Journal of critical care
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Journal of critical care · Feb 2018
ReviewIntensive care in severe malaria: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine.
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P vivax is increasingly found to cause severe malaria in Asia. ⋯ Aggressive fluid boluses may not be appropriate in children. Blood transfusions may be required and treatment of seizures and raised intracranial pressure is important in cerebral malaria in children. Mortality in severe disease ranges from 8 to 30% despite treatment.
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Journal of critical care · Feb 2018
Development of a prediction model for long-term quality of life in critically ill patients.
We developed a prediction model for quality of life (QOL) 1 year after intensive care unit (ICU) discharge based upon data available at the first ICU day to improve decision-making. ⋯ Although only 40% of variability in long-term QOL could be explained, this prediction model can be helpful in decision-making.
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Journal of critical care · Feb 2018
Multicenter StudyUntreated hypertension as predictor of in-hospital mortality in intracerebral hemorrhage: A multi-center study.
Hypertension is a significant risk factor for intracerebral hemorrhage (ICH). The importance of managing blood pressure to reduce the risk of ICH has been recognized. However, few studies have focused on ICH outcomes due to untreated hypertension. ⋯ Subjects with untreated-hypertension were younger and had fewer comorbidities when compared with treated-hypertension and were similar when compared to normotensive individuals. Once demographic and in-hospital factors were accounted for, untreated-hypertension subjects demonstrated significantly increased in-hospital mortality following ICH when compared with normotensive individuals.
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Journal of critical care · Feb 2018
ReviewOvercoming the Warburg Effect: Is it the key to survival in sepsis?
Sepsis is a leading cause of mortality in the U. S. and Europe. Sepsis and septic shock are the results of severe metabolic abnormalities following infection. ⋯ Although the initial pathways of cancer and sepsis may be different, the mechanisms which allow aerobic glycolysis to occur, even in the presence of oxygen, are similar. This review provides some evidence that reversing these steps reverses the Warburg Effect in model systems and some pathological consequences of this effect. Therefore, this implies that these steps might be modifiable in sepsis to reverse the Warburg Effect and possibly lead to better outcomes.
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Journal of critical care · Feb 2018
Observational StudyCirculating syndecan-1 predicts the development of disseminated intravascular coagulation in patients with sepsis.
One of the pathophysiological processes in sepsis is endothelial dysfunction, which leads to disseminated intravascular coagulation (DIC). Syndecan-1 is a major structural component of the endothelium and plays a key role in endothelial function. The purpose of this study was to assess the value of syndecan-1 as a predictive marker for DIC in sepsis. ⋯ Syndecan-1 levels were associated with not only the severity of illness and mortality but also DIC development in sepsis, suggesting that syndecan-1 could be a predictive marker of DIC.