Journal of critical care
-
Journal of critical care · Aug 2014
Multicenter StudyEffects of etomidate on vasopressor use in patients with sepsis or severe sepsis: A propensity-matched analysis.
The safety of single-bolus etomidate to facilitate intubation in septic patients is controversial due to its potential to suppress adrenal steroidogenesis. The purpose of this study was to evaluate the effects of etomidate on the development of shock when used as an induction agent to facilitate intubation in septic patients. ⋯ The use of etomidate for intubation in septic patients did not increase vasopressor requirements within 72 hours after intubation.
-
Journal of critical care · Aug 2014
The ability of current scoring systems in differentiating transient and persistent organ failure in patients with acute pancreatitis.
The purpose of this study is to investigate the accuracy of currently used scoring systems in differentiating transient and persistent organ failure in patients with acute pancreatitis (AP). ⋯ Current scoring systems are not accurate enough in differentiating transient and persistent organ failure in patients with AP.
-
Journal of critical care · Aug 2014
The cost-effectiveness ratio of a managed protocol for severe sepsis.
Severe sepsis is a time-dependent disease, and implementation of early treatment has been associated with mortality rate reduction. However, the literature is controversial regarding cost-effectiveness analysis of this intervention. The aim was to assess the cost-effectiveness of a managed protocol for the treatment of severe sepsis. ⋯ Given that the incremental cost was lower than or equal to zero, the effectiveness of the protocol was justified by the significant increase in the life-years saved and the reduced mortality.
-
Journal of critical care · Aug 2014
Prognostic factors in critically ill cancer patients admitted to the intensive care unit.
The objective of this study is to identify factors predicting intensive care unit (ICU) mortality in cancer patients admitted to a medical ICU. ⋯ Intensive care unit mortality rate was 55% in our cancer patients, which suggests that patients with cancer can benefit from ICU admission. We also found that ICU mortality rates of patients with hematological malignancies and solid tumors were similar.
-
Journal of critical care · Aug 2014
Controlling mechanical ventilation in acute respiratory distress syndrome with fuzzy logic.
The current ventilatory care goal for acute respiratory distress syndrome (ARDS) and the only evidence-based approach for managing ARDS is to ventilate with a tidal volume (VT) of 6 mL/kg predicted body weight (PBW). However, it is not uncommon for some caregivers to feel inclined to deviate from this strategy for one reason or another. To accommodate this inclination in a rationalized manner, we previously developed an algorithm that allows for VT to depart from 6 mL/kg PBW based on physiological criteria. The goal of the present study was to test the feasibility of this algorithm in a small retrospective study. ⋯ Within the limits imposed by a small retrospective study, we conclude that our fuzzy logic algorithm makes sensible decisions while at the same time keeping practice close to the current ventilatory care goal.