Journal of critical care
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Journal of critical care · Dec 2015
ReviewMechanistic similarities between trauma, atherosclerosis, and other inflammatory processes.
Most human diseases, including trauma, atherosclerosis, and malignancy, can be characterized by either an overexuberant inflammatory response or an inadequate immunologic response. As our understanding of the mechanisms underlying these inflammatory aberrations improves, so should our approach to the patient. ⋯ Trauma surgeons are uniquely positioned to usher in a new era of patient diagnostics and patient-directed therapies based on an understanding of the immune system's response to stimuli. These improvements are likely to affect not only trauma care but all aspects of medicine.
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Journal of critical care · Dec 2015
ReviewMagnesium status and magnesium therapy in critically ill patients: A systematic review.
Magnesium is frequently measured and administered in general intensive care unit patients. However, magnesium status, its association with outcomes, and therapeutic utility in such patients are unclear. We performed a systematic review of the relevant literature to define current knowledge in this field. ⋯ Total serum magnesium levels are generally used to estimate magnesium status in critical illness. Hypomagnesemia appears associated with greater risk of mortality, but the efficacy of magnesium administration is open to challenge.
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Journal of critical care · Dec 2015
Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure: a retrospective study.
Prone positioning (PP) improves oxygenation and outcome of patients with acute respiratory distress syndrome undergoing invasive ventilation. We evaluated feasibility and efficacy of PP in awake, non-intubated, spontaneously breathing patients with hypoxemic acute respiratory failure (ARF). ⋯ PP was feasible and improved oxygenation in non-intubated, spontaneously breathing patients with ARF.
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Journal of critical care · Dec 2015
ReviewPANCREATITIS OR NOT? - Elevated lipase and amylase in ICU patients.
Elevation in serum levels of pancreatic enzymes (Hyperamylasemia and/or Hyperlipasemia) can occur in any Intensive Care Unit (ICU) patient either as a result of true acute pancreatitis (AP) or as a reflection of a non-pancreatic disease. Although most patients may not have clinical pancreatitis, identifying true acute pancreatitis in the ICU setting may be critical in the presence of associated co-morbid conditions of the disease for which the patient is being managed. With neither amylase nor lipase being specific for pancreatitis, it is important for the clinician to be aware of different causes of hyperamylasemia and hyperlipasemia, especially when clinical diagnosis of pancreatitis is unclear. This review will focus on understanding different non-pancreatic conditions where there is elevation of pancreatitis enzymes and to identify true acute pancreatitis in critically ill patients without typical symptoms.
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Journal of critical care · Dec 2015
Multicenter Study Observational StudyPediatric Index of Mortality 2 as a predictor of death risk in children admitted to pediatric intensive care units in Latin America: A prospective, multicenter study.
The purpose of this study is to asses the performance of the Pediatric Index of Mortality 2 (PIM2) score in pediatric intensive care units (PICUs) in Latin America. ⋯ Pediatric Index of Mortality 2 showed good discrimination, but calibration was inadequate. To use PIM2 for monitoring PICU performance in Latin America, it might be necessary to recalibrate the score locally.