Journal of critical care
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Journal of critical care · Aug 2019
ReviewMajor publications in critical care pharmacotherapy literature in 2018.
To summarize selected original critical care pharmacotherapy research published in 2018. ⋯ This clinical review and expert commentary of impactful critical care pharmacotherapy publications in 2018 provides perspectives and insights for the critical care practitioner.
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Journal of critical care · Aug 2019
Randomized Controlled Trial Comparative StudyBolus therapy with 3% hypertonic saline or 0.9% saline in emergency department patients with suspected sepsis: A pilot randomised controlled trial.
Hypertonic saline administered during fluid resuscitation may mitigate endothelial glycocalyx (EG) shedding and inflammation. The objective of this pilot randomised controlled trial was to measure the effect of hypertonic saline, compared to isotonic saline, on biomarkers of EG shedding and inflammation in emergency department patients with suspected sepsis. ⋯ Although a single bolus of hypertonic saline increased serum osmolality, it did not reduce biomarkers of EG shedding or inflammation, compared to patients that received isotonic saline.
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Journal of critical care · Aug 2019
Multicenter StudyEpidemiology and outcomes of source control procedures in critically ill patients with intra-abdominal infection.
To describe the characteristics and procedural outcomes of source control interventions among Intensive Care Unit (ICU) patients with severe intra-abdominal-infection (IAI). ⋯ Approximately half of ICU patients with IAI require more than one intervention, yet successful source control is eventually achieved in a majority of cases.
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Journal of critical care · Aug 2019
Observational StudyChanges of plasma acetylcholine and inflammatory markers in critically ill patients during early enteral nutrition: A prospective observational study.
Acetylcholine (Ach) is the key anti-inflammatory transmitter in the cholinergic anti-inflammatory pathway. In this study, critically ill patients treated with early enteral nutrition (EEN) were observed to explore whether EEN affected Ach levels and inflammation. ⋯ The administration of EEN to critically ill patients contributed to the increased plasma Ach levels and decreased inflammatory markers. The effect of EEN on Ach levels is partially attributed to the increase in CCK levels. Elevated plasma Ach levels indicate a better prognosis. Clinical trials identifier: NCT03612206.
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Journal of critical care · Aug 2019
Comparative Study Observational StudyEvaluation of MR-proANP and copeptin for sepsis diagnosis after burn injury.
The significance of the validated biomarkers of sepsis Mid-regional pro-atrial natriuretic peptide (MR-proANP) and copeptin have not been tested in a burn injury setting. ⋯ Burn injury itself maybe associated with copeptin and to a lesser degree MR-proANP level increases. Subsequent increases in MR-proANP may be considered diagnostic for sepsis but demonstrated no advantages over PCT. The role of copeptin remains inappropriate for diagnosing sepsis after burn injury (ClinicalTrials.gov number, NCT01055587).