Journal of critical care
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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.
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Journal of critical care · Dec 2018
Observational StudyLower serum kallistatin level is associated with 28-day mortality in patients with septic shock.
Investigation for whether serum levels of kallistatin, vascular cell adhesion molecule-1 (VCAM-1), and E-selectin are associated with outcomes in patients with septic shock MATERIAL AND METHODS: Biomarker levels were measured using blood samples from patients with septic shock at admission, 24 h, and 72 h and from healthy volunteers. The primary outcome was 28-day mortality. ⋯ Lower serum kallistatin level at 24 h was independently associated with 28-day mortality in patients with septic shock.
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Journal of critical care · Dec 2018
Observational StudyPatients with small-vessel vasculitides have the highest mortality among systemic autoimmune diseases patients treated in intensive care unit: A retrospective study with 5-year follow-up.
Systemic autoimmune diseases are a heterogeneous group of disorders associated with dysfunction of multiple organs and unpredictable course. Complicated management and treatment become even more challenging when patients require critical care. This study aims to compare outcomes of small-vessel vasculitides (SVV) and other systemic autoimmune diseases (SAD) patients admitted to the intensive care unit (ICU). ⋯ Among systemic autoimmune diseases small vessel vasculitides appear to be associated with the highest ICU mortality, higher requirement for advanced procedures and aggressive immunosuppressive therapy.
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Journal of critical care · Dec 2018
Tolerability and effectiveness of 4-factor prothrombin complex concentrate (4F-PCC) for warfarin and non-warfarin reversals.
Current guidelines favor 4F-PCC over plasma for warfarin reversal. Uncertainty remains on its thrombotic risk and hemostatic effectiveness when used for direct-acting oral anticoagulants (DOACs), transplants, massive transfusion protocols (MTP), and non-anticoagulated patients. This study sought to evaluate the tolerability and effectiveness of 4F-PCC in a real-world setting. ⋯ Use of 4F-PCC in this real-world setting was associated with variable thromboembolic and hemostatic effectiveness rates based on the indication for reversal.
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Journal of critical care · Dec 2018
Case ReportsThe role of electrical impedance tomography for monitoring during bronchoscopy: A case report.
Continuous monitoring of lung ventilation can be useful in treating patients admitted to the intensive care unit (ICU). Electrical impedance tomography (EIT) has been used as a relatively new imaging technique for this purpose. ⋯ A drainage procedure and subsequent improvement in pulmonary function were monitored using EIT contributed to the treatment process. The patient has been discharged from the hospital with an improved general condition.