Journal of critical care
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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.
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Journal of critical care · Dec 2016
The prognostic value of the strong ion gap in acute pancreatitis.
In this study, we aimed to evaluate the predictive value of Stewart-derived parameters for the development of severe type of acute pancreatitis (AP) and for AP-related mortality. ⋯ In a cohort of patients with AP, SIG was a strong independent predictor of severity and mortality. Besides, SIG might also be an early marker for acute kidney injury in AP patients. Additional research is needed to identify the nature of the unmeasured anions responsible for such findings.
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Journal of critical care · Dec 2016
Validation of the Critical-Care Pain Observation Tool in brain-injured critically ill adults.
Pain is a common symptom in the intensive care unit (ICU). Brain-injured patients are often unable to reliably self-report their pain, calling forth the need to use behavioral scales such as the Critical-Care Pain Observation Tool (CPOT). This study aimed to test the reliability and validity of the CPOT use with brain-injured ICU adults. ⋯ Overall, the CPOT use was found to be reliable and valid in this patient group and is new evidence fulfilling an important gap highlighted in the Society of Critical Care Medicine practice guidelines.
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Journal of critical care · Dec 2016
Individual-specific principal component analysis of circulating inflammatory mediators predicts early organ dysfunction in trauma patients.
We hypothesized that early inflammation can drive, or impact, later multiple organ dysfunction syndrome (MODS), that patient-specific principal component analysis (PCA) of circulating inflammatory mediators could reveal conserved dynamic responses which would not be apparent from the unprocessed data, and that this computational approach could segregate trauma patients with regard to subsequent MODS. ⋯ Identification of patient-specific "core responses" can lead to early segregation of diverse trauma patients with regard to later MODS. Hence, we suggest that a focus on dynamic inflammatory networks rather than individual biomarkers is warranted.
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Journal of critical care · Dec 2016
Epidemiology and outcome of new-onset atrial fibrillation in the medical intensive care unit.
To assess the incidence of new-onset atrial fibrillation (NOAF) in the medical intensive care unit setting and describe associated characteristics and implications for long-term outcomes. ⋯ Risk factors for AF were less common in NOAF than in PEAF, yet NOAF incidence was associated with greater ICU disease severity and poorer short-term ICU outcomes. New-onset AF was not independently predictive of in-hospital mortality.