Journal of critical care
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Journal of critical care · Dec 2017
Multicenter StudyZika virus-induced neurological critical illness in Latin America: Severe Guillain-Barre Syndrome and encephalitis.
Zika virus (ZIKAV) is classically described as causing minor symptoms in adult patients, however neurologic complications have been recognized. The recent outbreak in Central and South America has resulted in serious illness in some adult patients. We report adult patients in Latin America diagnosed with ZIKAV infection admitted to Intensive Care Units (ICUs). ⋯ Differing from what was usually reported, ZIKAV infection can result in life-threatening neurologic illness in adults, including GBS and encephalitis. Collaborative reporting to identify severe illness from an emerging pathogen can provide valuable insights into disease epidemiology and clinical presentation, and inform public health authorities about acute care priorities.
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Journal of critical care · Dec 2017
Multicenter Study Comparative StudyIncreased healthcare facility use in veterans surviving sepsis hospitalization.
We sought to measure inpatient healthcare utilization among U.S. Veteran Affairs beneficiaries surviving sepsis hospitalization, and to examine how post-sepsis utilization varies by select patient characteristics. ⋯ Veterans surviving sepsis experience high rates of post-sepsis mortality and significant increases in healthcare facility use. Recent nursing facility use is strongly predictive of greater post-sepsis healthcare utilization.
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Journal of critical care · Dec 2017
Multicenter Study Observational StudyDelirium and exposure to psychoactive medications in critically ill adults: A multi-centre observational study.
Investigate the relationship between psychoactive drugs and delirium. ⋯ The identification of psychoactive drugs as modifiable delirium risk factors plays an important role in the management of critically ill patients. This is particularly important given the burden of exposure and combinations of drugs used in this vulnerable patient population.
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Journal of critical care · Dec 2017
Multicenter StudyApplicability of the APACHE II model to a lower middle income country.
To determine the utility of APACHE II in a low-and middle-income (LMIC) setting and the implications of missing data. ⋯ An incomplete dataset confounds interpretation of prognostic model performance in LMICs, wherein imputation using normal values is not a suitable strategy. Improving data availability, researching imputation methods and developing setting-adapted and simpler prognostic models are warranted.
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Journal of critical care · Dec 2017
Multicenter Study Observational StudyClinical predictors of early death from sepsis.
Patients with severe sepsis who experience rapid, early deterioration and death are of particular concern. Our objective was to identify predictors of early death in Emergency Department (ED) patients with severe sepsis. ⋯ Initial serum lactate and mSOFA score were independent predictors of mortality within 24h of ED admission in patients with severe sepsis.