Journal of critical care
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Journal of critical care · Dec 2020
Observational StudyCore-to-skin temperature gradient measured by thermography predicts day-8 mortality in septic shock: A prospective observational study.
Septic shock is associated with altered peripheral perfusion. Core-to-skin temperature gradient depends on skin perfusion and microcirculatory function. We hypothesized that a high core-to-skin temperature gradient is correlated with mortality in septic shock. ⋯ Core-to-index finger temperature gradient higher than 7 °C predicts day-8 mortality in septic shock and is correlated with other tissue perfusion markers.
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Journal of critical care · Dec 2020
The ONTAI study - a survey on antimicrobial dosing and the practice of therapeutic drug monitoring in German intensive care units.
Optimization of antibiotic therapy is still urgently needed in critically ill patients. The aim of the ONTAI survey (online survey on the use of Therapeutic Drug Monitoring of antibiotics in intensive care units) was to evaluate which strategies intensive care physicians in Germany use to improve the quality of antibiotic therapy and what role a Therapeutic Drug Monitoring (TDM) plays. ⋯ German intensive care physicians are convinced of TDM for dose optimization. However, practical implementation, the determination of MICs and defined target values are still lacking.
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Journal of critical care · Dec 2020
Observational StudyThe ability of Procalcitonin, lactate, white blood cell count and neutrophil-lymphocyte count ratio to predict blood stream infection. Analysis of a large database.
The global burden of death due to sepsis is considerable. Early diagnosis is essential to improve the outcome of this deadly syndrome. Yet, the diagnosis of sepsis is fraught with difficulties. Patients with blood stream infection (BSI) are at an increased risk of complications and death. The aim of this study was to determine the diagnostic accuracy of four readily available biomarkers to diagnose BSI in patients with suspected sepsis. ⋯ Our results suggest that PCT of less than 0.5 ng/mL may be an effective screening tool to exclude BSI as the cause of sepsis, while the diagnosis of BSI should be considered in patients with a PCT above this threshold. The total WBC count and blood lactate concentration may not be reliable biomarkers for the diagnosis of BSI. The NLCR may be a useful screening test for BSI when PCT assays are not available.