Journal of critical care
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Journal of critical care · Feb 2017
Review Multicenter Study Observational StudyNutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients-A multicenter prospective cohort study.
Characterize the nutritional risk of critically ill patients with the modified NUTrition Risk in the Critically ill (NUTRIC) score. ⋯ Almost half of the patients in Portuguese ICUs are at high nutritional risk. NUTRIC score was strongly associated with main clinical outcomes.
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Journal of critical care · Feb 2017
Impact of hospital case-volume on subarachnoid hemorrhage outcomes: A nationwide analysis adjusting for hemorrhage severity.
There have been suggestions that patients with subarachnoid hemorrhage (SAH) have a better outcome when treated in high-volume centers. Much of the published literature on the subject is limited by an inability to control for severity of SAH. ⋯ After adjustment for severity of SAH, treatment in a high-volume center was associated with a lower risk of in-hospital mortality and a higher odds of a good functional outcome.
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Journal of critical care · Feb 2017
Observational StudyEvaluation of sedatives, analgesics, and neuromuscular blocking agents in adults receiving extracorporeal membrane oxygenation.
The objective of this study was to evaluate the use of sedative, analgesic, and neuromuscular blocking agents (NMBAs) in patients undergoing extracorporeal membrane oxygenation (ECMO) support. ⋯ Patients received relatively low doses of sedatives and analgesics while at a light level of sedation on average. Patients rarely required neuromuscular blockade.
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Journal of critical care · Feb 2017
The clinical benefit of a follow-up thoracic computed tomography scan regarding parenchymal lung injury and acute respiratory distress syndrome in polytraumatized patients.
To evaluate the increase of parenchymal lung injury (PLI) volume between the initial and a follow-up computed tomography (CT) scan and to ascertain which of the 2 scans was more appropriate to predict acute respiratory distress syndrome (ARDS). ⋯ The CT scans performed directly after admission are sufficient to define patients at risk for ARDS. Therefore, solely the incidence of PLI does not justify a routine follow-up CT scan.
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Journal of critical care · Feb 2017
Case ReportsExtra-central nervous system target for assessment and treatment in refractory anti-N-methyl-d-aspartate receptor encephalitis.
Anti-N-methyl-d-aspartate-type glutamate receptor autoimmune encephalitis can arise in the setting of ovarian teratoma and often responds to resection. When it occurs in the absence of tumor, failure to respond to treatment may be more likely, and affected patients often require intensive care. To further understand the mechanisms and potential management, we present findings from an autopsy conducted on a young woman who died of refractory autoimmune encephalitis of this type. ⋯ Examination of lymph node tissue identified many plasma cells along sinusoids. These findings demonstrate that the antibody-producing cells are long-lived and can reside in lymphoid tissue. Awareness of continuing antibody production, the extra-central nervous system site, the indication for cytotoxic therapy, and the potential for biopsy assessment may lead to more effective treatment.