Journal of critical care
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Journal of critical care · Apr 2014
ReviewA systematic review of goal directed fluid therapy: Rating of evidence for goals and monitoring methods.
To review the literature on goal directed fluid therapy and evaluate the quality of evidence for each combination of goal and monitoring method. ⋯ This review has highlighted the plethora of goals and methods for monitoring fluid therapy. Strikingly, there is scant high quality evidence, in particular for non-invasive G/M combinations in non-operative and non-intensive care settings. There is an urgent need to address this research gap, which will be helped by methodologies to compare utility of G/M combinations.
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Journal of critical care · Apr 2014
Multicenter StudyWhat stops us from following sedation recommendations in intensive care units? A multicentric qualitative study.
The purpose of the study is to explore health care professionals' (HCPs) perceptions regarding sedation recommendations. ⋯ Barriers impairing implementation of sedation recommendations vary according to the type of HCP and the choice of strategy targeting light sedation (protocolized sedation vs DSI). Improvement strategies must target HCPs separately and tailored to specific recommendation choices.
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Journal of critical care · Apr 2014
Serum thiamine concentration and oxidative stress as predictors of mortality in patients with septic shock.
The purpose of the study is to determine the influence of serum thiamine, glutathione peroxidase (GPx) activity, and serum protein carbonyl concentrations in hospital mortality in patients with septic shock. ⋯ In patients with septic shock, oxidative stress was associated with mortality. On the other hand, thiamine was not associated with oxidative stress or mortality in these patients.
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Journal of critical care · Apr 2014
Hypoglycemia is associated with increased mortality in patients with acute decompensated liver cirrhosis.
The liver plays an important role in glucose metabolism, in terms of glucolysis and gluconeogenesis. Several studies have shown that hyperglycemia in patients with liver cirrhosis is associated with progression of the liver disease and increased mortality. However, no study has ever targeted the influence of hypoglycemia. The aim of this study was to assess the association of glucose disturbances with outcome in patients presenting to the emergency department with acute decompensated liver cirrhosis. ⋯ Hypoglycemia is associated with increased mortality in patients with acute decompensated liver cirrhosis. It is not yet clear whether hypoglycemia is jointly responsible for the increased short-term mortality of patients with acute decompensated liver cirrhosis or is only a consequence of the severity of the disease or the complications.
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Journal of critical care · Apr 2014
Severe acidosis does not predict fatal outcomes in intensive care unit patients: A retrospective analysis.
Severe acidosis is a potentially life-threatening acid-base imbalance. The outcome of patients with severe acidosis has only been anecdotally described. We therefore assessed the discharge rate of such patients from the intensive care unit (ICU) and survival time after the event. ⋯ A significant number of patients can outlast severe acidosis and return to their prehospitalization status. Larger studies are needed to define the patient population most likely to benefit from aggressive resuscitation efforts during severe acidosis.