Journal of critical care
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Journal of critical care · Oct 2015
Observational StudyAllogeneic hematopoietic stem cell transplantation after reduced intensity conditioning regimen: Outcomes of patients admitted to intensive care unit.
The prognosis of allogeneic hematopoietic stem cell transplantation (HSCT) patients admitted to the intensive care unit (ICU) is still poor. Overall, when these patients receive reduced intensity conditioning (RIC) regimens, the survival is better. To date, no study has specifically evaluated the outcome of RIC allogeneic HSCT admitted to the ICU. ⋯ From our study, short-term survival rates of ICU patients receiving RIC regimens justify a broad ICU admission policy. The use of IMV is associated with hospital mortality, whereas the use of NIV is frequently successful. Long-term outcome remains poor after ICU discharge.
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Journal of critical care · Oct 2015
Predialysis hypernatremia is a prognostic marker in acute kidney injury in need of renal replacement therapy.
The present study aimed to evaluate the prognostic impact of predialysis dysnatremia in patients with acute kidney injury requiring renal replacement therapy (RRT). ⋯ Almost 50% of patients with acute kidney injury in need of RRT in the ICU had mild or severe dysnatremia before dialysis initiation. Hypernatremia was the main sodium disturbance and independently associated with poor outcome in the study population.
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Journal of critical care · Oct 2015
Prospective analysis of cardiac collapsibility of inferior vena cava using ultrasonography.
The inferior vena cava (IVC) diameter and its respiratory change (respiratory variation) reportedly correlate well with the central venous pressure and response to fluid. However, changes in the IVC diameter are related to the cardiac rhythm (cardiac variation), which can be useful as an indicator for intravascular volume but can affect respiratory variation. We conducted a prospective analysis of this cardiac variation in adult emergency department patients. ⋯ The IVC cardiac variation affects our interpretation of ultrasonography IVC imaging. The IVC cardiac variation provides several advantages over other parameters of intravascular volume. Therefore, it can be a novel tool to assess the intravascular volume of the patients.
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Journal of critical care · Oct 2015
Faculty development for fellows: Developing and evaluating a broad-based career development course for critical care medicine trainees.
There is no defined training experience to teach the broad range of professional skills needed to transition from critical care trainee to practitioner. We hypothesized that a durable set of career development skills could be created for critical care medicine (CCM) trainees using a novel curriculum defined by both learners and content experts. ⋯ Teaching a broad range of career development skills can result in durable confidence when reinforced by regular use postgraduation. This course fills a critical care educational need, facilitating the transition to practitioner after CCM training.
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Journal of critical care · Oct 2015
A retrospective cohort study of age-based differences in the care of hospitalized patients with sudden clinical deterioration.
The proportion of elderly patients is increasing, but it is unknown if there are age-based differences in care of hospitalized patients with sudden clinical deterioration. We sought to examine the relation between patient age and care for hospitalized patients experiencing sudden clinical deterioration. ⋯ Patient age is associated with care for hospitalized patients with sudden clinical deterioration, suggesting that strategies to guide care of elderly patients during MET activation may be beneficial.