Journal of critical care
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Journal of critical care · Dec 2018
Observational StudyProgressive myocardial injury is associated with mortality in the acute respiratory distress syndrome.
Myocardial injury connotes worse prognosis in the Acute Respiratory Distress Syndrome (ARDS), however the prognostic connotation of changes in cardiac troponin (cTn) levels in ARDS patients is not known. ⋯ Progressive myocardial injury in ARDS patients is associated with worse outcome, independent of severity of critical illness. Investigation of the mechanisms underlying this relationship is warranted to guide possible strategies to mitigate myocardial injury in ARDS.
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Journal of critical care · Dec 2018
Factors associated with the progression of conservatively managed acute traumatic subdural hemorrhage.
Traumatic subdural hemorrhage (SDH) is associated with high mortality, yet many patients are not managed surgically. We sought to understand what factors might be associated with SDH enlargement to contribute to the triage of these conservatively managed patients. ⋯ Platelet transfusion, anticoagulation, and hypertension have significant associations with expansion in non-surgical cases of SDH. Monitoring these factors may assist triaging these patients.
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Journal of critical care · Dec 2018
Not all organ dysfunctions are created equal - Prevalence and mortality in sepsis.
While organ dysfunctions within sepsis have been widely studied, interaction between measures of organ dysfunction remains an understudied area. The objective of this study is to quantify the impact of organ dysfunction on in-hospital mortality in infected population. ⋯ There exist differences in measures of organ dysfunction occurrence and their association with mortality. These findings support increased clinical efforts to identify sepsis patients to inform diagnostic decisions.
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Journal of critical care · Dec 2018
Predicting early deterioration of admitted patients at the Intermediate Care Unit.
Under-triage is a major threat when admitting patients at the Intermediate Care Unit (IMCU). This study aims to identify risk factors and predict early deterioration of IMCU admissions, to reduce the risk of under-triage. ⋯ Patients with combined hemodynamic and respiratory instability should not be admitted to the IMCU. Patients with respiratory insufficiency and active diuresis, or complicated sepsis require close monitoring.
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Journal of critical care · Dec 2018
Patterns of palliative care utilization among patients with end stage liver disease during end-of-life hospitalizations: A population-level analysis.
To investigate the patterns and predictors of palliative care (PC) utilization across ICU- and non ICU-managed patients with end-stage liver disease (ESLD) during end-of-life hospitalization. ⋯ There was persistent gap in use of PC among ICU-managed patients with ESLD during end-of-life hospitalization. ICU utilization rose, unexpectedly, despite the increasing use of PC in this cohort, and PC utilization was, paradoxically, lower among patients with the highest need.