Journal of critical care
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Journal of critical care · Aug 2019
Randomized Controlled Trial Multicenter StudyImmune function testing in sepsis patients receiving sodium selenite.
We examined in a longitudinal study the role of sodium selenite in sepsis patients in strengthening the immune performance in whole blood samples using immune functional assays. ⋯ Selenium has long been an adjuvant therapy in treating sepsis. Recently, it was proven to not have beneficial effects on the mortality outcome. Using data from our center in this sub-cohort study, we identified no relative improvement in cytokine release of stimulated blood immune cells ex vivo from patients with selenium therapy over a three-week period. This offers a potential explanation for the lack of beneficial effects of selenium in sepsis patients.
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Journal of critical care · Aug 2019
Multicenter Study Comparative StudyNighttime and non-business days are not associated with increased risk of in-hospital mortality in patients with severe sepsis in intensive care units in Japan: The JAAM FORECAST study.
Hospital services are reduced during off-hour such as nighttime or weekend. Investigations of the off-hour effect on initial management and outcomes in sepsis are very limited. Thus, we tested the hypothesis that patients who were diagnosed with severe sepsis during the nighttime or on non-business days had altered initial management and clinical outcomes. ⋯ Nighttime and weekends were not associated with increased in-hospital mortality of severe sepsis.
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Journal of critical care · Aug 2019
Multicenter Study Comparative Study Clinical TrialA comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention.
We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (≥80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed. ⋯ VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.
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Journal of critical care · Aug 2019
Multicenter StudyDevelopment and daily use of a numeric rating score to assess sleep quality in ICU patients.
Insufficient sleep burdens critically ill patients, optimizing sleep may enhance patient's outcomes. Current assessment methods may unnecessary burden patients. Therefore, a single numeric rating score was validated for sleep assessment. ⋯ A single numeric rating score for sleep is interchangeable for the RCSQ score for assessment of sleep quality. Optimal cut-off is >5. Use of a numeric rating score for sleep is a practical way to evaluate and monitor sleep as perceived by patients in daily ICU practice.
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Journal of critical care · Aug 2019
Multicenter Study Observational StudyApplication of dynamic pulse pressure and vasopressor tools for predicting outcomes in patients with sepsis in intensive care units.
We aimed to determine whether the combination of dynamic pulse pressure and vasopressor (DPV) use is applicable for mortality risk stratification in patients with severe sepsis. We proposed the use of the DPV tool and compared it with traditional sepsis severity indices. ⋯ The DPV tool can be applied for 7-day and 28-day mortality risk prediction in patients with sepsis.