Journal of critical care
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Journal of critical care · Feb 2015
Observational StudySympathoadrenal activation and endothelial damage in patients with varying degrees of acute infectious disease: An observational study.
To investigate levels, associations between, and predictive value of plasma catecholamines and biomarkers of endothelial damage in patients with acute infectious illness stratified according to infection type and sepsis severity. ⋯ Biomarkers of endothelial glycocalyx and cell damage increased with increasing acute infectious disease severity, correlated with SOFA score, and predicted mortality together with plasma noradrenaline. Sympathoadrenal activation and endothelial damage are linked to disease pathology also in less sick patients.
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Journal of critical care · Feb 2015
A pilot assessment of alpha-stat vs pH-stat arterial blood gas analysis after cardiac arrest.
Resuscitated cardiac arrest (CA) patients typically receive therapeutic hypothermia, but arterial blood gases (ABGs) are often assessed after adjustment to 37°C (alpha-stat) instead of actual body temperature (pH-stat). We sought to compare alpha-stat and pH-stat assessment of PaO2 and PaCO2 in such patients. ⋯ Using the pH-stat method, fewer resuscitated CA patients admitted to intensive care unit were classified as hyperoxemic or hypercapnic compared with alpha-stat. These findings suggest an impact of ABG assessment methodology on PaO2, PaCO2 , and patient classification but not on associated outcomes.
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Journal of critical care · Feb 2015
Comparative StudyDynamic changes of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 after burn injury.
Severe burn is a life-threatening condition. Many trials discuss the role of matrix metalloproteinases and tissue inhibitor of metalloproteinases in diseases generating systemic inflammatory response syndrome, and in some, their prognostic importance has been established. We aimed to describe the time courses of the aforementioned system and to evaluate the difference between survivors and nonsurvivors in burns. ⋯ Our research is the first follow-up study elucidating the dynamic changes of MMP-9-TIMP-1 system in severe burns. Alteration of MMP-9-TIMP-1 balance might influence systemic inflammatory response and related mortality. Matrix metalloproteinase 9 might be a good injury marker in burns after an extensive trial.
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Journal of critical care · Feb 2015
Relation between peak and integral of the diaphragm electromyographic activity at different levels of support during weaning from mechanical ventilation: A physiologic study.
To investigate the relationship between peak (EAdipeak) and area under the curve (EAdiAUC) of diaphragm electrical activity, and to evaluate the validity of their ratio (P/I index) as a measure of the imbalance between drive and sustainability of effort demand at different support levels. ⋯ The relationship between EAdipeak and EAdiAUC and the P/I index may give important information on the balance between respiratory drive and inspiratory demand sustainability.
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Journal of critical care · Feb 2015
Low-dose recombinant factor VIIa for reversing coagulopathy in patients with isolated traumatic brain injury.
The purpose of this study was to investigate the role of low-dose recombinant factor VIIa (rFVIIa) (20 μg/kg) in reversing coagulopathy in patients with isolated traumatic brain injury (TBI). ⋯ The use of low-dose rFVIIa (20 μg/kg) is effective for correcting coagulopathy in patients with TBI without an increase in thromboembolic events. Moreover, it is more effective for preventing the occurrence of PHI.