Journal of critical care
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Journal of critical care · Apr 2017
Observational StudyChanges of central venous oxygen saturation define fluid responsiveness in patients with septic shock: A prospective observational study.
To evaluate whether the changes of central venous oxygen saturation (Scvo2) after fluid challenge can define fluid responsiveness in patients with septic shock. ⋯ The changes of Scvo2 correlate with the changes of CI, and the changes of Scvo2 define fluid responsiveness in patients with septic shock.
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Journal of critical care · Apr 2017
Bronchoscopic intubation is an effective airway strategy in critically ill patients.
American Society of Anesthesiologists guidelines recommend the use of bronchoscopic intubation as a rescue technique in critically ill patients. We sought to assess the safety and efficacy of bronchoscopic intubation as an initial approach in critically ill patients. ⋯ Bronchoscopic intubation as an initial strategy in critically ill patients is associated with a higher first-pass success rate than laryngoscopic intubation, and is not associated with an increase in complications.
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Journal of critical care · Apr 2017
Observational StudyAssociation between ventilatory settings and development of acute respiratory distress syndrome in mechanically ventilated patients due to brain injury.
In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury. ⋯ In a cohort of brain-injured patients the development of ARDS was not common. Driving pressure was associated with the development of this disease.
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Journal of critical care · Apr 2017
Cardiac troponin T is an important predictor of mortality after cardiac surgery.
Serum troponin (cTnT) levels, a commonly measured biomarker of myocardial injury, has rarely been considered in risk models after cardiac surgery. ⋯ We demonstrate that in patients without preoperative myocardial ischemia, the demonstration of myocardial injury (>0.6 ng/mL) in the postoperative period is highly predictive of in-hospital death.
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Journal of critical care · Apr 2017
Observational StudyDecreased high-density lipoprotein cholesterol level is an early prognostic marker for organ dysfunction and death in patients with suspected sepsis.
We sought to determine whether an early high-density lipoprotein cholesterol (HDL-C) measurement at emergency department (ED) admission is prognostic of multiorgan dysfunction syndrome (MODS) and death in a suspected sepsis cohort. ⋯ Plasma HDL-C level was characterized by early decrease and high stability, and was the best prognostic marker for adverse outcomes in a suspected sepsis cohort.