Journal of critical care
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Journal of critical care · Dec 2017
Randomized Controlled Trial Comparative Study Observational StudyCytochrome c in patients undergoing coronary artery bypass grafting: A post hoc analysis of a randomized trial.
To establish whether plasma cytochrome c is detectable in patients undergoing cardiac surgery, whether cytochrome c levels are associated with lactate/inflammatory markers/cellular oxygen consumption, and whether cytochrome c levels are associated with clinical outcomes. ⋯ Cytochrome c levels did not increase after cardiac surgery and was not associated with the degree of inflammation or clinical outcomes.
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Journal of critical care · Dec 2017
Multicenter Study Comparative StudyIncreased healthcare facility use in veterans surviving sepsis hospitalization.
We sought to measure inpatient healthcare utilization among U.S. Veteran Affairs beneficiaries surviving sepsis hospitalization, and to examine how post-sepsis utilization varies by select patient characteristics. ⋯ Veterans surviving sepsis experience high rates of post-sepsis mortality and significant increases in healthcare facility use. Recent nursing facility use is strongly predictive of greater post-sepsis healthcare utilization.
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Journal of critical care · Dec 2017
Review Meta AnalysisAccuracy of C - Reactive protein as a bacterial infection marker in critically immunosuppressed patients: A systematic review and meta-analysis.
There is a need for a better understanding of the role of C-reactive protein (CRP) as a valid marker for the detection of bacterial infections in critically immunosuppressed patients. A high negative predictive value of CRP is also needed to rule out sepsis and bacterial infections in immunocompetent patients. However, few studies have evaluated the performance of CRP in immunocompromised hosts. The aim of the present study was to evaluate the performance of CRP as a marker of infection in critically immunosuppressed patients. ⋯ CRP appears to be a good screening tool for sepsis in critically immunosuppressed patients. Submitted PROSPERO 2015: CRD42015019329.
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Journal of critical care · Dec 2017
Multicenter Study Observational StudyClinical predictors of early death from sepsis.
Patients with severe sepsis who experience rapid, early deterioration and death are of particular concern. Our objective was to identify predictors of early death in Emergency Department (ED) patients with severe sepsis. ⋯ Initial serum lactate and mSOFA score were independent predictors of mortality within 24h of ED admission in patients with severe sepsis.
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Journal of critical care · Dec 2017
Are graduated intensivists prepared for practice? A case study from The Netherlands.
An evaluation of the alignment between intensive care medicine (ICM) training and practice provides valuable information for the development of ICM training. Therefore this study examines how well recently licensed intensivists feel prepared for practice and whether intensivists from different background specialties attain comparable preparedness rates. ⋯ Although recently licensed intensivists are well prepared for most tasks in ICM, lower preparedness scores on tasks related to leadership and management, science, and professional development call for re-evaluation of the current curriculum.