Journal of critical care
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Journal of critical care · Feb 2014
Meta AnalysisA meta-analysis of continuous vs intermittent infusion of loop diuretics in hospitalized patients.
Several studies have examined the potential benefits of continuous vs intermittent (bolus) intravenous loop diuretic administration in hospitalized patients with conflicting results. We conducted a meta-analysis to compare the efficacy of these 2 strategies in hospitalized adults and children with extracellular fluid volume expansion. ⋯ Continuous infusion of loop diuretics preceded by a loading dose results in greater diuresis in hospitalized adults with extracellular fluid volume expansion compared with intermittent dosing regimens. Further studies are required to examine whether these benefits translate into improved clinical outcomes.
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Journal of critical care · Feb 2014
Diabetes mellitus and community-acquired bloodstream infections in the critically ill.
Community-acquired bloodstream infections have not been studied related to diabetes mellitus in the critically ill. ⋯ A diagnosis of diabetes mellitus and HbA1c of 6.5% or higher is associated with the risk of CA-BSI in the critically ill.
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Journal of critical care · Feb 2014
Predictors of extraventricular drain-associated bacterial ventriculitis.
Bacterial ventriculitis (BV) may develop in patients requiring external ventricular drains (EVDs). The purpose of this study was to determine predictors of EVD-associated BV onset. ⋯ An association exists between CSF sampling frequency and the development of EVD-associated BV. Larger prospective studies should be aimed at identifying causal relationships between these variables.
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Journal of critical care · Feb 2014
Does high-dose vasopressor therapy in medical intensive care patients indicate what we already suspect?
This study was conducted to determine the association between vasopressor requirement and outcome in medical intensive care patients in an environment where treatment is not withdrawn. ⋯ The requirement for high-dose vasopressor therapy at any time during ICU admission was associated with a very high mortality rate in the ICU and the hospital.
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Journal of critical care · Feb 2014
Auditory-evoked potentials during coma: Do they improve our prediction of awakening in comatose patients?
The mismatch negativity (MMN), an auditory event-related potential, has been identified as a good indicator of recovery of consciousness during coma. We explored the predictive value of the MMN and other auditory-evoked potentials including brainstem and middle-latency potentials for predicting awakening in comatose patients after cardiac arrest or cardiogenic shock. ⋯ The MMN is a good predictor of awakening in comatose patients after cardiac arrest and cardiogenic shock and can be measured days before awakening encouraging ongoing life support.