Journal of critical care
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Journal of critical care · Dec 2019
Observational StudyAssociation between DNA and RNA oxidative damage and mortality in septic patients.
DNA and RNA oxidative damage occurs during sepsis. Higher urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels (from oxidation of guanosine from DNA) have been found in non-surviving patients than in surviving septic patients. However, the relation between DNA and RNA oxidative damage and mortality in septic patients has never been published; thus, the objective of this study was to determine the existence of this association. ⋯ The new findings from our study were that oxidative DNA and RNA damage in septic patients was associated with mortality and lipid peroxidation.
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Journal of critical care · Dec 2019
Quality of care and safety measures of acute renal replacement therapy: Workgroup statements from the 22nd acute disease quality initiative (ADQI) consensus conference.
There is wide variation in the practice of acute renal replacement therapy (RRT). Quality of care is suboptimal, and substantial knowledge-to-care gaps need to be addressed. The quality of care for patients receiving acute RRT has been recognized as a clinical and research priority. Quality indicators (QIs) can be implemented to measure the quality of care received by patients and further be used as targets for continuous quality improvement initiatives focused on the prescription, delivery, and monitoring of acute RRT care. ⋯ Currently, there remains few validated QIs for acute RRT. These need further evaluation, need benchmarks established, and ultimately require implementation into clinical practice.
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Journal of critical care · Dec 2019
Time of admission to intensive care unit, strained capacity, and mortality: A retrospective cohort study.
We sought to study the association between afterhours ICU admission and ICU mortality considering measures of strained ICU capacity. ⋯ Afterhours ICU admission and measures of strained ICU capacity were associated with crude but not adjusted ICU mortality.
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Journal of critical care · Dec 2019
Safety of antimicrobial de-escalation for culture-negative severe pneumonia.
This study investigated the outcomes of antimicrobial de-escalation (ADE) based on mortality and the incidence of multi-drug resistant (MDR) pathogen occurrence in patients with culture-negative pneumonia presenting with sepsis and septic shock. ⋯ We observed similar ICU mortality and MDR pathogen occurrence in patients with culture-negative pneumonia presenting with sepsis/shock regardless of whether they received ADE. Additionally, ADE lowered the antimicrobial burden.
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Journal of critical care · Dec 2019
Activation of pituitary axis according to underlying critical illness and its effect on outcome.
Critical illness is a life threatening condition inducing a severe acute physical stress. The aim of the study was to investigate the activation of pituitary axis early after ICU admission in patients with critical illnesses of different etiology and its association with outcome. ⋯ Pituitary axis function is frequently altered early after ICU admission, the magnitude of hormonal response being different according to the underlying critical illness. The activation of the hypothalamic pituitary adrenal axis was a strong predictor of ICU mortality.