Journal of critical care
-
Journal of critical care · Dec 2019
Prospective validation and refinement of the APPROACH cardiovascular surgical intensive care unit readmission score.
The APPROACH cardiovascular surgical intensive care unit (CVICU) readmission score has excellent discrimination and calibration for CVICU readmission after discharge to a surgical ward; however, it has not been prospectively validated. ⋯ In a prospective validation cohort, the APPROACH CVICU readmission risk score had good discrimination and could be operationalized in future research and clinical practice.
-
Journal of critical care · Dec 2019
The incidence, predictors and outcomes of QTc prolongation in critically ill patients.
To study the incidence, predictors and outcomes of QTc prolongation (≥500 ms) during ICU admission. ⋯ A QTc ≥500 ms likely represents a marker of illness severity modulated by several risk factors, and carries no independent association with clinically-significant ventricular tachyarrhythmias. Thus, cessation of QT-prolonging medications to prevent arrhythmias may lack clinical benefit.
-
Journal of critical care · Dec 2019
A pilot study of a novel molecular host response assay to diagnose infection in patients after high-risk gastro-intestinal surgery.
SeptiCyte LAB measures the expression of four host-response RNAs in peripheral blood to distinguish sepsis from sterile inflammation. This study evaluates whether sequential monitoring of this assay has diagnostic utility in patients after esophageal surgery. ⋯ Sequential measurement of SeptiCyte LAB may have diagnostic value in the monitoring of surgical patients at high risk of postoperative infection, but its clinical performance in this setting needs to be validated.
-
Journal of critical care · Dec 2019
Hemodynamic decompensation in normotensive patients admitted to the ICU with pulmonary embolism.
Many normotensive patients with acute pulmonary embolism (PE) are admitted to an intensive care unit (ICU) to monitor for hemodynamic decompensation. We investigated the incidence and causes of early hemodynamic decompensation in normotensive patients admitted to an ICU with PE. ⋯ Among patients admitted to the ICU with acute normotensive PE, early hemodynamic decompensation was rare. In patients who experienced decompensation, major bleeding and thrombotic complications were equally likely to have been the precipitant- highlighting the risks of diagnostic anchoring in this population. As our results suggest that ICU-level care may not be necessary for many of these patients, additional tools are needed to assist in the triage of normotensive patients with PE.
-
The purpose of this study was to use an objective measure to evaluate sleep quality on the ward after ICU discharge in survivors of critical illness. ⋯ This study highlights the important role that future interventions might have in patients at high-risk of sleep disorders after critical illness.