Journal of critical care
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Journal of critical care · Feb 2017
Clinical study of a new Modified Early Warning System scoring system for rapidly evaluating shock in adults.
Shock, the most common severe emergency syndrome, has a complicated etiopathogenesis, is difficult to identify, progresses quickly, and is dangerous. Early identification and intervention play determining roles in the final outcomes of shock patients, but no specific scoring system for shock has been established to date. ⋯ The new MEWS scoring system could be an independent indicator to reflect shock severity. It has higher predictive efficacy in septic shock, especially for 28-day prognosis.
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Journal of critical care · Feb 2017
Safety and feasibility of a neuromuscular electrical stimulation chronaxie-based protocol in critical ill patients: A prospective observational study.
The aim of this study was to evaluate the safety and feasibility of a neuromuscular electrical stimulation (NMES) protocol based on neuromuscular excitability and applied in numerous muscle groups of critical ill patients. ⋯ We demonstrated that NMES chronaxie-based protocol is safe and feasible.
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Journal of critical care · Feb 2017
Cerebral oxidative metabolism failure in traumatic brain injury: "Brain shock".
Shock is a systemic form of acute circulatory failure leading to cellular dysoxia and death. Such a state of aerobic metabolism failure also underlies neuronal cell death in severe traumatic brain injury. ⋯ These different mechanisms can be usefully understood via analysis of the classic subdivisions of tissue hypoxia. This approach could lead to an alternative treatment paradigm toward cerebral oxygen metabolic rate targeting instead of the traditional targets of intracranial and perfusion pressures.
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Journal of critical care · Feb 2017
Precision and improving outcomes in acute kidney injury: Personalizing the approach.
It is now well over a decade since attempts at harmonization of acute renal failure into a definable entity termed acute kidney injury. This has led to several landmark studies outlining the epidemiology of acute kidney injury, particularly in the critically ill, as well as providing insights into the long-term effects of the syndrome. ⋯ The introduction of novel biomarkers associated with renal damage was primarily aimed at aiding early recognition of acute kidney injury. We argue that, in the future, using biomarkers may not only alert to acute kidney injury but may direct therapy in a personalized fashion rather than a one-size-fits-all approach.
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Journal of critical care · Feb 2017
Value of the oxygenation index during 1-lung ventilation for predicting respiratory complications after thoracic surgery.
Thoracic surgery requiring 1-lung ventilation (OLV) is associated with significant postoperative pulmonary complications (PPCs) due to patient- and surgery-specific risk factors. The aim of this study is to determine whether the oxygenation index (OI) (fraction of inspired oxygen × mean airway pressure/partial pressure of oxygen) during OLV predicts the development of PPC. ⋯ The calculated OI during OLV is not predictive of PPC in our sample. Additional studies in a larger cohort of patients are needed to identify intraoperative ventilation parameters during OLV that can predict the risk of PPC.