Journal of critical care
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Journal of critical care · Jun 2014
Randomized Controlled Trial Multicenter StudyHeparin-induced thrombocytopenia in the critically ill: Interpreting the 4Ts test in a randomized trial.
Thrombocytopenia occurs in 20% to 45% of critically ill medical-surgical patients. The 4Ts heparin-induced thrombocytopenia (HIT) score (with 4 domains: Thrombocytopenia, Timing of thrombocytopenia, Thrombosis and oTher reason[s] for thrombocytopenia) might reliably identify patients at low risk for HIT. Interobserver agreement on 4Ts scoring is uncertain in this setting. ⋯ Real-time 4Ts scoring by research coordinators at the time of testing for HIT was not consistent with 4Ts scores obtained by central adjudicators. The results of this comprehensive HIT testing highlight the need for further research to improve the assessment of PTP scoring of HIT for critically ill patients.
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Journal of critical care · Jun 2014
Duration of red blood cells storage and outcome in critically ill patients.
There is conflicting evidence on the effect of red blood cells (RBC) storage duration and clinical outcomes. We aimed to investigate the association between RBC storage duration and clinical outcomes in patients admitted to the intensive care unit (ICU). ⋯ RBC storage duration was not associated with increased mortality nor ICU and hospital LOS. These results support the view that the effect of RBC storage duration on outcomes in critically ill patients is uncertain.
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Journal of critical care · Jun 2014
Observational StudySafety of physical therapy interventions in critically ill patients: A single-center prospective evaluation of 1110 intensive care unit admissions.
Critical illness survivors commonly have impaired physical functioning. Physical therapy interventions delivered in the intensive care unit can reduce these impairments, but the safety of such interventions within routine clinical practice requires greater investigation. ⋯ In this large, single-center study, routine care physical therapy interventions were safe for critically ill patients.
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Journal of critical care · Jun 2014
Normal saline to dilute parenteral drugs and to keep catheters open is a major and preventable source of hypernatremia acquired in the intensive care unit.
We wanted to identify modifiable risk factors for intensive care unit (ICU)-acquired hypernatremia. ⋯ High sodium input by 0.9% saline used to dilute drugs and keep catheters open is a modifiable risk factor for ICU-acquired H. Dissolving drugs in dextrose 5% may partially prevent potentially harmful sodium overloading and H.
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Journal of critical care · Jun 2014
Acute bacterial meningitis in the intensive care unit and risk factors for adverse clinical outcomes: Retrospective study.
Bacterial meningitis constitutes a medical emergency. Its burden has driven from childhood to the elderly and the immunocompromised population. However, the admission of patients with bacterial meningitis to the intensive care unit (ICU) has been sparsely approached, as have the prognostic factors associated with an adverse clinical outcome. ⋯ Patients with acute bacterial meningitis admitted to ICU had substantial morbidity and mortality. Those with low GCS or absence of fever have a particularly high risk of an adverse outcome.