Journal of critical care
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Journal of critical care · Dec 2018
Right-to-left ventricular end diastolic diameter ratio in severe sepsis and septic shock.
The ratio of right ventricular end-diastolic diameter (EDD) to left ventricular EDD (RV/LV) is a measure predictive of right ventricular failure. We hypothesized that an increase in RV/LV would be associated with poor prognosis in severe sepsis and septic shock. ⋯ An increased RV/LV does not predict mortality in severe sepsis or septic shock.
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Journal of critical care · Dec 2018
Heart rate variability is associated with outcome in spontaneous intracerebral hemorrhage.
Autonomic imbalance as measured by heart rate variability (HRV) has been associated with poor outcome after stroke. Observations on HRV changes in intracerebral hemorrhage (ICH) are scarce. Here, we aimed to investigate HRV in ICH as compared to a control group and to explore associations with stroke severity, hemorrhage volume and outcome after ICH. ⋯ Autonomic changes seems to be present in acute ICH and are associated with poor outcome independently. This may have future monitoring and therapeutic implications.
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Journal of critical care · Dec 2018
Positive end-expiratory pressure titrated according to respiratory system mechanics or to ARDSNetwork table did not guarantee positive end-expiratory transpulmonary pressure in acute respiratory distress syndrome.
Pulmonary recruitment and positive end-expiratory pressure (PEEP) titrated according to minimal static elastance of the respiratory system (PEEPEstat,RS) compared to PEEP set according to the ARDSNetwork table (PEEPARDSNetwork) as a strategy to prevent ventilator-associated lung injury (VALI) in patients with acute respiratory distress syndrome (ARDS) increases mortality. Alternatively, avoiding negative end-expiratory transpulmonary pressure has been discussed as superior PEEP titration strategy. Therefore, we tested whether PEEPEstat,RS or PEEPARDSNetwork prevent negative end-expiratory transpulmonary pressure in ARDS patients. ⋯ In patients with moderate-to-severe ARDS, PEEP titrated according to the minimal static elastance of the respiratory system or according to the ARDSNetwork table did not prevent negative end-expiratory transpulmonary pressure.
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Journal of critical care · Dec 2018
An automated computerized critical illness severity scoring system derived from APACHE III: modified APACHE.
To evaluate the performance of an automated computerized ICU severity scoring derived from the APACHE III. ⋯ mAPACHE has adequate performance to predict mortality.
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Journal of critical care · Dec 2018
qSOFA as predictor of mortality and prolonged ICU admission in Emergency Department patients with suspected infection.
We assessed the quick Sequential Organ Failure Assessment (qSOFA) score as a predictor of in-hospital mortality or prolonged ICU stay in Emergency Department (ED) patients with suspected infection. ⋯ Among ED patients with suspected infection, a positive qSOFA identified those at much greater risk of mortality and longer ICU stay.