Journal of critical care
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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.
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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.
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Journal of critical care · Dec 2016
ReviewEarly goal-directed therapy for severe sepsis and septic shock: A living systematic review.
Studies and meta-analyses conflict regarding the use of early goal-directed therapy (EGDT) for septic shock. We sought to clarify the conflict by performing a living systematic review and meta-regression.
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Journal of critical care · Dec 2016
Comparative Study Observational StudyComparison of 1,3-β-d-glucan with galactomannan in serum and bronchoalveolar fluid for the detection of Aspergillus species in immunosuppressed mechanical ventilated critically ill patients.
Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity/mortality in immunocompromised critically ill patients. New diagnostic strategies for early detection of IPA include the noninvasive biomarkers 1,3-β-d-glucan (BDG), serum, and bronchoalveolar (BAL) fluid galactomannan (GM). The aim of this study was to compare these markers for early detection of IPA in immunosuppressed critically ill patients. ⋯ 1,3-β-d-Glucan may be a useful marker for patients under surveillance at risk for IPA. In critically ill patients with immunosuppression, early diagnosis of IPA may be improved by BDG as compared with serum GM. However, diagnostic performance and accuracy increase when BDG is run in parallel with GM from BAL; moreover, the association of the 2 parameters has also the advantage of detecting early and reliable IPA.
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Journal of critical care · Dec 2016
Determinants of 6-month survival of critically ill patients with an active hematologic malignancy.
This study assessed the determinants of 6-month survival of critically ill patients with an active hematologic malignancy (HM). ⋯ Differences in 6-month survival between critically ill patients with different types of active HM were substantial. Recent hematopoietic stem cell transplant, severity of illness, and use of mechanical ventilation were additional important determinants of 6-month survival in patients with an active HM.