Journal of critical care
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Journal of critical care · Oct 2014
Observational StudyImpact of serial measurements of lysophosphatidylcholine on 28-day mortality prediction in patients admitted to the intensive care unit with severe sepsis or septic shock.
The purpose of this study is to investigate the effect of serial lysophosphatidylcholine (LPC) measurement on 28-day mortality prediction in patients with severe sepsis or septic shock admitted to the medical intensive care unit (ICU). ⋯ Serial measurements of LPC help in the prediction of 28-day mortality in ICU patients with severe sepsis or septic shock.
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Journal of critical care · Oct 2014
An evaluation of the validity and potential utility of facial electromyelogram Responsiveness Index for sedation monitoring in critically ill patients.
The purpose of this study is to explore the validity of a novel sedation monitoring technology based on facial electromyelography (EMG) in sedated critically ill patients. ⋯ Responsiveness Index is not directly comparable with clinical sedation scores but is a potential continuous alert to possible deep sedation in critically ill patients.
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Journal of critical care · Oct 2014
Surveillance cultures in intensive care units: A nationwide survey on current practice providing future perspectives.
To explore the extent of surveillance culture (SC) implementation underlying motives for obtaining SC and decision making based on the results. ⋯ Surveillance culture implementation is common in Dutch ICUs to optimize individual patients' treatment. Consensus is lacking on how to deal with SC results when the focus of infection is not at the sampled site.
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Journal of critical care · Oct 2014
Drainage of pleural effusion in mechanically ventilated patients: Time to measure chest wall compliance?
Pleural effusion (PE) is commonly encountered in mechanically ventilated, critically ill patients and is generally addressed with evacuation or by fluid displacement using increased airway pressure (P(AW)). However, except when massive or infected, clear evidence is lacking to guide its management. The aim of this study was to investigate the effect of recruitment maneuvers and drainage of unilateral PE on respiratory mechanics, gas exchange, and lung volume. ⋯ Drainage of a moderate-sized effusion should not be routinely performed in unselected population of critically ill patients. We suggest that measurement of C(CW) may help in the decision-making process.
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Journal of critical care · Oct 2014
Observational StudyThe accuracy of Gram stain of respiratory specimens in excluding Staphylococcus aureus in ventilator-associated pneumonia.
To evaluate the Gram stain of deep tracheal aspirate as a tool to direct empiric antibiotic therapy, and more specifically as a tool to exclude the need for empiric antibiotic coverage against Staphylococcus aureus in ventilator-associated pneumonia (VAP). ⋯ Absence of gram-positive bacteria on Gram stain had a high negative predictive value. These data can be used to narrow the initial empiric antibiotic regimen and to avoid unnecessary exposure of patients to vancomycin and other antistaphyloccocal agents.