Journal of critical care
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Journal of critical care · Dec 2018
Multicenter StudyC-reactive protein and procalcitonin profile in ventilator-associated lower respiratory infections.
Ventilator-associated tracheobronchitis (VAT) has been suggested as an intermediate process between tracheobronchial colonization and ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation. The aim of this study was to evaluate the ability of C-reactive protein (CRP) and procalcitonin (PCT) to differentiate between VAT and VAP. ⋯ Although PCT and CRP presented lower values in VAT as compared to VAP, there was a marked overlap of both biomarkers values in both VA-LRTI not allowing adequate discrimination.
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Journal of critical care · Dec 2018
An open-loop, physiological model based decision support system can reduce pressure support while acting to preserve respiratory muscle function.
To assess whether a clinical decision support system (CDSS) suggests PS and FIO2 maintaining appropriate breathing effort, and minimizing FIO2. ⋯ The CDSS advised on low values of PS often not prohibiting extubation, while acting to preserve respiratory muscle function and preventing passive lung inflation. CDSS advice minimized FIO2 maintaining SpO2 at safe and beneficial values.
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Journal of critical care · Dec 2018
Risk of de novo infection following acute kidney injury: A retrospective cohort study.
Recent studies suggest that acute kidney injury (AKI) can affect distant organ function and increase non-renal complications. We determined whether AKI is associated with an increased risk of incident infections. ⋯ AKI was associated with incident in-hospital infections. However, newly occurring infections were not associated with an increased risk of mortality. Further studies are needed to understand how AKI affects distant organ function and associated clinical outcomes.
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Journal of critical care · Dec 2018
Observational StudyAssociation between death and loss of stage N2 sleep features among critically Ill patients with delirium.
Critically ill patients experience significant sleep disruption. In this study of ICU patients with delirium, we evaluated associations between the loss of stage N2 features (K-complexes, sleep spindles), grade of encephalopathy based on electroencephalography (EEG), and intensive care unit (ICU) outcomes. We hypothesized that loss of stage N2 features is associated with more severe grades of encephalopathy and worse ICU outcomes including death. ⋯ Loss of stage N2 features is common and associated with more severe encephalopathy and higher odds of death. The absence of either Stage N2 feature, K complexes or sleep spindles, may have important prognostic value.
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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.