Journal of critical care
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Journal of critical care · Aug 2016
Interleukin 6, galectin 3, growth differentiation factor 15, and soluble ST2 for mortality prediction in critically ill patients.
The aim of this study was to compare the prognostic value of interleukin 6 (IL-6), galectin 3, growth differentiation factor 15 (GDF-15), and soluble ST2 (sST2) in an unselected cohort of critically ill patients. ⋯ In this heterogeneous group of critically ill patients, only SAPS II, IL-6, and sST2 remained independent and additive prognostic markers for 90-day all-cause mortality. A combination of the SAPS II with the 2 complementary biomarkers might provide a valuable tool for risk stratification of critically ill patients.
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Journal of critical care · Aug 2016
A minimum blood glucose value less than or equal to 120 mg/dL under glycemic control is associated with increased 14-day mortality in nondiabetic intensive care unit patients with sepsis and stress hyperglycemia.
Hyperglycemia is common in critically ill patients, but results of previous trials on glycemic control have been controversial. This study aimed to investigate whether the minimum blood glucose value during the first 72 hours after admission (72-min-BGV) was associated with mortality in patients with severe sepsis. ⋯ A 72-min-BGV less than or equal to 120 mg/dL was an independent risk factor for 14-day mortality in nondiabetic patients with hyperglycemia admitted to our intensive care unit due to severe sepsis, but not in diabetic patients under the same setting.
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Journal of critical care · Aug 2016
Comparative StudyComparison between respiratory changes in the inferior vena cava diameter and pulse pressure variation to predict fluid responsiveness in postoperative patients.
The objective of our study was to assess the reliability of the distensibility index of the inferior vena cava (dIVC) as a predictor of fluid responsiveness in postoperative, mechanically ventilated patients and compare its accuracy with that of the pulse pressure variation (PPV) measurement. ⋯ The individual PPV discriminative properties for predicting fluid responsiveness in postoperative patients seemed superior to those of dIVC.
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Journal of critical care · Aug 2016
Observational StudyIdentification of acute brain failure using electronic medical records.
Up to 80% of critically ill patients have acute neurologic dysfunction syndromes. We evaluated interrater reliability between the examination by the investigator and the charted assessment by the nurse because the accuracy and reliability of detailed data sets extracted from the electronic medical records represents a keystone for creating EMR-based definitions. ⋯ Neurologic assessments documented on the EMR are reliable.
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Journal of critical care · Aug 2016
Letter Comparative StudyIncidence of iatrogenic pneumothorax in the United States in teaching vs. non-teaching hospitals from 2000 to 2012.
Iatrogenic pneumothorax is a patient safety indicator (PSI) representing a complication of procedures such as transthoracic needle aspiration, subclavicular needle stick, thoracentesis, transbronchial biopsy, pleural biopsy, and positive pressure ventilation. This study examined whether there was a significant difference in rate of iatrogenic pneumothorax in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. ⋯ Iatrogenic pneumothorax was more prevalent in teaching hospitals compared to non-teaching hospitals after the year 2000. Further randomized control studies are warranted to evaluate the etiology of this finding.