Journal of critical care
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Journal of critical care · Feb 2014
Review Meta AnalysisSelenium supplementation in critically ill patients: A systematic review and meta-analysis.
The oxidative stress is recognized as a constant feature in critical illness. Nevertheless, the use of antioxidant therapy remains controversial. We tried to demonstrate that intravenous selenium supplementation could promote antioxidant status and help protect against infection and organ failure, improving outcome in critically ill patients. ⋯ The use of high-dose selenium might be associated with a beneficial effect on 28-day mortality in critically ill patients. Nevertheless, the use of selenium as adjuvant therapy needs further evaluations.
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Journal of critical care · Feb 2014
Racial differences in withdrawal of mechanical ventilation do not alter mortality in neurologically injured patients.
Racial differences in withdrawal of mechanical ventilation (WMV) have been demonstrated among patients with severe neurologic injuries. We ascertained whether such differences might be accounted for by imbalances in socioeconomic status or disease severity, and whether such racial differences impact hospital mortality or result in greater discharge to long-term care facilities. ⋯ Surrogates of nonwhite neurologically injured patients chose WMV less often even after correcting for socioeconomic status and other confounders. This difference in end-of-life decision making does not appear to alter hospital mortality but may result in more survivors left in a disabled state.
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Journal of critical care · Feb 2014
Soluble urokinase-type plasminogen activator receptor as a prognostic biomarker in critically ill patients.
The aim of this study was to assess the role of blood soluble urokinase-type plasminogen activator receptor (suPAR) levels in the diagnosis and prognostication of sepsis in critically ill patients. ⋯ In ICU patients, serum suPAR concentrations have limited use for identifying sepsis, but their time course correlated with the degree of organ dysfunction, and they have prognostic value in septic and nonseptic populations.
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Journal of critical care · Feb 2014
Randomized Controlled TrialHeparin/N-acetylcysteine: An adjuvant in the management of burn inhalation injury: A study of different doses.
Nebulized heparin may reduce fibrin cast formation and reduce the degree of airway obstruction in burn inhalation injury. ⋯ Nebulized heparin 10,000 IU decreased lung injury scores and duration of mechanical ventilation but had no effect on length of ICU stay and mortality. Moreover, nebulized heparin 10,000 IU was safe and had no effect on coagulation parameters.
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Journal of critical care · Feb 2014
Review Meta AnalysisLoop diuretic strategies in patients with acute decompensated heart failure: A meta-analysis of randomized controlled trials.
The safety and efficacy of continuous infusion vs bolus injection of intravenous loop diuretics to treat acute decompensated heart failure were debated. Our aim is to compare the administration routes of diuretics in hospitalized patients with acute decompensated heart failure. ⋯ Meta-analysis of the existing limited studies did not confirm any significant differences in the safety and efficacy with continuous administration of loop diuretic, compared with bolus injection in patients with acute decompensated heart failure.