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
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.
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Journal of critical care · Feb 2015
Continuous electroencephalogram patterns are suggestive of eventual neurologic outcomes in post-cardiac arrest patients treated with therapeutic hypothermia.
Therapeutic hypothermia (TH) after cardiac arrest (CA) resuscitation is the first therapy proven to increase survival to discharge and neurologic recovery. Methods for neurologic and mortality prognostication after CA resuscitation have been called into question because they were developed based on evidence that was developed prior to the advent of TH. This study examines the relationship between electroencephalogram (EEG) patterns and mortality and neurologic outcomes in post-CA patients undergoing TH. ⋯ The use of cEEG can provide prognostication information otherwise not obtainable by clinical examination. Specific cEEG patterns predicted probability of mortality for patients according to their initial rhythm of CA as a function of cardiopulmonary resuscitation time.
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Journal of critical care · Feb 2015
Predictive value of plasma biomarkers for mortality and organ failure development in patients with acute respiratory distress syndrome.
To evaluate the predictive value of 6 different biomarkers in the development of multiple-organ failure (MOF) and mortality in a contemporary prospective cohort of acute respiratory distress syndrome (ARDS). ⋯ Addition of biomarkers did not improve mortality prediction in this cohort of ARDS. Association between elevated interleukin 8 levels and progression of organ failures suggests an important role of exaggerated inflammatory response in the development of MOF.
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Journal of critical care · Feb 2015
The role of noninvasive positive pressure ventilation in community-acquired pneumonia.
Despite the increasing use of noninvasive positive pressure ventilation (NIV) in the treatment of critically ill patients with respiratory failure, its role in the treatment of severe community-acquired pneumonia (CAP) is controversial. The aim of this study was to assess the use of NIV in patients with CAP requiring ventilation who are admitted an intensive care unit. ⋯ Noninvasive pressure ventilation is frequently used in CAP but is associated with high failure rates. Mortality was not improved in the group of patients who received NIV as first-line therapy despite clinical characteristics that might have suggested a more favorable prognosis. Given the high rates of NIV use, high failure rates, and the hypothesis generating nature of the data in this study, further randomized studies are needed to better delineate the role of NIV in CAP.