Journal of critical care
-
Journal of critical care · Oct 2018
Randomized Controlled TrialPopulation pharmacokinetics of intravenous paracetamol in critically ill patients with traumatic brain injury.
High-dose paracetamol (6 g/day) is a low-cost intervention that may prevent pyrexia. The purpose of this study was to describe the pharmacokinetics of high-dose intravenous paracetamol, in patients with traumatic brain injury (TBI). ⋯ Due to altered pharmacokinetics, patients experiencing severe TBI may require a higher dose of paracetamol to achieve drug exposure that results in preventing pyrexia.
-
Journal of critical care · Oct 2018
Multicenter StudyDiagnosis, management, and prognosis of patients with acute kidney injury in Japanese intensive care units: The JAKID study.
To determine the proportion of diagnosis and outcomes of critically ill patients with acute kidney injury (AKI), and its association with mortality using the complete Kidney Disease Improving Global Outcomes (KDIGO) classification and Sepsis-3 definition. ⋯ AKI accounted for >40% of ICU patients with the KDIGO classification and was associated with increased risk of hospital mortality. Septic AKI was diagnosed in three-fourths of patients with sepsis, while the impact of AKI on hospital mortality among sepsis was not observed.
-
Journal of critical care · Oct 2018
Multicenter Study Observational StudySafety incidents in airway and mechanical ventilation in Spanish ICUs: The IVeMVA study.
To assess incidence, related factors and characteristics of safety incidents associated with the whole process of airway management and mechanical ventilation (MV) in Spanish ICUs. ⋯ MV is a risk process in critical patients. Although most incidents did not harm patients, some caused damage and a few were related to the patient's death or permanent damage. Preventability is high.
-
Journal of critical care · Oct 2018
Days alive and free as an alternative to a mortality outcome in pivotal vasopressor and septic shock trials.
RCTs in septic shock negative for mortality may show organ dysfunction benefits. We hypothesized that RCTs in septic shock show significant differences between treatment groups in organ support despite no mortality differences. ⋯ Differences between treatment groups in organ dysfunction in RCTs in septic shock occur despite lack of mortality differences depending on calculation method. If standardized and validated further, DAF could become the primary endpoint of RCTs in septic shock.
-
Journal of critical care · Oct 2018
Acute respiratory distress syndrome without identifiable risk factors: A secondary analysis of the ARDS network trials.
We examined whether patients with acute respiratory distress syndrome (ARDS) lacking risk factors are enrolled in therapeutic trials and assessed their clinical characteristics and outcomes. ⋯ Patients with ARDS without identifiable risk factors are enrolled in therapeutic trials and may have better outcomes, including a higher proportion of rapidly resolving ARDS, than those with risk factors.