Journal of critical care
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Journal of critical care · Aug 2015
Weaning critically ill patients from mechanical ventilation: A prospective cohort study.
A proposal was made at the International Consensus Conference to classify weaning of patients in intensive care units from mechanical ventilation into simple, difficult, and prolonged weaning groups based on the difficulty and length of the weaning process. The objective of the present study was to determine the incidence and outcome of weaning according to these new categories. ⋯ Patients who experienced prolonged weaning had significantly higher mortality rates than patients who experienced either simple or difficult weaning. A lower Glasgow Coma Scale score and hypercapnia at the beginning of the weaning process were independent risk factors for prolonged weaning.
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Journal of critical care · Aug 2015
Development and validation of a clinical prediction rule for candidemia in hospitalized patients with severe sepsis and septic shock.
To develop and internally validate a prediction rule for the presence of candidemia in patients with severe sepsis and septic shock (candidemia rule) that will fill the gap left by previous rules. To compare the accuracy of the available Candida prediction models. ⋯ We developed and internally validated a prediction rule for candidemia in hospitalized patients with severe sepsis and septic shock that outperformed previous prediction rules. Our study suggests that locally derived prediction models may be superior by accounting for local case mix and risk factor distribution.
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Journal of critical care · Aug 2015
Observational StudyRisk factors for fluconazole-resistant invasive candidiasis in intensive care unit patients: An analysis from the China Survey of Candidiasis study.
To assess the risk factors for invasive Candida infection (ICI) caused by fluconazole-resistant (Flu-R) Candida species in intensive care unit (ICU) patients. ⋯ As many as 41% of ICI patients were infected with Flu-R Candida, and the main risk factor was longer ICU stay before onset of ICI, implying that caution should be exercised when treating patients who have been long stayed in ICU with fluconazole as the first-line drug before testing isolates for drug sensitivity.
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Journal of critical care · Aug 2015
Neutrophil-to-lymphocyte ratio: A novel and simple prognostic marker for infective endocarditis.
Infective endocarditis is a life-threatining infectious disease characterized by high morbidity and mortality. Leukocytes play a main role in infectious diseases. Neutrophils and lymphocytes are subgroup of leukocytes, and they are routinely measured as a part of automated complete blood count test. The neutrophil-to-lymphocyte ratio is an independent predictor of unfavorable clinical outcomes in infectious and cardiovascular diseases.
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Journal of critical care · Aug 2015
Implications of atypical antipsychotic prescribing in the intensive care unit.
The purpose of the study was to determine the downstream implications of atypical antipsychotic (AAP) prescribing in the intensive care unit (ICU), including discharge prescribing practices, monitoring, and attributable adverse drug events. ⋯ Because of significant patient-centered implications, AAPs initiated in the ICU require continued evaluation for indication to avoid prolonged and possibly unnecessary use.