Journal of critical care
-
Journal of critical care · Dec 2013
Multicenter Study Observational StudyAssociation between renal replacement therapy in critically ill patients with severe acute kidney injury and mortality.
To evaluate the characteristics and outcomes of critically ill patients with severe acute kidney injury (AKI) treated and not treated with renal replacement therapy (RRT). ⋯ In this cohort, reasons for not starting RRT included limitations of support and perception of impending renal recovery. Despite similar risk of mortality after adjusting for selection bias and confounders, RRT-treated patients were fundamentally different from non-treated patients across a spectrum of variables that precludes valid comparison in observational data.
-
Journal of critical care · Oct 2013
Multicenter StudyPrevalence of acute kidney injury in intensive care units: The "COrte de prevalencia de disFunción RenAl y DEpuración en críticos" point-prevalence multicenter study.
This study aimed to measure the point prevalence of kidney dysfunction (KD) in the intensive care setting. ⋯ Each day of study, more that half of the patients admitted to the ICU showed some derangement in kidney function. More than 25% of patients not fulfilling the KD criteria by serum creatinine or acute kidney injury network showed, in fact, a severe KD, and this finding was associated with higher mortality. More than 50% of the patients admitted to the ICU were subjected to at least 1 renal insult.
-
Journal of critical care · Oct 2013
Multicenter StudyDiscussion of treatment trials in intensive care.
This study aimed to characterize whether and how the option of a treatment trial is discussed with surrogates in intensive care units. ⋯ In this cohort of critically ill patients, trials were infrequently and incompletely discussed. Additional work is needed to improve communication about treatment trials and evaluate their impact on patient and family outcomes.
-
Journal of critical care · Aug 2013
Multicenter StudyMortality and complications in elderly patients undergoing cardiac surgery.
The purpose of the study was to analyze postoperative complications, mortality, and related factors of elderly patients undergoing cardiac surgery. ⋯ Age more than 75 years is an independent risk factor for ICU mortality when adjusted for EuroSCORE and cardiopulmonary bypass time. Elderly patients also have a higher rate of complications during ICU stay. Elderly patients develop MODS more frequently and present a higher mortality rate than younger patients with MODS.
-
Journal of critical care · Aug 2013
Multicenter StudySevere abnormalities in microvascular perfused vessel density are associated to organ dysfunctions and mortality and can be predicted by hyperlactatemia and norepinephrine requirements in septic shock patients.
The aims of this study are to determine the general relationship of perfused vessel density (PVD) to mortality and organ dysfunctions and to explore if patients in the lowest quartile of distribution for this parameter present a higher risk of bad outcome and to identify systemic hemodynamic and perfusion variables that enhances the probability of finding a severe underlying microvascular dysfunction. ⋯ Perfused vessel density is significantly related to organ dysfunctions and mortality in septic shock patients, particularly in patients exhibiting more severe abnormalities as represented by the lowest quartile of distribution for this parameter. The presence of hyperlactatemia and high norepinephrine requirements increases the odds of finding a severe underlying microvascular dysfunction during a sublingual microcirculatory assessment.