Journal of critical care
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Journal of critical care · Apr 2019
Observational StudyDecreasing re-intubation using prophylactic noninvasive ventilation in elderly patients: A propensity-matched study.
Prophylactic noninvasive ventilation (NIV) reduces re-intubation in high-risk patients. However, its effects in elderly patients remain unclear. Here, we investigated the efficacy of prophylactic NIV in elderly patients after a planned extubation. ⋯ Elderly patients received benefits from prophylactic NIV after a planned extubation.
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Journal of critical care · Apr 2019
Transient acute kidney injury after major abdominal surgery increases chronic kidney disease risk and 1-year mortality.
We conducted a retrospective cohort study to determine incidences of transient and persistent acute kidney injury (AKI) after major abdominal surgery and their impacts on long-term outcome. ⋯ Although most AKI cases after major abdominal surgery recover completely within 7 days, even these patients with transient AKI are at higher risk for 1-year mortality and chronic kidney disease progression compared to patients without AKI.
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Journal of critical care · Apr 2019
Prescription patterns for routine EEG ordering in patients with intracranial hemorrhage admitted to a neurointensive care unit.
To examine clinical factors, including established electroencephalography (EEG) consensus recommendations, that may influence EEG-prescription in critically-ill intracerebral hemorrhage (ICH) patients in the neurointensive care unit. ⋯ EEG appeared underused in ICH, since <50% of patients who fulfilled guideline criteria underwent EEG. Prescription of EEG was related to factors beyond those included in consensus recommendations. Validation of our findings and their association with outcome is required.
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Journal of critical care · Apr 2019
Variability in intensive care unit length of stay after liver transplant: Determinants and potential opportunities for improvement.
Recovery after liver transplant (LT) requires extensive resources, including prolonged intensive care unit stays. The objective of this study was to use an assessment tool to determine if LT recipients remain in ICU beyond designated indications. ⋯ Nearly half of the LT recipients remained in ICU an average of 1.6 additional days. Monitoring of organ function appeared to be the most common reason. Opportunities to improve resource utilization could include transfer to an intermediate/progressive care ("step-down") unit.
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Journal of critical care · Apr 2019
Association of septic shock definitions and standardized mortality ratio in a contemporary cohort of critically ill patients.
The newly proposed septic shock definition has provoked a substantial controversy in the emergency and critical care communities. We aim to compare new (SEPSIS-III) versus old (SEPSIS-II) definitions for septic shock in a contemporary cohort of critically ill patients. ⋯ Compared to SEPSIS-II, SEPSIS-III definition of septic shock identifies patients further along disease trajectory with higher likelihood of poor outcome.