Journal of critical care
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Journal of critical care · Jun 2017
Hyperoxia: At what level of SpO2 is a patient safe? A study in mechanically ventilated ICU patients.
Concerns have been expressed regarding a possible association between arterial hyperoxia and adverse outcomes in critically ill patients. Oxygen status is commonly monitored noninvasively by peripheral saturation monitoring (SpO2). However, the risk of hyperoxia above specific SpO2 levels in critically ill patients is unknown. The purpose of this study was to determine a threshold value of SpO2 above which the prevalence of arterial hyperoxia distinctly increases. ⋯ In critically ill patients, the prevalence of arterial hyperoxia increases when SpO2 is >95%. Above this saturation level, supplemental oxygen should be administered with caution in patients potentially susceptible to adverse effects of hyperoxia.
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Journal of critical care · Jun 2017
Interhospital transfers of the critically ill: Time spent at referring institutions influences survival.
To determine if the length of stay at a referring institution intensive care unit (ICU) before transfer to a tertiary/quaternary care facility is a risk factor for mortality. ⋯ Length of stay at the referring institution before transfer is a risk factor for worse outcomes, with longer stays associated with increased likelihood of mortality. Further studies delineating which factors most affect length of stay at referring institutions, though a difficult task, should be pursued.
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Journal of critical care · Jun 2017
The association of blood urea nitrogen levels with mortality in acute pulmonary embolism.
The aim of this study was to investigate the association of BUN levels with in-hospital and long-term adverse clinical outcomes in acute pulmonary embolism (APE) patients treated with tissue-plasminogen activator (t-PA). ⋯ In this study, elevated admission BUN level was found to be a predictor of all-cause in-hospital mortality. BUN testing is commonly part of the basic metabolic panel; and it can be used to detect high-risk patients with APE, and it bears little risk, is inexpensive, and easy to perform.
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Journal of critical care · Jun 2017
Fluid overload and outcomes in critically ill children: A single center prospective cohort study.
To prospectively evaluate the association between fluid overload (FO) and clinical outcomes, mortality, mechanical ventilation (MV), and duration and length of stay in a pediatric intensive care unit (PICU). ⋯ FO is frequent in a general PICU population, but PFO is not an independent risk factor for mortality. Future studies of FO should focus on patients with AKI and multiorgan failure for better classification of severity and potential interventions.