Journal of critical care
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Journal of critical care · Apr 2020
Randomized Controlled TrialLow dose Iloprost effect on platelet aggregation in comatose out-of-hospital cardiac arrest patients: A predefined sub-study of the ENDO-RCA randomized -phase 2- trial.
This is a predefined sub-study of the Endothelial Dysfunction in Resuscitated Cardiac Arrest (ENDO-RCA) trial. We aim to investigate Iloprost, a prostacyclin analogue, safety by evaluating change in whole blood platelet aggregometry (Multiplate) in out of hospital cardiac arrest (OHCA) patients from baseline to 96-h post randomization. ⋯ In conclusion, the iloprost infusion did not influence platelet aggregation as evaluated by the ASPI, TRAP, RISTO and ADP assays. There was no increased risk of bleeding or transfusion therapy. A decline in platelet aggregation was observed for the ASPI and ADP assays during the initial 96 h after OHCA.
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Journal of critical care · Apr 2020
ReviewManagement of civilians with penetrating brain injury: A systematic review.
There has been a dramatic increase in penetrating gunshot-inflicted civilian penetrating brain injuries (cvPBI). We undertook a systematic review with exclusive focus on the management of cvPBI. ⋯ Limited amount of published work is clinically meaningful; this systematic review identified key knowledge gaps.
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Journal of critical care · Apr 2020
Observational StudyFactor XIII activity in patients requiring surgical re-exploration for bleeding after elective cardiac surgery - A prospective case control study.
Surgical re-exploration due to postoperative bleeding is associated with increased morbidity and mortality. The aim of our study was to assess a potential association between the level of postoperative FXIII activity and need for re-exploration due to bleeding in patients undergoing cardiothoracic surgery. ⋯ Reduced postoperative FXIII activity may be associated with the need for surgical re-exploration. Postoperative assessment of FXIII activity should therefore be considered in patients undergoing elective cardiothoracic surgery.
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Journal of critical care · Apr 2020
Risk prediction of in-hospital mortality in patients with venoarterial extracorporeal membrane oxygenation for cardiopulmonary support: The ECMO-ACCEPTS score.
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an increasingly used treatment option for patients in need of mechanical cardiopulmonary support, while available outcome data is limited. The aim of this study was to identify predictors for 30-day in-hospital mortality. ⋯ The ECMO-ACCEPTS score might help clinicians to improve risk prediction among VA-ECMO patients for refractory cardiogenic shock.
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Journal of critical care · Apr 2020
Observational StudyA novel prediction equation of resting energy expenditure for Japanese septic patients.
Estimating nutrient consumption and administering appropriate nutritional therapy is essential for improving clinical outcomes in critically ill patients. Various equations, such as the Harris-Benedict equation, have been developed to estimate the required calories. Previous equations, however, targeted Westerners, whose physical characteristics are likely different from those of Asians. ⋯ The prediction error of our novel equations were smaller than those of other conventional equations. We further confirmed the accuracy of our equations and that they were unaffected by patient age and disease severity by using data obtained from another patient group. The current study suggested that these equations might allow accurate estimation of the total energy expenditure and proper management of nutritional therapy in Asian sepsis patients.