Journal of critical care
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Journal of critical care · Oct 2018
Observational StudyStrong ion difference and CVVH: Different response during nadroparin versus citrate anticoagulation.
To determine the effect on strong ion difference of citrate as an anticoagulant during continuous veno-venous hemofiltration (CVVH). ⋯ Citrate anticoagulation results in a persistently high SIG during CVVH compared to nadroparin. This is associated with the presence of unmeasured anions such as citrate in the systemic circulation.
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Journal of critical care · Oct 2018
Observational StudyImpact of acute kidney injury on neurological outcome and long-term survival after cardiac arrest - A 10 year observational follow up.
Acute kidney injury (AKI) may be associated with short- and long-term patient morbidity and mortality. Therefore, the impact of AKI after cardiac arrest on survival and neurological outcome was evaluated. ⋯ Our data suggest that AKI is a major risk factor for a poor neurological outcome and a higher mortality after cardiac arrest. Further important risk factors were age, time to ROSC and high NSE.
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Journal of critical care · Oct 2018
Review Meta AnalysisAssociation between arterial hyperoxia and mortality in critically ill patients: A systematic review and meta-analysis.
The relationship between arterial hyperoxia exposure and clinical outcome is under increasing scrutiny. We therefore performed an update meta-analysis to evaluate the effect of arterial hyperoxia on hospital mortality in critically ill adults. ⋯ The results of current meta-analysis suggest that arterial hyperoxia may be associated with increased hospital mortality in critically ill patients.
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Journal of critical care · Oct 2018
ReviewRespiratory depression in low acuity hospital settings-Seeking answers from the PRODIGY trial.
Predicting episodes or severity of cardiorespiratory decompensation has proved to be challenging in patients with stable surgical or medical conditions, recovering on the general care floor (ward). Critical cardiorespiratory events on hospital floors may be prevented by early detection of deterioration using continuous, electronic cardiorespiratory monitoring (CEM). ⋯ The validation-derivation cohort design will derive this score from RD detected by continuous, blinded, multiparameter cardiorespiratory (heart rate, respiratory rate, end tidal carbon dioxide, and pulse oximetry) monitoring of patients on the ward receiving parenteral (including epidural) opioids for primary analgesia. This review provides a comprehensive synopsis on respiratory compromise in lower acuity hospital settings (ward) and describes the protocol of the PRODIGY trial as a means to enable prediction and early response to these events.
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Journal of critical care · Oct 2018
ReviewThe use of IgM-enriched immunoglobulin in adult patients with sepsis.
The administration of intravenous immunoglobulins (IVIG) is one of the adjunct therapies investigated and applied to sepsis patients, with the first studies being published nearly four decades ago. Intravenous immunoglobulin preparations have several mechanisms of action e.g. antigen neutralization, Fc-receptor blockade on phagocytic cells, modulation of cytokine responses and modulation of immune cell functions. ⋯ Nevertheless, the results of studies examining its value are contradicting. The purpose of this review is to summarize and present, clearly and thoroughly, the currently available data regarding established and future potential clinical uses of IVIgGM in patients with sepsis.