Journal of critical care
-
Journal of critical care · Oct 2017
Benefit on optimal cerebral perfusion pressure targeted treatment for traumatic brain injury patients.
The maintenance of patient-specific optimal cerebral perfusion pressure (CPPopt) is crucial for patients with traumatic brain injury (TBI). The goal of the study was to explore the influence of CPP declination from CPPopt value on the TBI patients' outcome. ⋯ The CPPopt-targeted patient-specific management might be useful for stabilizing CA in TBI patients as well as for improving their outcome. Better outcomes were obtained by maintaining CPP in light hyperperfusion condition (up to 10mmHg above CPPopt) when CPPopt is in the range of 60-80mmHg, and keeping CPP within the range of CPPopt +/-5mmHg when CPPopt is above 80mmHg.
-
Journal of critical care · Oct 2017
Treatment outcomes after implementation of an adapted WHO protocol for severe sepsis and septic shock in Haiti.
The World Health Organization (WHO) has developed a simplified algorithm specific to resource-limited settings for the treatment of severe sepsis emphasizing early fluids and antibiotics. However, this protocol's clinical effectiveness is unknown. We describe patient outcomes before and after implementation of an adapted WHO severe sepsis protocol at a community hospital in Haiti. ⋯ Use of a simplified sepsis protocol based primarily on physiologic parameters allows for substantial improvements in process measures in the care of severely septic patients in a resource-constrained setting.
-
Journal of critical care · Oct 2017
Serial blood lactate measurements and its prognostic significance in intensive care unit management of aneurysmal subarachnoid hemorrhage patients.
This study assesses the behavior of serial blood lactate measurements during intensive care unit (ICU) stay to identify prognostic factors of unfavorable neurological outcomes (UO) in patients with aneurysmal subarachnoid hemorrhage (SAH). ⋯ The lactate level at 48h after admission was the most accurate predictor of UO with a high specificity in SAH patients.
-
Journal of critical care · Oct 2017
Observational StudyLow brain tissue oxygenation contributes to the development of delirium in critically ill patients: A prospective observational study.
To test the hypothesis that poor brain tissue oxygenation (BtO2) during the first 24h of critical illness correlates with the proportion of time spent delirious. We also sought to define the physiological determinants of BtO2. ⋯ Poor cerebral oxygenation during the first 24 hours of critical illness contributes to the development of delirium.
-
Journal of critical care · Oct 2017
The characteristics and impact of source of infection on sepsis-related ICU outcomes.
Source of infection is an independent predictor of sepsis-related mortality. To date, studies have failed to evaluate differences in septic patients based on the source of infection. ⋯ There are significant differences in patient characteristics, microbiology positivity, organs affected, mortality, length of stay and cost based on the source of sepsis. These differences should be considered in future studies to be able to deliver personalized care.