Journal of critical care
-
Journal of critical care · Dec 2016
Comparative Study Observational StudyComparing average levels and peak occurrence of overnight sound in the medical intensive care unit on A-weighted and C-weighted decibel scales.
Sound levels in the intensive care unit (ICU) are universally elevated and are believed to contribute to sleep and circadian disruption. The purpose of this study is to compare overnight ICU sound levels and peak occurrence on A- vs C-weighted scales. ⋯ Sound levels in the medical ICU are high throughout the night. Patient factors were not associated with Leq or peak occurrence. Significant discordance between A- and C-weighted values suggests that low-frequency sound is a meaningful factor in the medical ICU environment.
-
Journal of critical care · Dec 2016
Four-factor prothrombin complex concentrate for life-threatening bleeds or emergent surgery: A retrospective evaluation.
Previous trials investigating usage of four-factor prothrombin complex concentrate (4F-PCC) excluded patients with various thrombotic risk factors. The objective of this study was to evaluate the safety and effectiveness of 4F-PCC in a real-world setting based on an institutional protocol that does not have strict exclusion criteria. ⋯ 4F-PCC was associated with a notable thromboembolic risk. All patient-specific risk factors should be considered prior to administration. 4F-PCC remains a useful agent for warfarin reversal. Lack of concomitant vitamin K may contribute to INR rebound.
-
Journal of critical care · Dec 2016
Admission plasma levels of the neuronal injury marker neuron-specific enolase are associated with mortality and delirium in sepsis.
Neuron-specific enolase (NSE) concentrations are prognostic following traumatic and anoxic brain injury and may provide a method to quantify neuronal injury in other populations. We determined the association of admission plasma NSE concentrations with mortality and delirium in critically ill septic patients. ⋯ Higher plasma NSE concentrations were associated with mortality and delirium in critically ill septic patients, suggesting that NSE may have utility as a marker of neuronal injury in sepsis.
-
Journal of critical care · Dec 2016
Multicenter Study Observational StudyAssociation between acute gastrointestinal injury grading system and disease severity and prognosis in critically ill patients: A multicenter, prospective, observational study in China.
This prospective study investigated the association between disease severity and acute gastrointestinal injury (AGI) grade and between prognosis and AGI. ⋯ Differentiating AGI as gastrointestinal dysfunction or gastrointestinal failure appears to be more valid for predicting prognosis than the AGI 4-grade system.
-
Journal of critical care · Dec 2016
Health care-associated pneumonia in the intensive care unit: Guideline-concordant antibiotics and outcomes.
Recent data have not demonstrated improved outcomes when guideline-concordant (GC) antibiotics are given to patients with health care-associated pneumonia (HCAP). This study was designed to evaluate the relationship between health outcomes and GC therapy in patients admitted to an intensive care unit (ICU) with HCAP. ⋯ Our data do not demonstrate improved outcomes among ICU patients with HCAP who received GC-HCAP therapy.