Journal of critical care
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Journal of critical care · Dec 2017
The long-term quality of life in patients with persistent inflammation-immunosuppression and catabolism syndrome after severe acute pancreatitis: A retrospective cohort study.
To explore clinical characteristics and long-term quality of life (QOL) in severe acute pancreatitis (SAP) patients with persistent inflammation-immunosuppression and catabolism syndrome (PICS). ⋯ 214 SAP patients were enrolled, in which 149 (69.6%) patients met the criteria of PICS. PICS patients had more complications and ICU days compared to non-PICS patients (P<0.001), and their post-ICU mortality was higher (P=0.046). When adjusted for confounders, PICS was independently associated with higher post-ICU mortality (hazard ratio 4.5; 95% CI, 1.2 to 16.3; P=0.024). The 36-item Short Form Health Survey (SF-36) score was lower for PICS group in six subscales (P<0.001). Only 28.8% patients in the PICS group returned to work compared to 60% patients in the non-PICS group (P=0.001) CONCLUSIONS: SAP patients with prolonged ICU stay had a high morbidity of PICS, which was a risk factor for the post-ICU mortality and poor long-term QOL.
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Journal of critical care · Dec 2017
Circulating levels of the angiogenesis mediators endoglin, HB-EGF, BMP-9 and FGF-2 in patients with severe sepsis and septic shock.
Endothelial barrier dysfunction is a hallmark of sepsis, and is at least partially mediated by pathways that regulate endothelial barrier assembly during angiogenesis. Not surprisingly, increased levels of key angiogenic proteins such as VEGF-A and Angiopoietin-2 have been described in sepsis. The purpose of this study was to investigate if additional pathways that regulate endothelial barrier integrity during angiogenesis could also be involved in the host response of sepsis. ⋯ Endoglin and HB-EGF could be involved in the host response of sepsis. Additional studies are warrant to investigate their role as biomarker or therapeutic targets in sepsis.
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Newly diagnosed swallowing dysfunction is rare, with an incidence <1% in hospitalized patients. The purpose of this study was to evaluate the incidence and clinical characteristics of dysphagia in elderly trauma patients specifically. ⋯ Elderly trauma patients with a high comorbidity burden or with prolonged ICU lengths of stay should be screened for dysphagia.
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Journal of critical care · Dec 2017
A modified Delphi process to identify clinical and research priorities in patient and family centred critical care.
To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. ⋯ Stakeholders identified clear and distinct priorities for PFCC in clinical care and research, though there was greater consensus for clinical care.
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Journal of critical care · Dec 2017
Developing and testing a comprehensive tool to assess family meetings: Empirical distinctions between high- and low-quality meetings.
The heterogeneity with regard to findings on family meetings (or conferences) suggests a need to better understand factors that influence family meetings. While earlier studies have explored frequency or timing of family meetings, little is known about how factors (such as what is said during meetings, how it is said, and by whom) influence family meeting quality. ⋯ We filled a gap by developing an evaluation tool to assess family meetings, and we identified how what is said during meetings impacts quality.