation Inducing Ligand" (APRIL). However, up to now, APRIL has not been investigated in critical illness or sepsis. We therefore analyzed APRIL serum concentrations in a large cohort of well-characterized intensive care unit patients. ⋯ Serum levels of APRIL were significantly elevated in intensive care unit patients, with the highest concentrations in septic patients, and associated with unfavorable outcome. Besides being used as a single marker, APRIL may be implemented into established scoring systems to further improve their sensitivity and specificity in predicting patient's prognosis.
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Journal of critical care · Oct 2013
ReviewReporting the methodology of height and weight acquisition in studies of body mass index-based prognosis in critically ill patients.
Conflicting findings were reported on the body mass index (BMI)-based prognosis of critically patients. Errors in source weight and height data can confound BMI group allocation. The aim of the present work was to examine investigators' reporting on the methods of height and weight acquisition (HWA). ⋯ These findings demonstrate the prevalent risk for BMI group misallocation in the reviewed studies, which may confound BMI-based prognosis, raising concerns about the validity of reported BMI-related prognostic impact.
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Journal of critical care · Oct 2013
Development and validation of a novel fusion algorithm for continuous, accurate, and automated R-wave detection and calculation of signal-derived metrics.
Previous studies have shown that heart rate complexity may be a useful indicator of patient status in the critical care environment but will require continuous, accurate, and automated R-wave detection (RWD) in the electrocardiogram (ECG). Although numerous RWD algorithms exist, accurate detection remains a challenge. The purpose of this study was to develop and validate a novel fusion algorithm (Automated Electrocardiogram Selection of Peaks, or AESOP) that combines the strengths of several well-known algorithms to provide a more reliable real-time solution to the RWD problem. ⋯ By fusing several best algorithms, AESOP uses the strengths of each algorithm to perform more robustly and reliably in real time. The AESOP algorithm will be integrated into a real-time heart rate complexity software program for decision support and triage in critically ill patients.
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Journal of critical care · Oct 2013
Endotoxin activity levels as a prediction tool for risk of deterioration in patients with sepsis not admitted to the intensive care unit: A pilot observational study.
The aim of this prospective observational study was to evaluate in patients with sepsis not requiring intensive care unit admission the relationship between the levels of endotoxin activity assay (EAA) early after sepsis recognition and the risk of development of organ dysfunction (OD). ⋯ Endotoxin activity assay levels 0.60 or greater early after sepsis diagnosis in patients not requiring intensive care unit admission predict risk of development of new organ dysfunction. High EAA levels in the first 48 hours of recognition of sepsis are also predictive of risk of deterioration.
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Journal of critical care · Oct 2013
Critical illness is associated with decreased plasma levels of coenzyme Q10: A cross-sectional study.
Plasma coenzyme Q10 (CoQ10) levels are lower in patients with septic shock (SS) than in healthy controls (HCs). However, CoQ10 status in critically ill patients without SS is unknown. Here, we investigated CoQ10 concentrations in patients with SS and without SS as compared with HCs. ⋯ Decreased plasma CoQ10 levels are not specific to patients with SS, but rather observed in a broad range of critically ill patients. In critically ill patients, CoQ10 insufficiency may be associated with various conditions; age may be a risk factor.