Journal of critical care
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Journal of critical care · Aug 2013
Multicenter StudyMortality and complications in elderly patients undergoing cardiac surgery.
The purpose of the study was to analyze postoperative complications, mortality, and related factors of elderly patients undergoing cardiac surgery. ⋯ Age more than 75 years is an independent risk factor for ICU mortality when adjusted for EuroSCORE and cardiopulmonary bypass time. Elderly patients also have a higher rate of complications during ICU stay. Elderly patients develop MODS more frequently and present a higher mortality rate than younger patients with MODS.
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Journal of critical care · Aug 2013
Multicenter StudySevere abnormalities in microvascular perfused vessel density are associated to organ dysfunctions and mortality and can be predicted by hyperlactatemia and norepinephrine requirements in septic shock patients.
The aims of this study are to determine the general relationship of perfused vessel density (PVD) to mortality and organ dysfunctions and to explore if patients in the lowest quartile of distribution for this parameter present a higher risk of bad outcome and to identify systemic hemodynamic and perfusion variables that enhances the probability of finding a severe underlying microvascular dysfunction. ⋯ Perfused vessel density is significantly related to organ dysfunctions and mortality in septic shock patients, particularly in patients exhibiting more severe abnormalities as represented by the lowest quartile of distribution for this parameter. The presence of hyperlactatemia and high norepinephrine requirements increases the odds of finding a severe underlying microvascular dysfunction during a sublingual microcirculatory assessment.
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Journal of critical care · Aug 2013
Multicenter StudyRapid response teams, do not resuscitate orders, and potential opportunities to improve end-of-life care: a multicentre retrospective study.
Rapid response teams (RRTs) were created to stabilize acutely ill patients on the ward, but recent studies suggest that RRTs may improve end-of-life care (EOLC). To learn more about the role of the RRT in EOLC at our institutions, we conducted a retrospective review. ⋯ RRT consultation is an important milestone for many patients approaching EOL. RRTs frequently participate in EOL discussions and decision-making, but they may miss opportunities to facilitate EOLC.
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Journal of critical care · Aug 2013
Multicenter StudyPediatric upper airway obstruction: interobserver variability is the road to perdition.
The purposes of the study are to determine the interobserver variability in the clinical assessment of pediatric upper airway obstruction (UAO) and to explore how variability in assessment of UAO may contribute to risk factors and incidence of postextubation UAO. ⋯ Physical findings routinely used for UAO have poor interobserver reliability among bedside providers. This variability may contribute to inconsistent findings regarding incidence, risk factors, and therapies for postextubation UAO.
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Journal of critical care · Aug 2013
Multicenter StudyLength of stay and mortality due to Clostridium difficile infection acquired in the intensive care unit.
The purpose of this study was to determine the attributable intensive care unit (ICU) and hospital length of stay and mortality of ICU-acquired Clostridium difficile infection (CDI). ⋯ C difficile infection acquired in ICU is associated with an increase in length of ICU and hospital stay but not with any difference in ICU or hospital mortality.