Journal of critical care
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Journal of critical care · Oct 2019
Observational StudyEarly prediction of treatment failure in severe community-acquired pneumonia: The PRoFeSs score.
To identify a single/panel of biomarkers and to provide a point score that, after 48 h of treatment, could early predict treatment failure at fifth day of Intensive Care Unit (ICU) stay in severe community-acquired pneumonia (SCAP) patients. ⋯ In SCAP, a combination of biomarkers measured at admission and 48 h later may early predict treatment failure. PRoFeSs score may recognize patients with poor short-term prognosis.
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Journal of critical care · Oct 2019
High-sensitivity troponin T is an important independent predictor in addition to the Simplified Acute Physiology Score for short-term ICU mortality, particularly in patients with sepsis.
Elevated cardiac troponin levels have been shown to be associated with a poor prognosis under some intensive care conditions. This study investigated whether inclusion of high-sensitivity troponin T (hsTnT) increased the prognostic accuracy of the Simplified Acute Physiology Score (SAPS 3) for general intensive care unit (ICU) patients, cardiac arrest patients, or patients with a non-cardiac arrest diagnosis. ⋯ Addition of hsTnT evaluation to SAPS 3 enhances the predictive capability of this model in relation to mortality. In sepsis, the hsTnT level may be an important prognostic marker.
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Gender disparities in healthcare are striking, notwithstanding an increase in female students and physicians. Underrepresentation of women in leadership positions is well-documented; however, information from low and middle-income countries (LMICs) is still sparse. The Argentinian Society of Intensive Care Medicine (SATI) aimed to characterize the gender composition in Argentine ICUs. ⋯ Our data provide evidence of an important gender gap in ICU management in a LMIC. Women were poorly represented in the leadership positions, although qualifications were similar to men. Moreover, female physicians worked more frequently in the public health subsector, usually underfinanced in LMICs-a surrogate of a gender pay gap.
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Journal of critical care · Oct 2019
Short- and long-term survival after severe acute pancreatitis: A retrospective 17 years' cohort study from a single center.
To study mortality in severe acute pancreatitis (SAP) and to identify risk factors for mortality. ⋯ Although younger patients have excellent short-term survival after SAP, the long-term survival estimate is disappointing mostly due to alcohol abuse.
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Journal of critical care · Oct 2019
Technology-mediated macrocognition: Investigating how physicians, nurses, and respiratory therapists make critical decisions.
Although intensive care clinicians are expected to make data-driven critical decisions using the technologies available to them, the effect of those technologies on decision-making are not well understood. Using the macrocognitive framework, we studied critical decision-making and technology use to understand how different specialists within teams make decisions and guide the development of decision-making support technologies. ⋯ This exploratory study provides much needed details about the different ways in which specialists use technologies to support decision-making tasks, particularly those involving sensemaking, which are essential to the design and development of decision-support technologies.